Influence of marginal incision and Le Fort I osteotomy on periodontal tissues: a prospective longitudinal study.

The purpose of this prospective study was to evaluate whether the surgical protocol involving marginal incision and Le Fort I osteotomy affects the periodontal outcome. Twenty-nine patients requiring surgical correction of maxillary dysgnathia were selected for this study. Periodontal conditions of maxillary anterior teeth were assessed prior to the surgery (T(0)), one month (T(1)), and 6 months (T(2)) after the surgical procedure. Interdental papillae loss, periodontal parameters and aesthetic outcomes in the anterior zone were assessed. Statistical analysis was performed with Friedman s test and within ANOVA (p </= 0.05) followed by post-hoc tests. Papilla height decreased from T(0) to T(1) (p = 0.003), followed by an increase from T(1) to T(2) (p = 0.040). PPD (T(0) = 1.72 +/- 0.46; T(2) = 2.13 +/- 0.43) and CAL (T(0) = 1.24 +/- 0.55; T(2) = 1.99 +/- 0.70) increased after 6 months. There were statistically significant differences in aesthetic score among T(0), T(1) and T(2). Periodontal changes after orthognathic surgery were within acceptable biological levels. Although a change in papillae height was reported after the surgery, initial values were recovered after 6 months. Surgical incision design might improve the outcome of Le-Fort I osteotomy. Anterior aesthetic zone may benefit from a marginal incision design, as it respects vascularization principle and may ensure a wound healing without complications.