[Results of the application of the Goettingen concept for three-dimensional repositioning of the maxilla in orthognathic surgery].

During orthodontic-surgical treatment, a three-dimensional repositioning of the maxilla is needed after Le Fort I osteotomy. The preoperatively planned and desired position of the maxilla could often not be implemented satisfactorily in the surgical procedure. Several authors described deviations of up to 15 mm in the vertical dimension and 5 mm in the sagittal dimension between the planned and the achieved position. In order to avoid this error, the "model-repositioning instrument" for three-dimensionally controlled cast surgery and the "three-dimensional doublesplint method" in combination with a surgical facebow for actual surgery were developed. A group of 20 adult patients with severe dentofacial deformities were treated according to the Goettingen concept for combined orthodontic-surgical treatment with condylar position control with a surgical facebow. For each patient the position of three marked reference points on the maxillary dental arch under pre- and postoperative conditions was evaluated using superimposed tracings of lateral radiographs. These values were compared with the performed movements of the dental maxillary arch during cast surgery. It can be shown that with the new developments the planned position of the maxillary dental arch could be transferred from cast surgery to actual surgery with an accuracy of +/- 1 mm vertically and sagittally.