title: Maxillary posterior segmentation using an oscillating saw in Le Fort I posterior or superior movement without pterygomaxillary separation.
abstract: OBJECTIVE
  Any remaining tuberosity or pterygoid plate frequently interferes with posterior or superior movement of the maxilla, if no pterygomaxillary separation is performed in low-level Le Fort I osteotomy. The objective of this report is to describe a technique for maxillary posterior segmentation using an oscillating saw in Le Fort I posterior or superior movement without pterygomaxillary separation and to present the authors' preliminary multicenter experience with this technique.
  
  
  METHODS
  The authors retrospectively evaluated patients who underwent double-jaw surgery at 3 orthognathic surgery centers from May 2010 to December 2012. In all cases, the segmentation procedure was performed using an oscillating saw on a posterior or tuberosity area of the maxilla before downfracture obtained by leverage alone without pterygomaxillary separation, below or near the lower part of the pterygoid plate.
  
  
  RESULTS
  In total, 1,231 patients (411 male and 820 female; mean age, 24.9 yr) were enrolled. Mean surgical time for the maxillary procedure was 55.9 minutes. None of the patients received a blood transfusion, and no significant soft or hard tissue complications clinically compromised the healing of the repositioned maxilla. Mean maxillary posterior and superior movements were 3.4 mm (range, 2.1 to 5.6 mm) and 4.0 mm (range, 1.3 to 5.6 mm), respectively.
  
  
  CONCLUSIONS
  The preliminary results indicate that this maxillary posterior segmentation procedure using an oscillating saw in low-level stepped Le Fort I osteotomy can be completed safely and effectively for posterior or superior repositioning of the maxilla, with no need to disturb the integrity of the pterygoid plate.
authors.affiliation: Private Practice, Apgujeong New Face Surgery, Seoul, South Korea.
authors.forename: Nara
authors.initials: N
authors.lastname: Kang
authors.affiliation: Professor, Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul, South Korea.
authors.forename: Kyung-Gyun
authors.initials: KG
authors.lastname: Hwang
authors.affiliation: Assistant Professor, Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul, South Korea. Electronic address: fastchang@hanyang.ac.kr.
authors.forename: Chang-Joo
authors.initials: CJ
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D019340:Osteotomy, Le Fort / Q000295:instrumentation*; D055815:Young Adult