Safety of vertical osteotomies in segmental Le Fort I procedures: a one-year radiological follow-up study

The aim of this study was to evaluate dental and periodontal injuries and radiological bone healing at vertical osteotomies in patients treated with segmental Le Fort I (LFI) osteotomy, using cone beam computed tomography (CBCT) scans. This retrospective study analyzed 105 patients who underwent segmental LFI osteotomy. Vertical osteotomies were performed between the lateral incisor and canine using a bur and osteotome. CBCT scans were taken preoperatively and at 1-week and 1-year follow-ups. Measurements at 1-week included interdental distances, root injuries, and periodontal detachment, while 1-year follow-up assessed endodontic treatment and osteotomy healing. Results showed no damage to the 420 roots at risk, though 38 roots had osteotomy extensions into the periodontal ligament. The mean preoperative minimum distance between roots was significantly different between sites with intact and detached periodontal ligaments (P < 0.001). One tooth required endodontic treatment at 1-year follow-up. Incomplete healing of vertical osteotomies was more frequent in female patients (P = 0.012). The findings suggest that segmental LFI osteotomy is safe when performed with a bur and osteotome, provided a minimum distance of 2.5 mm between roots is maintained.