Le Fort I downsliding osteotomy

[Faaska]

recommendations no more than 7mm, highest in given study is 4.7mm
link
more evidence it provides better stability
long-term skeletal and dental stability of a Le Fort I maxillary downgraft performed using a Z-osteotomy with rigid internal fixation after a minimum 4-year follow-up period:

• MAIN BENEFIT IS STABILITY COST EFFECTIVENESS IN DEALING WITH VMD (VERTICAL MAXILLARY DEFICIENCY)
• The Z-osteotomy with rigid internal fixation demonstrated stability for maxillary downgrafts
• The procedure is a viable option for correcting vertical maxillary deficiency and anterior open bite
• The average long-term follow-up period was 5.64 years (ranging from 4 to 14 years).
• No significant vertical relapse was observed in the maxilla during the long-term follow-up period.
• 100% of patients maintained a positive overbite at both the debond and long-term follow-up stages.
• "The angulated osteotomy creates an inclined plane along which the maxilla is advanced and elongated. The inclined plane provides a goad bony contact. A relatively small amount of interpositional bone graft is required."
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Modified, aims to also include rotation: