![]() The goal is to achieve an anatomical correct repositioning by means of 3-D reconstruction. In order to properly achieve a passive position of the maxilla, the maxilla requires strong mobilization forces using various instrumentation: Rowe’s disimpaction forceps, “Stromeyer” hook, Tessier retromaxillary mobilizers, etc. When the MMF is removed, the condyles re-seat themselves into their normal position, bringing the mandibular dentition forward, creating a Class III malocclusion. The reason for this is that when patients are placed into MMF during the surgery, the soft-tissue tension from the attached musculature distalizes the mandibular condyles in the glenoid fossae. Without passive mobilization, Class III tendency occurs often in the postoperative period. Portions of the pterygoid plates and associated musculature are still attached to the posterior portion of the maxilla, so passive mobilization of the fracture can be difficult. These pillars can serve an even more important role in patients who lack dentition (partial or completely edentulous patients).Ī principle in all Le Fort fractures is to reestablish the premorbid dental occlusion. ![]() ![]() The aim of successful reconstruction of midface fractures is reestablishing the midfacial buttresses. Depending on the patient’s general condition, a tracheostomy might also be considered. If that is not feasible, primary submental/submandibular intubation should be considered. These fractures are also referred to as craniofacial dysjunction.Ĭonsiderations related to dental occlusion render nasotracheal intubation necessary. A Le Fort III fracture includes fracture of the nasofrontal junction, bilateral fractures through the area of the frontozygomatic suture, and probable fractures of the zygomatic arch.
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