Liuling Hui1, Kuo Feng Hung1, Michael Marc Bornstein2,3, Yiu Yan Leung4. 1. Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China. 2. Oral and Maxillofacial Radiology, Faculty of Dentistry, Applied Oral Sciences and Community Dental Care, The University of Hong Kong, Hong Kong SAR, China. 3. Department of Oral Health & Medicine, University Center of Dental Medicine Basel UZB, University of Basel, Basel, Switzerland. 4. Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China. mikeyyleung@hku.hk.
Abstract
OBJECTIVE: The study aimed to evaluate surgical angles for tuberosity cut and linear and angular measurements for all horizontal cuts in Le Fort I osteotomy using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: This study included 189 CBCT scans to assess the surgical angles on 3 different sites distal to maxillary second molars relative to the midsagittal plane (MSP) and the buccal cortical plane (BCP) in relation to the descending palatine foramen for tuberosity cut. The linear and angular measurements for all horizontal cuts in Le Fort I osteotomy were also evaluated. RESULTS: The mean surgical angles for tuberosity cut varied from 58.90 to 95.28° and 74.85 to 100.93° according to the MSP and the BCP, respectively. For the horizontal cuts, mean lengths (angles) for posterior buccal and lateral nasal wall osteotomies were 27.44 mm (13.62°) and 33.20 mm (9.60°), respectively, and a mean length of 47.12 mm was measured for nasal septum osteotomy. Additionally, the presence of impacted third molar resulted in significantly higher mean surgical angles than those with fully erupted or without third molars (p < 0.01). CONCLUSIONS: Overall, angles running through the buccal midpoint of the third molars relative to the MSP (76.56°) or the BCP (92.31°) might be the most appropriate in clinical practice. Furthermore, some caution seems warranted when performing tuberosity cuts with the impacted third molars. CLINICAL RELEVANCE: To avoid potential damage to the descending palatine artery for tuberosity cut in Le Fort I osteotomy.
OBJECTIVE: The study aimed to evaluate surgical angles for tuberosity cut and linear and angular measurements for all horizontal cuts in Le Fort I osteotomy using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: This study included 189 CBCT scans to assess the surgical angles on 3 different sites distal to maxillary second molars relative to the midsagittal plane (MSP) and the buccal cortical plane (BCP) in relation to the descending palatine foramen for tuberosity cut. The linear and angular measurements for all horizontal cuts in Le Fort I osteotomy were also evaluated. RESULTS: The mean surgical angles for tuberosity cut varied from 58.90 to 95.28° and 74.85 to 100.93° according to the MSP and the BCP, respectively. For the horizontal cuts, mean lengths (angles) for posterior buccal and lateral nasal wall osteotomies were 27.44 mm (13.62°) and 33.20 mm (9.60°), respectively, and a mean length of 47.12 mm was measured for nasal septum osteotomy. Additionally, the presence of impacted third molar resulted in significantly higher mean surgical angles than those with fully erupted or without third molars (p < 0.01). CONCLUSIONS: Overall, angles running through the buccal midpoint of the third molars relative to the MSP (76.56°) or the BCP (92.31°) might be the most appropriate in clinical practice. Furthermore, some caution seems warranted when performing tuberosity cuts with the impacted third molars. CLINICAL RELEVANCE: To avoid potential damage to the descending palatine artery for tuberosity cut in Le Fort I osteotomy.
Authors: A Christabel; P Anantanarayanan; P Subash; C L Soh; M Ramanathan; M R Muthusekhar; V Narayanan Journal: Int J Oral Maxillofac Surg Date: 2015-09-01 Impact factor: 2.789