Periodontal and pulpal condition of the central incisors after midline osteotomy of the maxilla

Abstract

Purpose: The purpose of this study was to evaluate the periodontal and pulpal condition of the central incisors after Le Fort I and midline osteotomies for transverse expansion of the maxilla. Patients and Methods: The series included 12 women and eight men, with an average age at operation of 28.4 years (range, 17 to 48 years). Each patient, examined retrospectively, underwent transverse expansion of the maxilla by combined Le Fort I and midline osteotomies. The minimum follow-up was 12 months (range, 12 to 85 months, with an average of 38 months). The central incisors were tested for percussion sound, mobility, and pulpal response to electric stimulation, and then compared with the lateral incisors. The pocket depths and the height of the alveolar bone were measured, and the root surface was evaluated for resorption on radiographs. Results: Percussion and mobility tests indicated normal values for all teeth. Four (11%) of the central incisors did not respond to electrical stimulation. There was no difference in pocket depth between the mesial and distal sulci of the central incisors. In one tooth, resorption was detectable on the medial surface of the root. Minor root surface injury was seen in two roots, although these injuries were not progressive. The alveolar bone level of the central incisors was located slightly more superiorly on the mesial than on the distal side. Conclusions: Although there may be some minor complications to the periodontal and pulpal tissues after combined Le Fort I and midline osteotomies, the harmful effects seem to be of negligible clinical significance.