The stability of maxillary advancement using Le Fort I osteotomy with and without genial bone grafting.

The purpose of this study was to determine whether better stability is achieved with genial bone grafts and four-plate rigid fixation for large advancement Le Fort I osteotomies of the maxilla than with nongrafted osteotomies. We analyzed radiographic data on 22 patients with obstructive sleep apnea syndrome. All patients underwent Le Fort I osteotomy for maxillary advancement, 11 patients without bone grafts and 11 patients with bone grafts harvested from the mandibular symphyseal area. Bilateral sagittal split advancement osteotomies and genial tubercle advancements were also performed in all patients. Patients in the genial bone-grafted group had a mean advancement (surgical change) of 9.7 mm and a mean relapse (postsurgical change) of 0.7 mm (7%). Patients who had rigid fixation alone had a mean advancement of 10 mm and a mean relapse of 1.8 mm (18%). It is concluded that the stability with genial bone grafts to the lateral wall of the maxilla with four-plate rigid fixation was better than in the nongrafted group.