This is a very rare isolated fracture pattern, mostly occurring in edentulous patients wearing dentures during trauma. More often it occurs in combination with other midface fractures (Le Fort II and Le Fort III).
|Non- or minimally mobile Le Fort I fractures with unaffected occlusion in compliant patients with good dentition.|
|Non- or minimally displaced fractures in a compliant patient amenable to MMF.|
Fractures with minor malocclusion readily correctable with maxillary manipulation, and not grossly mobile after repositioning may be treated closed. However, closed reduction is more commonly used in conjunction with other stabilization techniques (skeletal suspension, external fixators, etc.).
- Premorbid or unstable medical condition preventing general anesthetic
- Conditions making open reduction and internal fixation difficult
- Patient refusal of operative treatment (eg, for religious/cultural or financial reasons)
- Unavailability of plates and screws
Special consideration: MMF may be contraindicated in patients with psychiatric disorders, seizure disorders, and alcoholics.
|Open reduction internal fixation|
|Mobile maxillae with resulting malocclusion in cases where vertical restoration of one or more of the buttresses are indicated.|
Usually, open reduction and internal fixation is the method of choice for mobile maxillae with malocclusion. A minimum of two plates are used to provide stability along the buttresses. Additional plates may support the fragments.
|Basic surgical experience, no specialized skills|
|Some specialized surgical experience|
|Highly experienced and skilled surgeon|
|Basic equipment only|
|Simple surgical and imaging resources|
|Full specialized surgical and imaging resources|