Defining the Optimal Screw Length in Le Fort I Osteotomy: A Retrospective Analysis of Postoperative Complications

Background This study aimed to investigate the relationship between screw lengths in Le Fort I osteotomy and postoperative complications, with a focus on mucosal thickening. Material and Methods This retrospective study analyzed 37 patients who underwent Le Fort I osteotomy, either in isolation or in combination with mandibular surgery. Postoperative CT scans were utilized to measure screw lengths and bone widths. Postoperative complications, including maxillary mobility, mucosal thickening, and epiphora due to iatrogenic injury to the nasolacrimal duct, were recorded and analyzed. Results The study population consisted of 25 female and 12 male patients, with a mean age of 26.49 ± 6.75 years. Among the 592 screws analyzed, 530 (89.5%) exceeded the optimal length, while only 62 (10.5%) met the ideal criteria. Statistical analysis revealed a significant difference in bone thickness between the piriform and zygomatic buttress regions (p < 0.001). No statistically significant difference in bone thickness was found between males and females. However, there was a significant association between excessive screw length and the occurrence of postoperative mucosal thickening (p = 0.033). Conclusion Accurate screw length selection is crucial for reducing postoperative mucosal thickening. A 5 mm screw length ensures stable fixation while minimizing sinus mucosal thickening, contributing to improved surgical outcomes and patient satisfaction.