Changes in dental pulp blood flow of different maxillary tooth types after Le Fort I osteotomy.

Abstract

This study examined the effects of Le Fort I (LF-I) osteotomy on pulpal blood flow (PBF) in maxillary teeth during a 12-month postsurgical period. A laser Doppler flowmeter was used to measure PBF in maxillary incisors, canines, and first premolars of 14 patients undergoing LF-I osteotomy (study group), 7 patients undergoing mandibular osteotomy (surgical control group), and 7 nonsurgical controls. The PBF was measured at baseline (preoperatively) and at 1 week and 1, 3, 6, and 12 months postoperatively and at similar intervals in nonsurgical control subjects. Data were evaluated using Kruskal-Wallis and post hoc Mann-Whitney tests. Changes in PBF over time for each tooth type were evaluated using the Wilcoxon signed-rank test. The level of significance was set at P < 0.05. Study findings showed that baseline PBF values did not differ significantly between groups. Maxillary PBF in the control group did not vary over time; however, an initial decrease in PBF was observed in all tooth types immediately after surgery in the study group. A gradual increase to near-preoperative levels was then observed during a 12-month healing period. Although dramatic reductions in maxillary perfusion of the first premolar and canine pulps were observed at 1 week and 1 month after LF-I osteotomy when compared with baseline (P < 0.001), PBF significantly recovered over time. Moreover, hyperemia was observed in lateral incisors 3 months postoperatively, demonstrating a tooth type-specific effect of LF-I osteotomy on PBF.