title: Skeletal stability after maxillary posterior-superior movement for skeletal Class III deformities: pterygoid process fracture versus removal.
abstract: OBJECTIVE
  To evaluate maxillary stability after Le Fort I osteotomy using posterosuperior movement after pterygoid process fracture or removal and mandibular setback surgery for skeletal Class III deformities.
  
  
  METHODS
  A retrospective cohort study was performed of changes in 28 patients with skeletal Class III deformity using 3-dimensional (3D) measurement point coordinates obtained by cone-beam computed tomographic superimposition. The predictor variable was management of the pterygoid process (fracture vs removal). The outcome variables were changes in measurement points based on 3D coordinates obtained preoperatively, immediately postoperatively, and 6 months after surgery. Linear mixed-effects models were applied to evaluate postoperative stability.
  
  
  RESULTS
  The 3D cephalometric outcome variables for 14 patients who had undergone pterygoid process fracture were compared with those for 14 patients who had undergone pterygoid process removal. The postoperative nasopalatine canal points moved superiorly 0.11 mm and inferiorly 0.06 mm in the fracture and removal groups, respectively. However, most of the postoperative relapse was within 1 mm. There were no differences in postoperative skeletal changes shown by the fracture and removal groups (P < .05).
  
  
  CONCLUSIONS
  The results suggest that surgeons can achieve good skeletal stability in posterosuperior movement from Le Fort I osteotomy, regardless of whether the pterygoid process is fractured or removed.
authors.affiliation: Assistant Professor, Department of Oral and Maxillofacial Surgery, Pusan National University Hospital, Busan, South Korea.
authors.forename: Jae-Yeol
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Assistant Professor, Department of Orthodontics, Biomedical Research Institute, Pusan National University Hospital, Dental Research Institute, Pusan National University Dental Hospital, Yangsan, South Korea. Electronic address: kimyongil@pusan.ac.kr.
authors.forename: Yong-Il
authors.initials: YI
authors.lastname: Kim
authors.affiliation: Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, Pusan National University Hospital, Busan, South Korea.
authors.forename: Jae-Min
authors.initials: JM
authors.lastname: Song
authors.affiliation: Assistant Professor, Department of Oral and Maxillofacial Surgery, Pusan National University Hospital, Busan, South Korea.
authors.forename: Dae-Seok
authors.initials: DS
authors.lastname: Hwang
authors.affiliation: Professor, Department of Orthodontics, Pusan National University Dental Hospital, Yangsan, South Korea.
authors.forename: Soo-Byung
authors.initials: SB
authors.lastname: Park
mesh_terms: D002508:Cephalometry / Q000379:methods; D015331:Cohort Studies; D054893:Cone-Beam Computed Tomography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007180:Incisor / Q000000981:diagnostic imaging; D008297:Male; D008313:Malocclusion, Angle Class III / Q000601:surgery*; D063168:Mandibular Osteotomy / Q000379:methods; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery*; D008963:Molar / Q000000981:diagnostic imaging; D009666:Nose / Q000000981:diagnostic imaging; D009915:Orbit / Q000000981:diagnostic imaging; D019340:Osteotomy, Le Fort / Q000379:methods*; D010159:Palate / Q000000981:diagnostic imaging; D012008:Recurrence; D012189:Retrospective Studies; D013100:Sphenoid Bone / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult