Top

Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie

Published in:

01-05-2020 | Digital Volume Tomography | Original Article

Relationship between pterygomaxillary fissure morphology and maxillary/mandibular position

A cone beam computed tomography assessment

Authors: M. Icen, K. Orhan, U. Oz, DDS PhD, S. Horasan, H. Avsever

Published in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie | Issue 3/2020

Abstract

Purpose

The aim of this study was to investigate the possible correlation between maxillary and mandibular positioning via cephalometric analysis with pterygomaxillary fissure (PMF) morphology using cone beam computed tomography (CBCT).

Methods

In this study, CBCT images from 825 individuals (448 female, 377 male; age range was 18-91 years with this cohort) were analyzed; PMF length and width were measured. Three-dimensional cephalometric analysis was also performed using cephalometric analysis software. The landmarks and measurements in relation to maxillary and mandibular positions were identified and performed for the cephalometric analysis. Analysis of variance (ANOVA) was used for comparison of the parameters, while the Bonferroni test was used for multiple comparisons. Pearson’s test was also used to assess the correlations between the parameters.

Results

The results showed that males had significantly larger PMF length (p < 0.001) and width (p < 0.001) compared to females. The mean PMF length was 17.7 mm (standard deviation [SD] 3.2 mm) for right and 17.7 mm (SD 3.3 mm) for left but were not significantly different (p > 0.05). In terms of the cephalometric measurements, a significant correlation was found between upper central incisor (U1toAperp2D) and posterior facial height (PostFaceHtSGo2D) and PMF length, while correlations were found between PMF width and several cephalometric parameters such as lower lip (LwLiptoEPln2D and LwLiptoHLine2D) and occlusal plane (OPtoFHAng2D) (p < 0.05).

Conclusion

A significant relationship was observed between PMF morphology and the position of the maxilla or mandible. PMF lengths and widths were larger in males than females. Posteroanterior maxillary and mandibular lengths and posterior facial height are associated with PMF length and width.

Andria LM, Reagin KB, Leite LP, King LB (2004) Statistical evaluation of possible factors affecting the sagittal position of the first permanent molar in the maxilla. Angle Orthod 74:220–225PubMed

Baccetti T, Reyes BC, McNamara JA Jr (2005) Gender differences in class III malocclusion. Angle Orthod 75:510–520PubMed

Breeze J, Verea Linares C, Stockton P (2016) Is an osteotome necessary for pterygomaxillary dysjunction or dysjunction through the tuberosity during Le Fort I osteotomy? A systematic review. Br J Oral Maxillofac Surg 54:248–252PubMedCrossRef

Carlson DS (2005) Theories of craniofacial growth in the postgenomic era. Semin Orthod 11:172183

Cevidanes LH, Franco AA, Gerig G, Proffit WR, Slice DE, Enlow DH et al (2005) Comparison of relative mandibular growth vectors with high-resolution 3‑dimensional imaging. Am J Orthod Dentofacial Orthop 128:27–34PubMedCrossRef

Chin YP, Leno MB, Dumrongwongsiri S, Chung KH, Lin HH, Lo LJ (2017) The pterygomaxillary junction: an imaging study for surgical information of LeFort I osteotomy. Sci Rep 30:9953CrossRef

Dargaud J, Cotton F, Buttin R, Morin A (2003) The maxillary sinus: evolution and function in aging. Morphologie 87:17–22PubMed

Deljo E, Filipovic M, Babacic R, Grabus J (2012) Correlation analysis of the hyoid bone position in relation to the cranial base, mandible and cervical part of vertebra with particular reference to bimaxillary relations/teleroentgenogram analysis. Acta Inform Med 20:25–31PubMedPubMedCentralCrossRef

Dibbets J (1996) Morphological associations between the Angle classes. Eur J Orthod 18:111–118PubMedCrossRef

10.

Ghoneima A, Abdel-Fattah E, Hartsfield J, El-Bedwehi A, Kamel A, Kula K (2011) Effects of rapid maxillary expansion on the cranial and circummaxillary sutures. Am J Orthod Dentofacial Orthop 140:510–519PubMedPubMedCentralCrossRef

11.

Graber LW (1978) Hyoid changes following orthopedic treatment of mandibular prognathism. Angle Orthod 48:33–38PubMed

12.

Hwang SH, Seo JH, Joo YH, Kim BG, Cho JH, Kang JM (2011) An anatomic study using three-dimensional reconstruction for pterygopalatine fossa infiltration via the greater palatine canal. Clin Anat 24:576–582PubMedCrossRef

13.

Icen M, Orhan K (2019) Cone-beam computed tomography evaluation of the pterygomaxillary fissure and pterygopalatine fossa using 3D rendering programs. Surg Radiol Anat 41:513–522PubMedCrossRef

14.

Iseri H, Solow B (1995) Average surface remodeling of the maxillary base and the orbital floor in female subjects from 8 to 25 years. An implant study. Am J Orthod Dentofacial Orthop 107:48–57PubMedCrossRef

15.

Krey KF, Dannhauer KH, Hierl T (2015) Morphology of open bite. J Orofac Orthop 76:213–224PubMedCrossRef

16.

Kumar Jena A, Duggal R (2011) Hyoid bone position in subjects with different vertical jaw dysplasias. Angle Orthod 81:81–85CrossRef

17.

