• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제26권1호
• /
• pp.1-4
• /
• 2000

저자 등은 경희대학교 구강악안면외과에 내원한 중안면성장 부전을 동반한 하악전돌증 환자의 치료에 있어 관상절개를 통한 Le Fort III 골절단술 및 Le Fort I 골절단술과 양측 하악지시상분 할골절단술을 2회법으로 시행하여 기능적 심미적으로 만족할만한 결과를 얻었기에 보고하는 바이다.

• 대한구순구개열학회지
• /
• 제4권2호
• /
• pp.29-35
• /
• 2001

Midfacial retrusion is one of characteristics of cleft patients due to underdevelopment of the midface. In this case, Le Fort II advancement is indicated. But there has not been reported on intraoral approach to Le Fort II osteotomy for correction of midface, which traditional technique resulted in facial scar. To overcome the problems, Le Fort II osteotomy via only intraoral approach named 'Intraoral Le Fort IT osteotomy' was developed by Choung in 1994, this technique was applied to cleft patients. A new technique of Intraoral Le Fort IT osteotomy for correction of midface in cleft patients was successfully carried out with good results. This technique showed no noticeable relapse nor complications, which is reported.

• 대한치과교정학회지
• /
• 제40권6호
• /
• pp.383-397
• /
• 2010

본 연구는 상순돌출을 동반한 골격성 III급 부정교합에서 전방분절골절단술(anterior segmental osteotomy, ASO)을 병용한 상행지시상분할골절단술(bilateral sagittal split ramus osteotomy, BSSRO)과 Le Fort I 골절 단술을 병용한 상행지시상분할골절단술(BSSRO) 후 상악의 경 연조직 변화 및 경조직 변화에 대한 연조직 변화율을 비교하였다. A군은 ASO/BSSRO를 시행한 군 14명, B군은 Le Fort I/BSSRO를 시행한 환자 중 상악의 후방부가 상방으로 이동(posterior impaction)된 15명으로 구성되었다. 수술 전 2개월 이내와 수술 후 6개월 이후에 촬영한 측모두부방사선사진을 분석하여 다음과 같은 결과를 얻었다. 두 군 모두 수술 후 상악 전방부 경조직과 연조직이 후방이동되었고, A군에서 더 큰 변화량을 보였다. A point의 후방이동에 따른 superior labial sulcus의 변화율은 A군에서 79%, B군에서 15%를 보였고, supradentale에 대해 labrale superious는 A군에서 80%, B군에서 68%의 비율로 후방이동하였다. 교합평면각은 B군에서 증가한 반면, A군에서는 통계적으로 유의성 있는 변화가 없었다. 이상의 연구결과 골격성 III급 부정교합의 양악수술 시 상악 수술은 상악 전방부와 상순의 돌출이 심한 경우에는 ASO를 시행하고 교합평면각의 증가가 필요한 경우에는 posterior impaction을 동반한 Le Fort I 골절단술을 시행하는 것이 바람직하다.

• 대한두개안면성형외과학회지
• /
• 제18권1호
• /
• pp.5-8
• /
• 2017

Among the classification of maxillary fracture, the Le Fort classification is the best-known categorization. Le Fort (1901) completed experiments that determined the maxilla areas of structural weakness which he designated as the "lines of weakness". According to these results, there are three basic fracture line patterns (transverse, pyramidal and craniofacial disjunction). A transverse fracture is a Le Fort I fracture that is above the level of the apices of the maxillary teeth section, including the entire alveolar process of the maxilla, vault of the palate and inferior ends of the pterygoid processes in a single block from the upper craniofacial skeleton. Le Fort fractures result in both a cosmetic and a functional deficit if treated inappropriately. In this article, authors review the management of a Le Fort I fracture with a case-based discussion.

• 치과방사선
• /
• 제25권2호
• /
• pp.545-553
• /
• 1995

The subjects of this study consisted of 58 patients with Le Fort fractures, who were admitted to Chonbuk National University Hospital from Jan. 1988 to Oct. 1995. The author classified the maxillofacial fractures by Le Fort classification and examined the. incidence of Le Fort fractures by age, sex and etiology. The purpose of this study was to compare the imagings of conventional radiograms with those of computed tomograms and to aid in the diagnosis of patients with Le Fort fractures. The obtained results were as follows: 1. The Le Fort fractures occured mainly in 3rd and 4th decades, but there was no significant difference between decades. A ratio of men to women was 5.5 : 1. The major etiologic factors were traffic accident(69％), assault(14％) and fall-down(12％). 2. The most common type of Le Fort fracture was type I(49.3％). The numbers of Le Fort II, ill fractures were 41.3％, 9.4％ respectively. And 8.6％ were midsagittal splitting fractures. 3. The discontinuity and haziness of the maxillary sinus were easily detected by Waters' view. In skull PI A view, it was difficult to observe fractures due to overlapping of the other structures, but the haziness of the maxillary sinus was sometimes observed. 4. In Le Fort fracture, the fracture pattern of orbit, the wall of maxillary sinus, nasal bone and pterygoid plate were more easily detected in computed tomograms than in conventional radiograms.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제22권1호
• /
• pp.63-69
• /
• 2000

