Huge Vertical lengthening maxillary movement without bonegraft

[Suchislife]

See this video at the timestamp: https://youtu.be/zTTgRJEWb7k?t=428

I have a situation similar to this man. Short face requiring CW rotation and anterior downgrafting. My case however does not require such a huge downgraft (but still substantial, maybe 5mm) or as much rotation (less than 5 degrees whilst i think his is 10+ degrees).

In the section I have highlighted the Dr said that he did not use bonegrafts and just used the titanium plates from a traditional le fort 1 osteotomy...This to me seems quite crazy because I thought even if only 2-3mm of a gap is created from rotation, bonegrafts are used posteriorly and anteriorly. And even with bonegrafts this kind of vertical lengthening is known to have stability issues. Wouldn't this man have a dramatically heightened chance of relapse...

Does anyone have some insight to share about this, big vertical movement of the maxilla without downgrafts being used and its stability. I am going to a consult with a surgeon soon and want to comment about this.  In time I might end up going for a video consult with dr antipov as well to clarify this..

Ty

[PloskoPlus]

Some surgeons don't use any grafting for gaps of up to 5-6 mm.  They will shove the bone scraps created by the osteotomy back into the gap, but that's about it.

[kavan]

His presentation as to how he fills the large gap you see in the 3-D planning is kind of unclear. Although he says he doesn't use 'bone grafts', what's unclear is whether he's referring to bone harvested from one's body when he uses the term 'bone graft' or whether or not he uses a bone BUTTRESS, made from hydroxyappetite, to fill the gap as do other surgeons doing similar surgery.