Le Fort I osteotomy using an ultrasonic bone curette to fracture the pterygoid plates.
OBJECTIVE
The purpose of this study was to evaluate the advantageous use of an ultrasonic bone curette and to assess the mobilization of the pterygoid process after a Le Fort I osteotomy.


METHODS
14 Japanese adults (ranging in age from 17 to 30 years, mean 22.4) with jaw deformities diagnosed as mandibular prognathism or bimaxillary asymmetry underwent Le Fort I osteotomy with bilateral sagittal split ramus osteotomy or intraoral vertical ramus osteotomy. During the Le Fort I osteotomy, the Sonopet UST-2000 ultrasonic bone curette was used to fracture the pterygoid process slightly above the level of the maxillary osteotomy without damaging the descending palatine artery or other blood vessels and nerves. After surgery, the pterygoid process osteotomy and its mobility were evaluated from three-dimensional computed tomographic images.


RESULTS
In all cases, the mobility of the pterygoid process could be achieved by using the device safely with minimal bleeding and no notable complications. The maxillary segment could be fixed in an ideal position and in all 14 cases, an ideal profile was achieved.


CONCLUSIONS
Ultrasonic bone curette offers a safe procedure for performing pterygoid process fractures without damaging the surrounding tissue such as the descending palatine artery.
Ueki
Koichiro
K
Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kanazawa University, Kanazawa, Japan. kueki@med.kanazawa-u.ac.jp
Nakagawa
Kiyomasa
K
Marukawa
Kohei
K
Yamamoto
Etsuhide
E
D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D003475:Curettage / Q000295:instrumentation*; D004867:Equipment Design; D005146:Facial Asymmetry / Q000601:surgery; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D008334:Mandible / Q000601:surgery; D008437:Maxilla / Q000601:surgery; D010027:Osteotomy / Q000379:methods; D019340:Osteotomy, Le Fort / Q000295:instrumentation* / Q000379:methods; D010159:Palate / Q000098:blood supply / Q000294:innervation; D011378:Prognathism / Q000601:surgery; D013100:Sphenoid Bone / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014464:Ultrasonic Therapy / Q000295:instrumentation*