Wound healing after multisegmental le fort i osteotomy and transection of the descending palatine vessels

Purpose: Vascular ischemia has been associated with improper soft tissue flap design, stretching of the palatal vascular pedicle, bony segmentation, transection of the descending palatal vessels, or hypotension. This study examined Le Fort I osteotomy wound healing after some of these surgical maneuvers. Materials and Methods: Clinically analogous four-segment Le Fort I osteotomies were accomplished through circumvestibular incisions in nine adult rhesus monkeys and the animals were killed at 0, 3, 7, 14, and 28 days after surgery. Revascularization and bone healing were studied by microangiographic and histologic techniques. Results: The findings indicated that the palatal mucosa or labial-buccal gingiva and mucosa provide adequate nutrient pedicles for Le Fort I osteotomies accomplished through a circumvestibular type incision. Conclusions: It was concluded that segmentalization, stretching of the vascular pedicles, or transection of the descending palatine vessels have only transitory discernible effects on revascularization and bone healing.