Lieberman D (2011) The evolution of the human head. Harvard University Press, CambridgeCrossRef

18.

Moiseiwitsch J, Irvine T (2001) Clinical significance of the length of the pterygopalatine fissure in dental anesthesia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 92:325–328PubMedCrossRef

19.

Moss ML (1997) The functional matrix hypothesis revisited. 1. the role of mechanotransduction. Am J Orthod Dentofacial Orthop 112:8–11PubMedCrossRef

20.

Moss ML (1997) The functional matrix hypothesis revisited 2. The role of an osseous connected cellular network. Am J Orthod Dentofacial Orthop 112:221–226PubMedCrossRef

21.

Moss ML, Salentijn L (1969) The capsular matrix. Am J Orthod 56:474–490PubMedCrossRef

22.

Moss ML, Salentijn L (1969) The primary role of functional matrices in facial growth. Am J Orthod 55:566–577PubMedCrossRef

23.

Oliveira GQV, Rossi MA, Vasconcelos TV, Neves FS, Crusoé-Rebello I (2017) Cone beam computed tomography assessment of the pterygomaxillary region and palatine canal for Le Fort I osteotomy. Int J Oral Maxillofac Surg 46:1017–1023PubMedCrossRef

24.

Orhan K, Gorurgoz C, Akyol M, Ozarslanturk S, Avsever H (2018) An anatomical variant: evaluation of accessory canals of the canalis sinuosus using cone beam computed tomography. Folia Morphol 77:551–557CrossRef

25.

Orhan K, Sakul BU, Oz U, Bilecenoglu B (2011) Evaluation of the pterygoid hamulus morphology using cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 112:e48–e55PubMedCrossRef

26.

Orra S, Tierney WS, Capone AC, Gharb BB, Papay FA, Doumit G (2017) Relevant surgical anatomy of pterygomaxillary dysjunction in Le Fort III osteotomy. Plast Reconstr Surg 139:701–709PubMedCrossRef

27.

Oz U, Orhan K, Aksoy S, Ciftci F, Özdoğanoğlu T, Rasmussen F (2011) Association between pterygoid hamulus length and apnea hypopnea index in patients with obstructive sleep apnea: a combined three-dimensional cone beam computed tomography and polysomnographic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 112:e48–e55PubMed

28.

Oz U, Rubenduz M (2011) Craniofacial differences between skeletal Class II and skeletal Class I malocclusions according to vertical classification. Int J Stomatol Occlusion Med 4:105–111CrossRef

29.

Pan J‑Y, Chou S‑T, Chang H‑P, Liu P‑H (2006) Morphometric analysis of the mandible in subjects with Class III malocclusion. The Kaohsiung Journal of Medical Sciences 22:331–338PubMedCrossRef

30.

Piva LM, Brito HH, Leite HR, O’Reilly M (2005) Effects of cervical headgear and fixed appliances on the space available for maxillary second molars. Am J Orthod Dentofacial Orthop 128:366–371PubMedCrossRef

31.

Stojcev Stajcić L, Gacić B, Popović N, Stajcić Z (2010) Anatomical study of the pterygopalatine fossa pertinent to the maxillary nerve block at the foramen rotundum. Int J Oral Maxillofac Surg 39:493–496PubMedCrossRef

32.

Tashi S, Purohit BS, Becker M, Mundada P (2016) The pterygopalatine fossa: imaging anatomy, communications, and pathology revisited. Insights Imaging 7:589–599PubMedPubMedCentralCrossRef

33.

Tausche E, Deeb W, Hansen L, Hietschold V, Harzer W, Schneider M (2009) CT analysis of nasal volume changes after surgically-assisted rapid maxillary expansion. J Orofac Orthop 70:306–17. https://doi.org/10.1007/s00056-009-9910-5 PubMedCrossRef

34.

Triftshauser R, Walters RD (1976) Cervical retraction of the maxillae in the Macaca mulatta monkey using heavy orthopedic force. Angle Orthod 46:37–46PubMed

35.

Wieslander L, Tandläkare L (1963) The effect of orthodontic treatment on the concurrent development of the craniofacial complex. Am J Orthod 49:15–27CrossRef

36.

Wieslander L (1975) Early or late cervical traction therapy of Class II malocclusion in the mixed dentition. Am J Orthod 67:432–439PubMedCrossRef

Title: Relationship between pterygomaxillary fissure morphology and maxillary/mandibular position
A cone beam computed tomography assessment
Authors: M. Icen
K. Orhan
U. Oz, DDS PhD
S. Horasan
H. Avsever
Publication date: 01-05-2020
Publisher: Springer Medizin
Keywords: Digital Volume Tomography
Digital Volume Tomography
Published in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie / Issue 3/2020
Print ISSN: 1434-5293
Electronic ISSN: 1615-6714
DOI: https://doi.org/10.1007/s00056-019-00215-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Relationship between pterygomaxillary fissure morphology and maxillary/mandibular position

A cone beam computed tomography assessment

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 3/2020

Banded versus modified appliances for anchorage during maxillary protraction

Mitteilungen der DGKFO

Condylar alterations and facial growth in children with juvenile idiopathic arthritis

Longitudinal changes in the dental arches and soft tissue profile of untreated subjects with normal occlusion

Upper canine response to rapid maxillary expander anchored to deciduous vs. permanent molars

Maxillary protraction in patients with unilateral cleft lip and palate