Le Fort I osteotomy and interpositional bone grafts for the severely resorbed maxilla: A case report
Vassilios A. BOUSDRAS, Colin HOPPER
Department of Oral and Maxillofacial Surgery, University College London Hospitals, London, UK (Head: Professor C. Hopper)
Hellenic Archives of Oral & Maxillofacial Surgery (2019) 3, 113-117
SUMMARY: Bone grafting for reconstruction of severe alveolar atrophy in the maxilla has been the method of choice for many years. Onlay grafting is mainly used to repair defects in the alveolar process, or to increase the width of a thin alveolar process. Grafting is performed either by means of sinus lifting procedures, or local augmentation for single teeth, or by means of more extensive procedures, like maxillary osteotomy with interpositional bone grafts. The severe alveolar resorption in the maxilla is often combined with an increasing sagittal dis- crepancy between the jaws, which to some extent can be corrected by a maxillary osteotomy.
This case highlights successful jaw bone augmentation and implant osseointegration, following Le Fort I maxillary osteotomy and autogenous interpositional bone grafts obtained from iliac crest.
KEY WORDS: Autogenous graft, iliac crest, resorbed jaw, maxillary osteotomy.
REFERENCES
Block MS, Baumhman DG: Reconstruction of severe anterior maxillary defects using distraction osteogenesis, bone grafts, and implants. J Oral Maxillofac Surg 63:291-297, 2005
Boyne PJ, James RA: Grafting of the maxillary sinus floor with autoge- nous marrow and bone. J Oral Surg 38:613-616, 1980
Cawood J, Howell RA: Classification of the edentulous jaws. Int J Oral Maxillofac Surg 17:232-236, 1988
Cawood JI, Stoelinga PJW, Brouns JA: Reconstruction of a severely re- sorbed (Class VI) maxilla. A two-step procedure. Int J Oral Max- illofac Surg 23:219-225, 1994
Jensen J, Sindet-Pedersen S, Oliver AJ: Varying treatment strategies for reconstruction of maxillary atrophy with implants. Results in 98 patients. J Oral Maxillofac Surg 8:38-45, 1994
Jensen J, Krantz-Simonsen E, Sindet-Pedersen S: Reconstruction of the severely resorbed maxilla with bone grafting and osseointegrated implants: A preliminary report. J Oral Maxillofac Surg 48:27-32, 1990
Farrell CD, Kent JN, Guerra LR: One stage inter-positional bone graft- ing and vestibuloplasty of the atrophic maxilla. J Oral Surg 34:901- 906, 1976
Isaksson S, Ekfeldt A, Alberius P, Blomqvist JE: Early results from re- construction of severely (Class VI) maxillas by immediate en- dosseous implants in conjunction with bone grafting and Le Fort I osteotomy. Int J Oral Maxillofac Surg 22:144-148, 1993
Kahnberg K-E, Nilsson P, Rasmusson L: Le Fort I osteotomy with inter- positional bone grafts and implants for rehabilitation of the se- verely resorbed maxilla: A 2 stage procedure. Int J Oral Maxillofac Implants 14:571-578, 1999
Keller EE, Triplet WW: Illiac bone grafting: Review of 160 consecutive cases. J Oral Maxillofac Surg 45:11-14, 1987
Keller EE, Van Roekel NB, Desjardins RP. Tolman DE: Prosthetic re- construction of the severely resorbed maxilla with iliac grafting and tissue integrated prostheses. Int J Oral Maxillofac Implants 2:155-165, 1982
Neil-Dwyer JG, Evans RD, Jones BM, Hayward RD: Tumescent steroid infiltration to reduce postoperative swelling after craniofacial swelling. Br J Plast Surg 54(7):565-9.2001
Otero JJ, Detriche O, Mommaerts MY: Fast track Orthognathic Surgery: An evidence-based review. Ann Maxillofac Surg 7:166-75, 2017
Ward J, Mulligan J, Smith B, Fielding A: The use of subcutaneous marcaine infusion pump for control of postoperative pain in iliac crest bone graft reconstruction Oral Surg Oral Med Oral Pathol 2008;e18
Department of Oral and Maxillofacial Surgery, University College London Hospitals, London, UK (Head: Professor C. Hopper)
Hellenic Archives of Oral & Maxillofacial Surgery (2019) 3, 113-117
SUMMARY: Bone grafting for reconstruction of severe alveolar atrophy in the maxilla has been the method of choice for many years. Onlay grafting is mainly used to repair defects in the alveolar process, or to increase the width of a thin alveolar process. Grafting is performed either by means of sinus lifting procedures, or local augmentation for single teeth, or by means of more extensive procedures, like maxillary osteotomy with interpositional bone grafts. The severe alveolar resorption in the maxilla is often combined with an increasing sagittal dis- crepancy between the jaws, which to some extent can be corrected by a maxillary osteotomy.
