Influence of routine bone grafting on the stability of the non-cleft Le Fort 1 osteotomy

Although bone grafting is known to improve stability after midface cleft osteotomy, it is advocated only rarely for people without clefts. To assess the influence of routine bone grafting on stability in such patients we analysed radiographic data of 112 patients retrospectively. All patients had had Le Fort 1 osteotomy with autogenous bone grafts harvested by trephine from the iliac crest, and 76 had had concurrent mandibular procedures. Rigid internal fixation was adopted throughout. Impaction proved to be the most stable move. While there was little postoperative relapse of the anterior maxilla (0.9%), the posterior maxilla tended to move further upwards with time (2.3%). Overall relapse after advancement and inferior repositioning was low (3.5% and 5%, respectively). The only complication noted at the iliac crest donor site was spread of the scar, which affected three patients. When we compared these results with previously published data, they suggested that in patients without clefts rigid internal fixation combined with bone grafting may improve stability after selected Le Fort 1 osteotomy moves.