Transmucosal pterygomaxillary disjunction using a piezoelectric device, in the context of the minimally invasive Le Fort I osteotomy protocol

• Published in: International journal of oral and maxillofacial surgery 2023-05, Vol.52 (5), p.569-576
• Main Authors: Hernández-Alfaro, F., Ghuloom, M., Giralt-Hernando, M., Lázaro-Abdulkarim, A., Valls-Ontañón, A.
• Format: Article
• Language: English
• Subjects: Cone-beam computed tomography; Cranial suture; Craniotomy; Follow-Up Studies; Humans; Le Fort osteotomy; Maxilla - diagnostic imaging; Maxilla - surgery; Molar; Orthognathic surgery; Osteotomy; Osteotomy, Le Fort; Piezo-electric surgery
• ISSN: 0901-5027; 1399-0020
• DOI: 10.1016/j.ijom.2022.08.003

The aim of this study was to assess the accuracy and clinical implications of pterygomaxillary junction (PMJ) disjunction with a transmucosal PMJ osteotomy using a piezoelectric hand-piece device, in the context of Le Fort I osteotomy, by evaluating the level of PMJ disarticulation and the need for bone trimming around the pedicle. An ambidirectional 1-month follow-up cohort study was designed involving consecutive patients undergoing minimally invasive maxillary Le Fort I osteotomy through the twist technique. Two cohorts were defined according to whether or not the transmucosal PMJ osteotomy was performed. The site of PMJ disjunction was analysed radiographically. A total of 114 patients were included in the study, 57 in each group. The overall accuracy of the PMJ disjunction path was higher in the test group (43.9%) than in the control group (15.8%). Multiple logistic regression analysis identified the need for bone trimming (odds ratio 0.02; P