A modification of the pterygoid plate separation in low-level maxillary osteotomies

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

“…In Group 2, the osteotomy trajectory was similar to Group 1 until the second molar; then the cut goes lower as it moves posterior to the second molar, aiming to finish off below the pterygomaxillary plate (Figure 1B). In Group 3, the level of the osteotomy was the same as in Group 1; however, as proposed by Trimble et al [18], it finished up in the third molar alveolar region or in the area of the maxillary tuberosity (Figure 1C). In all groups, the same osteotomy was performed on both sides; the canine buttress and anterior lateral wall of the nasal cavity were osteotomized, as was the nasal septum.…”

“…In Group 3, the level of the osteotomy was the same as in Group 1; however, as proposed by Trimble et al. [18], it finished up in the third molar alveolar region or in the area of the maxillary tuberosity (Figure 1C). In all groups, the same osteotomy was performed on both sides; the canine buttress and anterior lateral wall of the nasal cavity were osteotomized, as was the nasal septum.…”

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

“…In Group 2, the osteotomy trajectory was similar to Group 1 until the second molar; then the cut goes lower as it moves posterior to the second molar, aiming to finish off below the pterygomaxillary plate (Figure 1B). In Group 3, the level of the osteotomy was the same as in Group 1; however, as proposed by Trimble et al [18], it finished up in the third molar alveolar region or in the area of the maxillary tuberosity (Figure 1C). In all groups, the same osteotomy was performed on both sides; the canine buttress and anterior lateral wall of the nasal cavity were osteotomized, as was the nasal septum.…”

“…In Group 3, the level of the osteotomy was the same as in Group 1; however, as proposed by Trimble et al. [18], it finished up in the third molar alveolar region or in the area of the maxillary tuberosity (Figure 1C). In all groups, the same osteotomy was performed on both sides; the canine buttress and anterior lateral wall of the nasal cavity were osteotomized, as was the nasal septum.…”

Three-Dimensional Computed Tomographic Evaluation of Bilateral Sagittal Split Osteotomy Lingual Fracture Line and Le Fort I Pterygomaxillary Separation in Orthognathic Surgery Using Cadaver Heads: Ultrasonic Osteotome Versus Conventional Saw

“…Different techniques have been proposed in the literature to improve pterygoid separation and to eliminate unwanted fractures. [49][50][51][52][53][54] The type of separation obtained in the pterygomaxillary area in the present study was compared with that obtained in other studies (Table 6). 28,[55][56][57][58] Lanigan and Guest 54 and Lanigan and Loewy 55 concluded that using the curved Obwegeser osteotome to achieve pterygomaxillary disjunction should be abandoned because it resulted in an unacceptably high incidence of high-level pterygoid plate fractures at or near the base of the skull.…”

Clinical anatomy of the posterior maxilla pertaining to Le Fort I osteotomy in Thais

“…The pterygomaxillary dysjunction and mobilization of the maxilla can lead to unfavorable fractures of the pterygoid plate and severe hemorrhage (Turvey and Fonseca, 1980;Newhouse et al, 1982;Lanigan and West, 1984;Robinson and Hendy, 1986). The swan's neck osteotome, the right-angled micro-oscillating saw and the straight osteotome have been used to minimize the risks of unfavorable effects (Wikkeling and Tacoma, 1975;Trimble et al, 1983;Hiranuma et al, 1988;Juniper and Stajcic, 1991;Lanigan and Guest, 1993).…”

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

“…In Group 2, the osteotomy trajectory was similar to Group 1 until the second molar; then the cut goes lower as it moves posterior to the second molar, aiming to finish off below the pterygomaxillary plate (Figure 1B). In Group 3, the level of the osteotomy was the same as in Group 1; however, as proposed by Trimble et al [18], it finished up in the third molar alveolar region or in the area of the maxillary tuberosity (Figure 1C). In all groups, the same osteotomy was performed on both sides; the canine buttress and anterior lateral wall of the nasal cavity were osteotomized, as was the nasal septum.…”

