Maxillary canting and anatomical variation relevant to Le Fort I osteotomy: a morphometric study using cone beam...

Area of Science:

• Oral and Maxillofacial Surgery
• Anatomical Studies
• Radiographic Analysis

Background:

• Maxillary canting is a common asymmetry requiring surgical correction.
• Le Fort I osteotomy is a standard procedure for correcting midface deformities.
• Understanding anatomical variations is crucial for surgical success.

Purpose of the Study:

• To investigate anatomical variations in the maxilla related to Le Fort I osteotomy in patients with maxillary canting.
• To measure distances between surgically relevant structures and key landmarks.
• To assess the impact of maxillary canting on these measurements using cone beam computed tomography (CBCT).

Main Methods:

• Retrospective analysis of CBCT scans from 63 patients indicated for orthognathic surgery.
• Measurement of distances to the descending palatine artery, pterygomaxillary junction, infraorbital foramen, and nasolacrimal duct.
• Statistical analysis to correlate measurements with the magnitude of maxillary canting.

Main Results:

• Maxillary canting averaged 3.26 mm vertically and 3.62° angularly.
• Significant differences in distances were observed for the descending palatine artery, pterygomaxillary junction, and infraorbital foramen between longer and shorter sides.
• Increased maxillary canting correlated with increased distances to the pterygomaxillary junction, infraorbital foramen, and nasolacrimal duct.

Conclusions:

• Maxillary canting significantly impacts the morphometrics of the pterygomaxillary junction, infraorbital foramen, and nasolacrimal duct.
• These anatomical variations must be considered during Le Fort I osteotomy planning in patients with maxillary canting.
• CBCT is a valuable tool for assessing these pre-operative anatomical details.