The pterygomaxillary junction: An imaging study for surgical information of LeFort I osteotomy.

Maxillary osteotomy is a common surgical procedure and often involves separation of the pterygomaxillary junction (PMJ), which is a "blinded" procedure with inherent risks. Knowledge of the PMJ structure is essential. It remains unclear whether patients with different facial types have different PMJ structures, or different surgical outcome. This study evaluated the computed tomographic images of 283 consecutive patients who received orthognathic surgery. Patients were classified into Angle class I, II, III and cleft lip/palate groups. The results showed that the PMJ was 5.1 ± 1.4 mm in thickness, 9.7 ± 1.7 mm in width, and 102.0 ± 4.0 degrees relative to the sagittal plane in the level of posterior nasal spine. There were no statistically significant differences in these measurements among the groups. The class III group demonstrated significantly smaller angle relative to the maxillary occlusal plane. The cleft group showed significantly longer vertical distance between the posterior nasal spine and the lower border of PMJ, shorter distance between the second molar and PMJ, and longer distance between the descending palatine artery and PMJ. With regard to postoperative outcome, the cleft group showed higher incidence of pterygoid plate fracture. The results in this study provide additional surgical anatomic information.

Comparison of functional outcomes and patient-reported satisfaction between titanium and absorbable plates and screws for fixation of mandibular fractures: A one-year prospective study.

PURPOSE: The aim of this study is to compare the 1-year functional outcomes and patient-reported satisfaction in treating mandibular fractures between resorbable and titanium fixation devices. MATERIALS AND METHODS: A 1-year prospective study was conducted; 41 consecutive patients presenting with mandibular fractures were included. A resorbable system was used in 21 patients, while in 20 patients a titanium fixation device was used. Functional outcome was evaluated objectively at several time points (2, 4 and 6 weeks, 3 and 6 months, and 1 year after surgery). Bite forces over molars and incisors, mouth opening distance, occlusal status, operation time, fee for implants, bone healing and plate-associated complications were evaluated. Functional and overall satisfaction was measured by patients themselves subjectively. RESULTS: A statistical difference was found only in maximal mouth opening and molar bite force, both greater for the titanium group in the 2-week time point, achieving comparable measurements in subsequent ones. This coincides with the patient-reported statistically lower satisfaction rates. The cost of the resorbable device was nearly 3 times more expensive than the titanium devices. CONCLUSION: Resorbable fixation can achieve stability of bone healing at 1 year postoperatively, with functional and satisfaction outcomes comparable to those associated with titanium hardware from the fourth week postoperatively, while yielding unique advantages.