“…In Group 3, the level of the osteotomy was the same as in Group 1; however, as proposed by Trimble et al. [18], it finished up in the third molar alveolar region or in the area of the maxillary tuberosity (Figure 1C). In all groups, the same osteotomy was performed on both sides; the canine buttress and anterior lateral wall of the nasal cavity were osteotomized, as was the nasal septum.…”

Three-Dimensional Computed Tomographic Evaluation of Bilateral Sagittal Split Osteotomy Lingual Fracture Line and Le Fort I Pterygomaxillary Separation in Orthognathic Surgery Using Cadaver Heads: Ultrasonic Osteotome Versus Conventional Saw

“…Different techniques have been proposed in the literature to improve pterygoid separation and to eliminate unwanted fractures. [49][50][51][52][53][54] The type of separation obtained in the pterygomaxillary area in the present study was compared with that obtained in other studies (Table 6). 28,[55][56][57][58] Lanigan and Guest 54 and Lanigan and Loewy 55 concluded that using the curved Obwegeser osteotome to achieve pterygomaxillary disjunction should be abandoned because it resulted in an unacceptably high incidence of high-level pterygoid plate fractures at or near the base of the skull.…”

Clinical anatomy of the posterior maxilla pertaining to Le Fort I osteotomy in Thais

“…The pterygomaxillary dysjunction and mobilization of the maxilla can lead to unfavorable fractures of the pterygoid plate and severe hemorrhage (Turvey and Fonseca, 1980;Newhouse et al, 1982;Lanigan and West, 1984;Robinson and Hendy, 1986). The swan's neck osteotome, the right-angled micro-oscillating saw and the straight osteotome have been used to minimize the risks of unfavorable effects (Wikkeling and Tacoma, 1975;Trimble et al, 1983;Hiranuma et al, 1988;Juniper and Stajcic, 1991;Lanigan and Guest, 1993).…”

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

“…In Group 2, the osteotomy trajectory was similar to Group 1 until the second molar; then the cut goes lower as it moves posterior to the second molar, aiming to finish off below the pterygomaxillary plate (Figure 1B). In Group 3, the level of the osteotomy was the same as in Group 1; however, as proposed by Trimble et al [18], it finished up in the third molar alveolar region or in the area of the maxillary tuberosity (Figure 1C). In all groups, the same osteotomy was performed on both sides; the canine buttress and anterior lateral wall of the nasal cavity were osteotomized, as was the nasal septum.…”

“…In Group 3, the level of the osteotomy was the same as in Group 1; however, as proposed by Trimble et al. [18], it finished up in the third molar alveolar region or in the area of the maxillary tuberosity (Figure 1C). In all groups, the same osteotomy was performed on both sides; the canine buttress and anterior lateral wall of the nasal cavity were osteotomized, as was the nasal septum.…”

Three-Dimensional Computed Tomographic Evaluation of Bilateral Sagittal Split Osteotomy Lingual Fracture Line and Le Fort I Pterygomaxillary Separation in Orthognathic Surgery Using Cadaver Heads: Ultrasonic Osteotome Versus Conventional Saw

“…Different techniques have been proposed in the literature to improve pterygoid separation and to eliminate unwanted fractures. [49][50][51][52][53][54] The type of separation obtained in the pterygomaxillary area in the present study was compared with that obtained in other studies (Table 6). 28,[55][56][57][58] Lanigan and Guest 54 and Lanigan and Loewy 55 concluded that using the curved Obwegeser osteotome to achieve pterygomaxillary disjunction should be abandoned because it resulted in an unacceptably high incidence of high-level pterygoid plate fractures at or near the base of the skull.…”

Clinical anatomy of the posterior maxilla pertaining to Le Fort I osteotomy in Thais

“…The pterygomaxillary dysjunction and mobilization of the maxilla can lead to unfavorable fractures of the pterygoid plate and severe hemorrhage (Turvey and Fonseca, 1980;Newhouse et al, 1982;Lanigan and West, 1984;Robinson and Hendy, 1986). The swan's neck osteotome, the right-angled micro-oscillating saw and the straight osteotome have been used to minimize the risks of unfavorable effects (Wikkeling and Tacoma, 1975;Trimble et al, 1983;Hiranuma et al, 1988;Juniper and Stajcic, 1991;Lanigan and Guest, 1993).…”