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.