Complications of Lefort I Osteotomies- A Review on Pre and Post-Operative Implications

Abstract

LeFort I osteotomy is routinely performed for reduction of complex midfacial fractures, correction of maxillary‐zygomatic deformities, and severe orthodontic malocclusion requiring elective orthognathic surgery thus allowing movement with segmentation expansion effectively. Despite developments in the field of orthognathic surgery, a wide range of intra operative and post-operative complications like hemorrhage, neurosensory deficit, maxillary sinusitis, aseptic necrosis, Malunion, maxillary instability, loss of tooth vitality, ophthalmic problems, and nasal deformity though occurs with lower incidence play a significant role in risk assessment and overall treatment outcomes. The present review was aimed to briefly elaborate various pre-operative and post-operative complications of LeFort I osteotomies with special emphasis on their evaluation, management methods and its associated clinical implications. It was observed that overall complication ranges between 6.1% and 9% following LeFort I osteotomies that depends on several factors such as Patient compliance, surgical technique, complexity of fracture, association with vascular structures, and underlying systemic conditions. Consequently, with proper case selection, appropriate treatment planning, careful instrumentation, ideal pre-surgical orthodontic treatment, and adequate care assisted by patient education, psychological support and post-operative medications can effectively reduce complications thus decreasing patient morbidity and increasing the quality of life.