This case highlights successful jaw bone augmentation and implant osseointegration, following Le Fort I maxillary osteotomy and autogenous interpositional bone grafts obtained from iliac crest.
KEY WORDS: Autogenous graft, iliac crest, resorbed jaw, maxillary osteotomy.
REFERENCES
Block MS, Baumhman DG: Reconstruction of severe anterior maxillary defects using distraction osteogenesis, bone grafts, and implants. J Oral Maxillofac Surg 63:291-297, 2005
Boyne PJ, James RA: Grafting of the maxillary sinus floor with autoge- nous marrow and bone. J Oral Surg 38:613-616, 1980
Cawood J, Howell RA: Classification of the edentulous jaws. Int J Oral Maxillofac Surg 17:232-236, 1988
Cawood JI, Stoelinga PJW, Brouns JA: Reconstruction of a severely re- sorbed (Class VI) maxilla. A two-step procedure. Int J Oral Max- illofac Surg 23:219-225, 1994
Jensen J, Sindet-Pedersen S, Oliver AJ: Varying treatment strategies for reconstruction of maxillary atrophy with implants. Results in 98 patients. J Oral Maxillofac Surg 8:38-45, 1994
Jensen J, Krantz-Simonsen E, Sindet-Pedersen S: Reconstruction of the severely resorbed maxilla with bone grafting and osseointegrated implants: A preliminary report. J Oral Maxillofac Surg 48:27-32, 1990
Farrell CD, Kent JN, Guerra LR: One stage inter-positional bone graft- ing and vestibuloplasty of the atrophic maxilla. J Oral Surg 34:901- 906, 1976
Isaksson S, Ekfeldt A, Alberius P, Blomqvist JE: Early results from re- construction of severely (Class VI) maxillas by immediate en- dosseous implants in conjunction with bone grafting and Le Fort I osteotomy. Int J Oral Maxillofac Surg 22:144-148, 1993
Kahnberg K-E, Nilsson P, Rasmusson L: Le Fort I osteotomy with inter- positional bone grafts and implants for rehabilitation of the se- verely resorbed maxilla: A 2 stage procedure. Int J Oral Maxillofac Implants 14:571-578, 1999
Keller EE, Triplet WW: Illiac bone grafting: Review of 160 consecutive cases. J Oral Maxillofac Surg 45:11-14, 1987
Keller EE, Van Roekel NB, Desjardins RP. Tolman DE: Prosthetic re- construction of the severely resorbed maxilla with iliac grafting and tissue integrated prostheses. Int J Oral Maxillofac Implants 2:155-165, 1982
Neil-Dwyer JG, Evans RD, Jones BM, Hayward RD: Tumescent steroid infiltration to reduce postoperative swelling after craniofacial swelling. Br J Plast Surg 54(7):565-9.2001
Otero JJ, Detriche O, Mommaerts MY: Fast track Orthognathic Surgery: An evidence-based review. Ann Maxillofac Surg 7:166-75, 2017
Ward J, Mulligan J, Smith B, Fielding A: The use of subcutaneous marcaine infusion pump for control of postoperative pain in iliac crest bone graft reconstruction Oral Surg Oral Med Oral Pathol 2008;e18
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