Inferior scleral show changes following le fort I osteotomy in CL III patients with maxillary retrusion

Introduction : In a balanced and symmetric face no sclera should be exposed below the irises. This study evaluated the inferior sclera exposure changes after maxillary advancement in skeletal cl III patients. Materials and Methods : Eight consecutive patients (4 male and 4 female) with maxillary deficiency who underwent Le Fort I osteotomy were assessed using adobe photoshop CS5. Inferior sclera height to total eye height proportion was determined in both eyes in each patient and the propotional changes before and six month after surgery was statistically analyzed using Wilcoxon signed–rank test. Results : Average maxillary advancement was 3.75 mm at the incisors. Proportion of inferior sclera to total eye height decreased by a ratio of 8% (p<0.001) in total 16 eyes of 8 patients. All 8 patients achieved a decrease of their scleral show. None of the patients required further cosmetic procedures in preorbital region. Conclusion : Maxillary advancement in CI III patients with existing excessive scleral exporsure changes the lower lid position and leads to significant decreased scleral show. Key words : Sclera show, Le fort osteotomy, skeletal cl III, Orthognathic Surgery.