Article: Volume 12 Number 3 Page 92 - July 2019

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  Orth Update 2019; 12: 92-97

Orthodontics:  Nasal Considerations with the Le Fort I Osteotomy

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Abstract: Orthognathic surgery involves the correction of severe dentofacial deformities through a combination of orthodontics, surgery and, occasionally, restorative dentistry. This procedure, when involving surgical movement of the maxilla, can lead to changes in the overlying nasal morphology. In this paper, the standard nasal assessment that is undertaken prior to a Le Fort I osteotomy is outlined along with the reported nasal changes seen following this procedure. In addition, the various risk factors associated with adverse nasal changes are considered, as are the management techniques adopted by clinicians to minimize these changes

Clinical relevance: Clinicians should be aware of the adverse nasal changes associated with the Le Fort I osteotomy.

Author notes: Timothy McSwiney, BDS(Hons), MFDS RCS, DClinDent(Orth), MOrth RCS, FDS(Orth) RCS, Locum Consultant Orthodontist, Dublin Dental University Hospital, 2 Lincoln Place, Dublin, Ireland (email:, Sadaf Khan, BSc(Hons), BDS(Hons), MFDS RCS, MSc, MOrth RCS, FDS(Orth) RCS, Consultant Orthodontist, Eastman Dental Hospital, 256 Gray’s Inn Road, London and Daljit Dhariwal, BDS, FDS RCS, MBBCh, FRCS, FRCS(OMFJ), Consultant Oral and Maxillofacial Surgeon, John Radcliffe Hospital, Oxford, UK.

Objective: To highlight the importance of nasal considerations in orthodontic patients undergoing a Le Fort I osteotomy.