This forum is for discussions relating to oral surgery for orthodontics.
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Is anyone familiar with LeFort I and when, exactly, bone grafting would be necessary? My new doc's treatment plan includes a one-piece LeFort I WITHOUT bone grafting, but my former doc (and possibly better doc?) had recommended a treatment where the front of the maxilla would be raised (thus addressing what is now a "gummy smile"), but the back of the maxilla would actually drop slightly, presumably to help open my airway in that area. Would this drop in the back necessitate a bone graft? Or is bone grafting usually reserved for when the maxilla is being lowered entirely, rather than just in the back? The front of the maxilla was to be raised about 6mm and the back of the maxilla was to be lowered about 2mm. Trying to be clear and concise but this is a somewhat technical question. Let me know if you think you have an answer but need clarification on what I'm asking! Thanks everybody
I think it depends on how much "gap" your particular movements will create. This is definitely a question for your surgeon directly. (Note; he/she may not know the final movements until after your pre-op appointment where your surgical molds get made and the surgeon has a chance to perform "model surgery" on them.)
The gap would be wedge-shaped, 2mm high at the back. I don't think bone will grow across a 2mm gap all by itself... Would it? I'm trying to get the info from my old surgeon on whether or not he had planned to do a graft, but since I'm no longer a patient there (and therefore I'm not giving them anymore money) they seem apprehensive to tell me anything about his proposed treatment plan. Still working on trying to get that info, tho. Clearly my new surgeon doesn't think the graft is necessary, but I want optimal results here, in terms of aesthetics. I'd hate to think she wouldn't get me as good of results as the other doc, but pretty much ALL he does is orthognathic surgery. I trust his expertise. My new surgeon does lots of other procedures too.