The upper jaw can be moved forward with a Graft implant in the posterior region, which helps stabilize the treatment. Full backward movement of the upper jaw is not easy because the bones that normally surround the upper jaw interfere with its backward movement. However, this problem can be overcome by segmenting the upper jaw so that only the front part can be moved backward, with the Down Fracture technique, it is possible to move the upper jaw significantly forward. The limiting factors in this regard are the blood vessels and soft tissues, and it is usually necessary to implant a Graft in the posterior region or a staircase created in the lateral wall. Various materials can be used for Graft implantation such as autogenous bone, dry frozen bone, and alloplastic materials.
Maxillary retraction is limited by anatomical structures adjacent to the trigeminal maxillary groove. Although removing the bone from the hump area allows some movement, it is difficult to reach and the operation area is full of arteries. The most common procedure is to remove the premolars, dissect the upper jaw and move the front part into the space created. Lefort 1 maxillary surgery is performed to treat an open skeletal bite. This surgery is performed to lift the upper jaw, or in other words, Impaction the back of the upper jaw to correct the open bite.