How Sufficiently Should the Iliac Crest Bone Graft Be Positioned After Lefort I Maxillary Osteotomy When Downgrafting With Advancement Exceeds Five Millimeters?

The iliac crest bone can be used in many situations in the maxillofacial area. The corticocancellous bone blocks provide a lot of bone material, which can be shaped to the proper contour, volume, and bent to the desired position. Most commonly, syndromic cases are treated with the use of such bone blocks. In some special situations and unusual cases, when maxillary downgrafting with extrusion and advancement exceeds 5 mm, an increased bone gap is present. To promote good bone healing, achieve proper union, and maintain stable bone position with occlusion, the grafted bone material should be positioned correctly and plated in the desired location. The corticocancellous bone blocks should be used in some selected cases of skeletal malocclusion with insufficient horizontal or vertical bone disturbances that could benefit greatly in advancing bones over the safe bone distances and improving bith bone proportions and smile exposure. Authors would want to present their approach with iliac crest bone grafting and the method of their placement within the increased osteotomy gap.