Posterior maxillary anatomy: implications for Le Fort I osteotomy

Area of Science:

• Oral and Maxillofacial Surgery
• Anatomy
• Surgical Safety

Background:

• Hemorrhage in the posterior maxilla is a common complication during maxillary osteotomies.
• A detailed understanding of the anatomical structures in the posterior maxilla is essential for minimizing vascular risks.
• The Le Fort I osteotomy is a widely used surgical procedure involving the maxilla.

Purpose of the Study:

• To investigate the osteology of the posterior maxillary region.
• To establish clinical safety guidelines for performing the Le Fort I osteotomy.
• To identify anatomical variations that may influence surgical outcomes.

Main Methods:

• Analysis of 30 human dry skulls.
• Utilized direct inspection, computerized imaging, and computed tomography (CT) scans.
• Evaluated the pterygomaxillary junction and descending palatine canal anatomy.

Main Results:

• Maxillary third molars impacted the angulation of the posterior vertical cut.
• Pterygomaxillary junction synostosis observed in 12% of specimens.
• The descending palatine canal's trajectory and position relative to anatomical landmarks were quantified.

Conclusions:

• Anatomical variations in the posterior maxilla, such as third molar presence and pterygomaxillary synostosis, require consideration during Le Fort I osteotomy.
• Precise knowledge of the descending palatine canal's course aids in surgical planning.
• Established anatomical data can inform safety guidelines to reduce vascular complications in maxillary osteotomies.