Observation of bone healing after Le Fort I osteotomy with tuberosity separation

Objective: This study aimed to examine bone healing after Le Fort I (LFI) osteotomy with tuberosity separation. Methods: Twenty patients who had undergone maxillary advance and clockwise rotation for skeletal class III malocclusion were included. LFI osteotomy with tuberosity separation was performed on the patients. The osteotomized maxilla was fixed to the piriform rim using bioabsorbable plates and to the zygomatic buttress using titanium miniplates (thickness: 0.6 mm). Computed tomography (CT) images were taken after 2 months (T1) and > 10 months (T2) of surgery. The piriform rim, maxillary sinus anterior wall, zygomatic buttress, and maxillary tuberosity were evaluated on a four-point scale: bone resorption (−2), no bone contact (−1), bone contact (0), and bone continuity (1). Results: The average total scores for each site were as follows: maxillary tuberosity, 0.5 ± 0.4 (T1) and 1.0 ± 1.2 (T2); zygomatic buttress, −0.6 ± 0.6 (T1) and 0.1 ± 0.9 (T2); maxillary sinus anterior wall, −0.9 ± −0.6 (T1) and −0.3 ± 2.0 (T2); and aperture piriform rim, −0.5 ± 0.8 (T1) and 0.9 ± 1.5 (T2). The score increased significantly at all sites at T2 (p < 0.001). The CT values in the tuberosity site were 347.6 ± 134.1 at T1 and 418.8 ± 161.4. Conclusions: The maxillary tuberosity showed the earliest evidence of bone continuity.