TY - JOUR
T1 - Le fort-based maxillofacial transplantation
T2 - Current state of the art and a refined technique using orthognathic applications
AU - Gordon, Chad R.
AU - Susarla, Srinivas M.
AU - Peacock, Zachary S.
AU - Kaban, Leonard B.
AU - Yaremchuk, Michael J.
PY - 2012/1/1
Y1 - 2012/1/1
N2 - Following encouraging results from the first 6 maxillofacial allotransplants, there has been a dramatic rise in interest worldwide. Numerous groups are now devoting resources to increase the frequency of these complex procedures, and with this, the craniomaxillofacial surgeon should become familiar with the emerging state of the art. This article reviews the evolution of Le Fort-based cadaveric studies pertaining to maxillofacial allotransplantation, briefly describes the clinical reports through 2010, and introduces a refined technique applying orthognathic applications. Preliminary studies over the last 5 years have highlighted the challenges associated with transplanting skeletal components, and clinical results presented thus far have been extremely promising. However, a notable area for improvement is suboptimal facial-skeletal harmony and profile in the context of sagittal skeletal projection and maxillomandibular relation. To our knowledge, orthognathic planning as applied to osteocutaneous face transplantation has not been described. Many recipients seen thus far demonstrate some degree of malocclusion and suboptimal harmony, as expected, given the donor-to-recipient skeletal/jaw discrepancies. Given that the goal is to improve function as well as form, the importance of orthognathic planning cannot be overstated with respect to optimizing harmony, profile, and occlusion. Preoperative planning, including generation of donor/recipient dental cast models, as described herein for the first time, is essential.
AB - Following encouraging results from the first 6 maxillofacial allotransplants, there has been a dramatic rise in interest worldwide. Numerous groups are now devoting resources to increase the frequency of these complex procedures, and with this, the craniomaxillofacial surgeon should become familiar with the emerging state of the art. This article reviews the evolution of Le Fort-based cadaveric studies pertaining to maxillofacial allotransplantation, briefly describes the clinical reports through 2010, and introduces a refined technique applying orthognathic applications. Preliminary studies over the last 5 years have highlighted the challenges associated with transplanting skeletal components, and clinical results presented thus far have been extremely promising. However, a notable area for improvement is suboptimal facial-skeletal harmony and profile in the context of sagittal skeletal projection and maxillomandibular relation. To our knowledge, orthognathic planning as applied to osteocutaneous face transplantation has not been described. Many recipients seen thus far demonstrate some degree of malocclusion and suboptimal harmony, as expected, given the donor-to-recipient skeletal/jaw discrepancies. Given that the goal is to improve function as well as form, the importance of orthognathic planning cannot be overstated with respect to optimizing harmony, profile, and occlusion. Preoperative planning, including generation of donor/recipient dental cast models, as described herein for the first time, is essential.
KW - Craniomaxillofacial surgery
KW - Face transplant
KW - Facial composite tissue allograft
KW - Le Fort osteotomy
KW - Maxillofacial allotransplant
KW - Orthognathic
KW - Osteocutaneous
UR - http://www.scopus.com/inward/record.url?scp=84858111799&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84858111799&partnerID=8YFLogxK
U2 - 10.1097/SCS.0b013e318240ca77
DO - 10.1097/SCS.0b013e318240ca77
M3 - Review article
C2 - 22337380
AN - SCOPUS:84858111799
SN - 1049-2275
VL - 23
SP - 81
EP - 87
JO - Journal of Craniofacial Surgery
JF - Journal of Craniofacial Surgery
IS - 1
ER -