Aseptic necrosis following maxillary osteotomies: report of 36 cases.

The sequelae of insufficient vascularity following maxillary orthognathic surgery can vary from loss of tooth vitality, to periodontal defects, to tooth loss, to loss of major maxillary dentoalveolar segments. The results of a questionnaire mailed to oral and maxillofacial surgeons found this complication was most likely to occur with Le Fort I osteotomies done in multiple segments in conjunction with superior repositioning and transverse expansion. Significant palatal perforations definitely seem to compromise the already tenuous blood supply to the anterior maxilla. Suggestions are given regarding the prevention and treatment of this complication.