MOJ
eISSN: 2381-179X
Submit manuscript...
Case Report Volume 16 Issue 3
Management of maxillary non-union following Orthognathic surgery in skeletal class III malocclusion: a case report
Panchali Batra, Sujata Mohanty, Arisha Izhar
Received: April 10, 2026 | Published: May 25, 2026
Citation: Batra P, Mohanty S, Izhar A. Management of maxillary non-union following Orthognathic surgery in skeletal class III malocclusion: a case report. MOJ Clin Med Case Rep. 2026;16(2):44-48. DOI: 10.15406/mojcr.2026.16.00498
Abstract
Background: Maxillary non-union is a rare but serious complication following Le Fort I osteotomy in the surgical management of skeletal Class III malocclusion. It can compromise skeletal stability, occlusion, and facial aesthetics, requiring timely diagnosis and appropriate intervention. Case presentation: This case report describes a 27-year-old female with skeletal Class III malocclusion characterized by maxillary hypoplasia and mandibular prognathism. Following presurgical orthodontic decompensation, the patient underwent bimaxillary orthognathic surgery involving a 4 mm maxillary advancement and a 6 mm mandibular setback. Nine months postoperatively, clinical examination revealed mobility of the maxillary segment, and radiographic findings confirmed fibrous non-union at the left osteotomy site. Initial management included intermaxillary fixation using IMF screws and adjunctive sclerosing injections. Due to persistent mobility, a revision procedure with circumzygomatic wiring and debridement of fibrous tissue was performed without the need for bone grafting. Results: Successful stabilization and osseous healing of the maxilla were achieved within six months following revision surgery. Subsequent postsurgical orthodontic treatment resulted in a stable occlusion with positive overjet and overbite, Class I canine and molar relationships, correction of crossbites, and significant improvement in facial aesthetics. The patient expressed high satisfaction with the functional and esthetic outcomes. Conclusion: Maxillary non-union after Le Fort I osteotomy, although uncommon, should be considered when postoperative mobility persists. Circumzygomatic wiring combined with adequate immobilization can be an effective alternative to bone grafting in selected cases. Early recognition and appropriate management are essential for achieving stable functional and esthetic results.
Keywords: skeletal class iii malocclusion, le fort i osteotomy, maxillary non-union, pseudoarthrosis, circumzygomatic wiring, orthognathic surgery
©2026 Batra, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.