Analysis of Three Approaches to the Pterygomaxillary Region in the Le Fort I Osteotomy

ABSTRACT Objective The purpose of this study was to measure the association between the Le Fort I osteotomy technique and the pterygomaxillary separation pattern. Materials and Methods The sample was comprised of the medical records of 39 patients undergoing orthognathic surgery. The type of Le Fort I osteotomy technique was divided into three groups: (1) traditional Le Fort I; (2) modified Le Fort I in which the osteotome was not applied and (3) modified Le Fort I with the end point in the third molar alveolar region or in the area of the maxillary tuberosity. The pterygomaxillary separation pattern was defined as the region where it occurred and the presence or absence of pterygoid plate and palatine process fractures. Results The study sample consisted of 24 women and 15 men, a ratio of 1.6:1. Regarding the pattern of pterygomaxillary separation, in Group 1 there were 3 cases involving the maxillary tuberosity (25%), 10 cases occurring in the region of the pterygomaxillary junction (83.34%) and 4 cases involving the region of the pterygoid plates (33.34%). In Group 2, there were 2 (13.33%), 9 (60%) and 7 (46.67%), respectively. Although Group 3 had 11 (91.67%), 6 (50%) and 3 (25%), respectively. Conclusion No statistical difference was observed in the pterygomaxillary separation pattern between the three techniques and when gender and age were analysed.