Presurgical Maxillary Segmented Orthodontics Associated with 3-Piece Le Fort 1 Osteotomy for Palatal Expansion

Objective: The aim of this study is to assess maxillary transverse dimension following presurgical maxillary segmented orthodontics associated with 3-piece Le Fort 1 osteotomy in a cohort of “long face syndrome” patients with palatal constriction. Methods: Patients with maxillary transverse insufficiency were retrospectively included. They all underwent maxillary segmented orthodontics followed by a 3-piece Le Fort 1 osteotomy with palatal expansion. Palatal width dimensions were collected preoperatively, postoperatively, and at the time of the final follow-up, the stability of the expansion was analyzed. Results: Nineteen patients were included. There was no complication. The mean postoperative expansion was 6 mm (range: 3.1–8.7 mm) in the canine region and 4.3 mm (range: 0–9.1 mm) in the second molar region. The mean relapse was 0.36 mm (range: 0–1.4 mm) or 6% (range: 0%–16.1%) in the canine region and 0.17 mm (range: 0–1.3 mm) or 4% (range: 0%–14%) in the second molar region. Conclusion: Presurgical maxillary segmented orthodontics with 3-piece Le Fort 1 osteotomy has shown high stability of the maxillary transverse dimension in a 1-step surgery without dental tipping. It should be considered as an alternative to rapid palatal expansion.