Evaluation of strain values of critical anatomic regions for two different pterygomaxillary approaches in Le Fort I osteotomy: An experimental study

Background: The purpose of this experimental study was to measure stresses both on the pterygoid plates and the skull base following two different pterygomaxillary approaches in Le Fort I osteotomy. Material and Methods: The prepared skull models were randomly divided into 2 groups of 7. In the first group (A), the pterygomaxillary area was left intact. In the second group (B), pterygomaxillary separation was performed with a fine bur. The stresses were measured by using strain gauges. These strain gauges were attached to 6 different anatomical sites. The skull models were mounted on a servo-hydraulic testing unit. Each model was then subjected to a continuous linear tension until a plastic deformation was seen. Results: The statistical analyses showed that there were no significant differences (p>.05) between the 2 groups regarding the strain values. Moreover, no statistical differences (p>.05) were found between the two groups in terms of maximum applied forces. Conclusions: Considering the clinical conditions, the present study shows that when Le Fort I osteotomy performed without pterygomaxillary separation, there is no significant stress on the skull base during the downfracture. Moreover, it is considered that there is no need for an excessive force applied to perform downfracture in Le Fort osteotomies without pterygomaxillary separation.