• Mustafa Ayhan, Sedef Ayşe Taşyapan, Abdulsamet Kundakçıoğlu, Metin Berk Kasapoğlu, Sabri Cemil İşler, Barış Altuğ Aydil, Ilknur Özcan, and Gülce Ecem Doğancalı.
• Department of Oral and Maxillofacial Surgery, İstanbul University Faculty of Dentistry, İstanbul-Türkiye.
• Ulus Travma Acil Cer. 2023 Feb 1; 29 (2): 149154149-154.

BackgroundLe Fort 1 (LF1) osteotomies are widely used to correct midface deformities. To move the maxilla freely, the ptery-gomaxillary junction (PMJ) must be separated. When performing this osteotomy, the pterygoid plate must remain intact. The objective of this study was to evaluate relationship between the anatomical features of the PMJ and fracture patterns in LF1 osteotomy.MethodsPre-operative and post-operative cone-beam computed tomography images of 41 patients (82 samples) who have undergone LF1 osteotomy surgery were radiologically evaluated. Morphologic measurements of the pterygomaxillary fissure area and pterygoid plate were carried out. Moreover, pterygomaxillary separation was divided into the clean-cut, maxillary sinus, and pterygoid plate fracture types.ResultsStatistically significant difference was observed between clean-type fracture and pterygoid plate fracture groups' thickness of the pterygoid process and thickness of the pterygomaxillary region.ConclusionAnatomical variations make it difficult to separate the PMJ properly. Low thickness of PMJ increases the risk of unwanted fractures; however, according to our experience, the use of an osteotome with an incorrect angle, excessive force, and inexperienced surgeons can also cause undesirable pterygoid plate fractures.

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