This black-and-white clinical photograph displays an intraoperative view of a maxillary Le Fort I osteotomy. The surgical site is accessed through an intraoral approach with the upper lip and labial mucosa retracted superiorly using metal surgical retractors, exposing the maxilla. A clear, horizontal osteotomy line is visible extending across the midface, superior to the apices of the maxillary teeth. The cut originates near the piriform aperture and canine pillar, traversing the lateral maxillary wall. The underlying bone is exposed, and the soft tissues are reflected to provide a clear operative field. A surgical instrument is positioned inferiorly near the midline of the maxillary incisors to stabilize or manipulate the dental arch. This procedure is a fundamental component of orthognathic surgery, often utilized here as part of a transmaxillary approach to access deeper structures such as the clivus or to correct dentofacial deformities.

This intra-oral clinical photograph captures an active surgical field during a Le Fort I osteotomy for maxillary advancement. The image shows the maxilla with surgical retraction of the labial and buccal mucosa to expose the bone. Four internal fixation mini-plates, secured with cortical screws, are visible bridging the osteotomy sites to provide rigid stabilization of the repositioned maxillary segments. Specifically, two plates are visible on each side of the mid-face region. Orthodontic hardware, including brackets on the maxillary teeth and a stabilizing archwire, is present to facilitate dental alignment and intraoperative intermaxillary fixation if required. The surgical field demonstrates exposed alveolar bone, soft tissue hemorrhage typical of the procedure, and the use of metal surgical retractors. The image illustrates a critical phase of orthognathic surgery in a patient with a history of cleft palate repair and skeletal Class III malocclusion, focusing on the mechanical stabilization of the advanced maxilla.

Side-by-side intraoperative clinical photographs documenting a Le Fort I osteotomy procedure using robotic laser guidance. Both images show a wide surgical exposure of the maxilla with a vestibular incision and mucoperiosteal flap elevation, maintained by surgical retractors. Image (a) demonstrates the pre-drilling phase, where the robot-guided laser (CARLO system) has accurately marked the planned osteotomy line and specific locations for patient-specific implant (PSI) drill holes, indicated by precise black thermal markings on the cortical bone. Image (b) shows the subsequent phase after a conventional rotating handpiece was used to create the physical drill holes following the laser-marked guides. The bone surface in (b) exhibits focal bleeding and structural disruption at the drill sites. This comparison illustrates the clinical application of laser-guided navigation to improve the accuracy of surgical planning and execution in orthognathic surgery for skeletal malocclusion.

An intraoperative clinical photograph showing a Le Fort I osteotomy site in the anterior maxilla during bimaxillary orthognathic surgery. The surgical field is exposed using metal retractors, revealing the maxillary bone superior to the upper dentition. Two autogenous bone blocks (indicated by black arrows) are grafted bilaterally at the maxillary sinus wall gaps to ensure postoperative stability and facilitate sinus drainage. These pale, dense bone grafts are secured into position using titanium osteosynthesis screws. Multiple L-shaped and straight metal fixation plates are visible, bridging the osteotomy lines. Additionally, several small, circular drainage holes are drilled into the anterior maxillary wall, intended for the placement of Maxillary Sinus Vacuum Drainage (MSVD) tubes. The image demonstrates complex maxillofacial reconstruction techniques, highlighting the integration of rigid internal fixation, autogenous grafting, and sinus management protocols.

Anatomical diagram illustrating the Le Fort classification system for midface fractures, presented through frontal (anterior) and lateral (profile) line drawings of a human skull. Three distinct fracture patterns are highlighted with red lines. Le Fort I (horizontal) depicts a fracture line passing through the lower maxilla and nasal septum, effectively separating the alveolar process and palate from the rest of the facial skeleton. Le Fort II (pyramidal) shows a fracture line originating at the nasal bridge, extending through the lacrimal bones, infraorbital rim, and downward through the maxillary sinuses. Le Fort III (craniofacial dysjunction) illustrates a complete separation of the facial bones from the cranial base, with fracture lines traversing the frontonasal suture, orbits, and zygomatic arches. This diagram serves as a primary educational resource for maxillofacial surgery and emergency medicine, demonstrating the complex planes of facial trauma and the anatomical relationship between the maxilla, orbits, and zygoma.

Educational 3D CT reconstruction of an adult human skull demonstrating the classic classification of midface fractures. The image consists of two panels: (a) a frontal (anterior) view and (b) an oblique view, both featuring overlaid black lines representing the three types of Le Fort fractures. - Le Fort I: Indicated by a horizontal fracture line passing through the maxilla, superior to the alveolar process and maxillary teeth, effectively separating the palate from the rest of the face. - Le Fort II: Depicted as a pyramidal fracture line extending from the lateral maxilla, through the infraorbital rims and nasal bones, involving the midfacial structures. - Le Fort III: Labeled at the superior aspect, showing complete craniofacial disjunction where the fracture line traverses the zygomatic arches, the lateral orbital walls, and the nasofrontal suture, separating the facial skeleton from the cranial base. The visualization serves as a diagnostic algorithm for maxillofacial trauma, highlighting the anatomical involvement of the orbits, nasal cavity, and zygomaticomaxillary complex.

This diagnostic diagram and illustration series displays a 3D medical model of a human skull, used to demonstrate the classification of Le Fort fractures through computer-assisted clipping paths. The series includes four panels: (a) a normal skull with the cranium in pale yellow and the mandible in light green; (b) a Le Fort I fracture, indicated by a red highlight on the lower maxilla and alveolar process, separated by a horizontal plane; (c) a Le Fort II fracture (pyramidal fracture), with the red highlight extending through the nasal bridge, lacrimal bones, and infraorbital rim; and (d) a Le Fort III fracture (craniofacial dysjunction), showing the most extensive red highlight encompassing the entire midface, including the zygomatic arches and orbital floors. Overlaid white, purple, and blue geometric lines represent the implicit clipping paths used in surgical planning software to segment these complex fracture patterns. The visual serves as an educational tool for maxillofacial surgery, illustrating different levels of midfacial instability and the digital tools used for their analysis.