CBCT study on the positional relationship between marginal points of pterygomaxillary junction and anterior nasal spine
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ANATOMIC BASES OF MEDICAL, RADIOLOGICAL AND SURGICAL TECHNIQUES
CBCT study on the positional relationship between marginal points of pterygomaxillary junction and anterior nasal spine Xin Chen1,3 · Jiadong Zhu2 · Songsong Guo1 · Yong Hu2 · Hongbing Jiang1,3 Received: 12 July 2020 / Accepted: 15 September 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Purpose This study aimed to locate the inferior end (Pti) and the superior end (Pts) of pterygomaxillary junction (PMJ) relative to anterior nasal spine (ANS) so as to provide references for pterygomaxillary separation. Methods The study was based on CBCT images of 109 Chinese patients. We projected Pti and Pts to the frontal plane and measured the distance as well as the positional relationship between the projection points and ANS via three-dimensional reconstruction image. Results On average, the ANS was 5.18 mm above the Pti and the horizontal distance between the Pti and ANS was 21.86 mm. The horizontal and vertical distances between Pts and ANS was 20.41 mm and 10.91 mm, respectively. The vertical height of PMJ was 16.09 mm. Scatter plots diagrammatic centered on ANS showed that 73% (160/218) Pti and 64% (140/218) Pts appeared in a 45° fan shape ranged from 20 to 25 mm radius in bilateral inferior and superior quadrant, respectively. There was no significant difference in the distance between both sides (P > 0.05). Conclusion During the pterygomaxillary disjunction, it exists a risk of injuring neurovascular bundle of the pterygopalatine fossa 16.09 mm above the lowest border of the pterygomaxillary junction. The region within a 45° fan shape ranged in 20–25 mm radius in inferior quadrant centered on ANS might be suitable for the osteotome position. The positional relationship especially between the ANS and Pti found in this study provides a reference for surgeons during pterygomaxillary disjunction. Keywords Cone-beam computed tomography · Osteotomy · Le Fort · Maxillary bone
Introduction
Xin Chen and Jiadong Zhu contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00276-020-02582-9) contains supplementary material, which is available to authorized users. * Hongbing Jiang [email protected] 1
Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, No. 136, Hanzhong Road, Nanjing 210029, Jiangsu, China
2
Department of Stomatology, Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China
3
Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, Jiangsu, China
Le Fort I osteotomy is a widely-used surgical technique for treatment of the skeletal malocclusion, trauma or even the tumors in the skull base [8, 11]. The pterygomaxillary disjunction is performed in this osteotomy to separate the maxilla from the pterygoid process and the palatal bone [4]. However, many complications could occur from the u
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