Le fort II osteotomy is much useful technique to correct the midfacial hypoplasia including nasomaxillary complex especilly in patient with dish face appearance. Not in simple orthognathic surgery but in Le Fort II osteotomy, the standardization of prognostic value is essential in treatment planning to achieve satisfactory postoperative results. According to pervious reports, the ratio of soft tissue change to hard tissue movements varies as to different surgical methods and different facial regions. But there are few report about the ratio of soft tissue change to hard tissue movement following Le Fort II osteotomy. So we tried to develop standarized soft tissue surgical treatment objective. We have followed up 16 patients, who had received Le Fort II osteotomy by one operator from 1990 to 1996, one year postoperatively. In cephalometrics, we used Frankfort line as horizontal reference line, and vertical reference line as one drawn from Sella to horizontal line perpendicularly. The landmarks are G to soft tissue G, N on reference line to soft tissue N, ANS to Pn and A to Sn. The results are as follows. 1. The value of soft tissue change to hard tissue movement showed positive correlation, having statistical significancy at G, N2, N3 point. 2. At G, N2, N3 point, the ratio of soft tissue change to hard tissue movement was 0.51, 0.98 and 0.80 respectively and showed statistical significancy, while at N1, ANS, A point, that was 0.72, 0.49 and 0.26 but didn't showed statistical significance. 3. This result shows much the same change of the soft tissue change to hard tissue movement on the upper nasomaxilla, and less the same change on the lower maxilla and so the Le Fort II osteotomy can be recommended as a reliable effective operation method for correction of nasomaxillary retrusion.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제23권2호
• /
• pp.169-173
• /
• 2001

본 교실에서는 조선대학교 구강악안면외과에 내원한 중안면성장부전을 동반한 하악전돌증소견을 보이는 22세 여자 환자의 치료에 있어서 변형 LeFort III 골절단술과 양측 하악지 시상분할골절단술 그리고 자가 장골 이식술을 동시에 시행하여 기능적 심미적으로 만족할 만한 결과를 얻었기에 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제42권
• /
• pp.32.1-32.4
• /
• 2020

Background: Le Fort I osteotomy is a highly effective treatment for skeletal jaw deformities and is commonly performed. High Le Fort I osteotomy is a modified surgical procedure performed for improving the depression of the cheeks by setting the osteotomy higher than the conventional Le Fort I osteotomy. Developments in three-dimensional (3D) technology have popularized the use of 3D printers in various institutions, especially in orthognathic surgeries. In this study, we report a safe and inexpensive method of performing a high Le Fort I osteotomy using a novel 3D device and piezosurgery, which prevent tooth root injury without disturbing the operation field for patients with a short midface and long tooth roots. Results: A 17-year-old woman presented with facial asymmetry, mandibular protrusion, a short midface, and long tooth roots. We planned high Le Fort I osteotomy and bilateral sagittal split ramus osteotomy. Prevention of damage to the roots of the teeth and the infraorbital nerve and accurate determination of the posterior osteotomy line were crucial for clinical success. Le Fort I osteotomy using 3D devices has been reported previously but were particularly large in size for this case. Additionally, setting the fixing screw of the device was difficult, because of the risk of damage to the roots of the teeth. Therefore, a different surgical technique, other than the conventional Le Fort I osteotomy and 3D device, was required. The left and right parts of the 3D device were fabricated separately, to prevent any interference in the surgical field. Further, the 3D device was designed to accurately cover the bone surface from the piriform aperture to the infra-zygomatic crest with two fixation points (the anterior nasal spine and the piriform aperture), which ensured stabilization of the 3D device. The device is thin and does not interfere with the surgical field. Safe and accurate surgical performance is possible using this device and piezosurgery. The roots of the teeth and the infraorbital nerve were unharmed during the surgery. Conclusions: This device is considerably smaller than conventional devices and is a simple, low-cost, and efficient method for performing accurate high Le Fort I osteotomy.

• 대한치과교정학회지
• /
• 제48권1호
• /
• pp.63-70
• /
• 2018

Objective: The aim of this study is to quantitatively evaluate the stability of the skeletal and dental widths using cone-beam computed tomography (CBCT) after segmental Le Fort I osteotomy in adult patients with skeletal Class III malocclusion requiring maxillary expansion. Methods: In total, 25 and 36 patients with skeletal Class III malocclusion underwent Le Fort I osteotomy (control group) and segmental Le Fort I osteotomy (experimental group), respectively. Coronal CBCT images were used to measure the dental and skeletal widths before (T1) and after (T2) surgery and at the end of treatment (T3). The correlation between the extent of surgery and the amount of relapse in the experimental group was also determined. Results: In the control group, the dental width exhibited a significant decrease of $0.70{\pm}1.28mm$ between T3 and T2. In the experimental group, dental and skeletal expansion of $1.83{\pm}1.66$ and $2.55{\pm}1.94mm$, respectively, was observed between T2 and T1. The mean changes in the dental and skeletal widths between T3 and T2 were $-1.41{\pm}1.98$ and $-0.67{\pm}0.72mm$, respectively. There was a weak correlation between the amount of skeletal expansion during segmental Le Fort I osteotomy and the amount of postoperative skeletal relapse in the experimental group. Conclusions: Maxillary expansion via segmental Le Fort I osteotomy showed good stability, with a skeletal relapse rate of 26.3% over approximately 12 months. Our results suggest that a greater amount of expansion requires greater efforts for the prevention of relapse.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제11권1호
• /
• pp.243-248
• /
• 1989

This is a report of 2 cases on old maxilla fractures accompanied with sagittal palatal fracture and severe malocclusion. We treated them by using of classic Le Fort I osteotomy and modified Le Fort I osteotomy along the old fracture lines satisfactorily. The results obtained from treatment are as follows : 1. Careful examination and correct care on sagittal palatal fracture should be need during initial diagnosis and emergency care of maxilla fracture showed malocclusion. 2. Although early definite treatment of maxilla injuries is difficult due to major organ injuries associated with accident, the positive effort to induce normal occlusion is always necessary as soon as possible. 3. In the cases of malocclusion due to transverse discrepancy of maxillary dentition associated with injury as like as our cases, classic and modified Le Fort I osteotomy and rigid internal fixation were useful to correct occlusion, to ease operation and return normal functions early.