Lefort 1 Osteotomy Study of Maxillary Bone in Caprine Skull Model: Comparison of Different Osteotomy Techniques (Piezo Versus Lindemann Bur Versus Manual Chisel)

Abstract

Objective:In this study, we aimed to compare the efficiency of different osteotomy techniques for Lefort 1 osteotomy in an experimental caprine skull model. Methods:Twelve caprine skulls were used for the study. Skulls were divided into 3 groups: (1) manual chisel group, (2) Lindemann bur group, and (3) piezo osteotomy group. Bilateral osteotomies were performed on each skull. Results were evaluated with three-dimensional computerized tomography scans and macroscopic observations of the mucosal tears and soft tissue. Results:The mean length of the bone gap in the manual, Lindemann, and piezo groups was 4.8 (+/- 0.7), 3.38 (+/- 1.49), and 1.39 (+/- 0.3) mm, respectively (P < 0.05). The mean number of comminuted fractures in the manual, Lindemann, and piezo groups was 5.5 (+/- 1.4), 1.6 (+/- 0.3), and 0.6 (+/- 0.5), respectively (P < 0.05). Mucosal tearing and soft tissue damage based on subjective inspection observations were negligible in the piezo technique. Soft tissue and mucosal damage were observed significantly more in the manual chisel osteotomy method compared with the other 2 techniques. Conclusion:We anticipate that piezo, which has started to be used in new application areas besides rhinoplasty, will continue to be used more widely, especially in reconstructive orthognathic surgery, due to the minimal damage it causes to tissues. With the long-term results, much healthier interpretations can be made.