Can palatal splint improve stability of segmental Le Fort I osteotomies?

Abstract

The purpose of this study was to evaluate the influence of a palatal splint on stability in multi-segment maxillary osteotomies. Retrospective series of fifty-one adult patients, consecutively operated with bilateral sagittal split osteotomy (BSSO) and three-piece maxillary osteotomies, divided according to the use of a palatal splint (Group 1, n=30) or no palatal splint (Group 2, n=21). Maxillary surgical casts (T1) and post-retention casts (T2), taken at least six months after discontinuation of orthodontic retention, were digitized (MicroScribe-3DX), measured and compared. Fifty-one landmarks were identified on the maxillary, transverse dimension changes and arch length were calculated. Longitudinal changes in all measurements were assessed by t test. Post-surgical transverse instability in group 1 ranged from 0.3±0.4 to -1.3±0.2mm and was statistically significantly smaller than in group 2 that ranged from -1.0±0.3 to -2.5±0.5mm. The use of a palatal splint after segmental Le Fort I maxillary osteotomy improved transverse stability in the posterior region. The post-surgical transverse instability occurred only between canine gingival points and thus suggesting no clinical relevance.