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Choanal atresia is defined as the complete obstruction of the posterior nasal airway. The obstruction is the origin of maxillary impairment in the development. We describe a case of a man with unilateral choanal atresia who was referred to the maxilla-facial surgery department for his maxillary anomalies. The patient suffered from hypoplasia of the midface with class III malocclusion. and retromaxillia. He had also solitary median maxillary central incisor syndrome (SMMCI). Choanal atresia leads to nasal obstruction resulting in mouth breathing. The maxillary consequences are long face, contraction of the upper dental arch and high arched palate. The patients present class III malocclusion with posterior cross bite, anterior open bite. SMMCI may also be present. The maxillary anomalies would be only slightly due to the presence of chronic nasal obstruction. The mouth breathing, which results from the nasal obstruction, is an etiological factor at the origin of maxillary anomalies.

Introduction: Several medical devices (MDs) are used to assist surgeons in positioning the upper dental arch (UDA) during Le Fort I osteotomies (LFIOs). Some only allow holding, others only positioning. This study aimed to assess the accuracy of a new MD (PirifixTM) coupling these two functions during LFIO on 3D-printed models. Materials and Methods: DICOM data were selected from patients who underwent surgical planning for LFIO between 27 July 2020 and 1 December 2022. Their anatomy was reproduced after segmentation, planning, and stereolithography in two models. Each model was assigned to one of two surgical groups: the control group (positioning by occlusal splint) and the PirifixTM group. Each patient's model was planned with the objective of horizontalizing and recentering the UDA. After positioning, models were digitalized using Einscan Pro 2X and compared to the planned model with CloudCompare. The statistical analysis was performed using the Wilcoxon Mann–Whitney test. The result was considered significant if the p-value was less than 0.05. Results: Twenty-one patients were selected. Forty-two anatomical models were 3D-printed. The mean difference compared to the planned and corrected positions was 0.69 mm for the control group and 0.84 mm for the PirifixTM group (p = 0.036). Conclusion: PirifixTM may be a new alternative to available MDs. Further investigations are needed to describe the relationship between the device and facial soft tissues. [ABSTRACT FROM AUTHOR]