Assessment of the skull base, pterygomaxillary junction, and its association with the orbit in skeletal malocclusion and cleft lip/palate implications for Le Fort I osteotomy

Q: What was the aim of the study?

To evaluate anatomical characteristics of the skull base and the pterygomaxillary junction (PMJ) in relation to the orbit in individuals with skeletal deformities and cleft lip and palate (CLP).

Q: How were the patients grouped and what imaging was used?

Patients were classified into four groups (Class I, II, III, and CLP) and analyzed using cone-beam computed tomography (CBCT) scans.

Q: What clinically relevant outcome did the study emphasize for Le Fort I osteotomy?

The study highlighted anatomical differences in the PMJ among groups, emphasizing that these variations are clinically relevant for preoperative planning to reduce the risk of unfavorable fractures and ophthalmic complications.

Sep 30, 2026

Uploaded by Anna Hans

This study evaluates anatomical characteristics of the skull base and the pterygomaxillary junction (PMJ) in relation to the orbit in individuals with skeletal deformities and cleft lip and palate (CLP). Cone-beam computed tomography (CBCT) scans were analyzed across four groups (Class I, II, III, and CLP), using measurements of PMJ, skull base, and orbital structures. Group comparisons identified significant morphological differences, supporting clinically relevant preoperative considerations for Le Fort I osteotomy planning to reduce risks of unfavorable fractures and ophthalmic complications.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages14

Reading Time35 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusion

Introduction

Yıldırım etal. BMCOral Health (2026) 26:39 BMC Oral Health [https://doi.org/10.1186/s12903-025-07388-y](https://doi.org/10.1186/s12903-025-07388-y) RESEARCH Open Access Assessment of the skull base, pterygomaxillary junction, and its association with the orbit in skeletal malocclusion and cleft lip/palate implications for Le fort I osteotomy El if Betül Yıldırım 1*, Yeliz Kılınç 1 and Gülsün Akay2 Abstract Background This study aimed to evaluate the anatomical characteristics of the skull base and the pterygomaxillary junction (PMJ) in relation to the orbit in individuals with various skeletal deformitiesand cleft lip and palate (CLP) . Methods Cone beam computed tomography (CBCT) scans of patients classified into four groups (Class I, II, III, and CLP) were analyzed. Various anatomical measurements of the PMJ, skull base, and orbital structures were assessed. Statistical comparisons between groups were performed to identify significant morphological differences. Results Significant variations in PMJ morphology were observed among the study groups. The mean anterior length was significantly greater in patients with CLP (p = 0 . 000), whereas the posterior length was greater in Class III patients (p = 0 . 042) . The thinnest pterygomaxillary region was found in Class III patients (p = 0 . 002) . The width of the maxillary tuberosity, the distance from the superior orbital fissure (SOF)-PMJ and the orbital canal (OC)-PMJ, and the distance between the medial and lateral pterygoid plates on both sides were the lowest in the CLP group (p < 0. 05) . The angle of the PMJ was the highest in the Class II group (p = 0 . 014), whereas the distance between the lateral plates at the hamul us level was the lowest in the Class II group. (p = 0 . 005) Conclusion Our study highlights notable anatomical differences in the PMJ among individuals with skeletal malocclusion and CLP. These variations are clinically relevant for preoperative planning in Le Fort I osteotomy, particularly in reducing the risk of unfavorable fractures and ophthalmic complications. These findings underscore the importance of individualized surgical approaches based on anatomical assessments. Keywords Cleft lip and palate, Cone-beam computed tomography, Skeletal malocclusion, Pterygomaxillary junction *Correspondence: El if Betül Yıldırım [elifbetulyildirim@gazi.edu.tr](elifbetulyildirim@gazi.edu.tr) 1Faculty of Dentistry, Department of Oral and Dentomaxillofacial Surgery, Gazi University, Bişkek Ave. 1st St. No: 8 Emek, Çankaya, Ankara, Turkey 2Faculty of Dentistry, Department of Oral and Dentomaxillofacial Radiology, Gazi University, Ankara, Turkey © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/l](vecommons.org/l)icenses/by-nc-nd/4.0/. Yıldırım et al. BMC Oral Health (2026) 26:39 Introduction The history of Le Fort I osteotomy dates back to 1859, when Von Langenbeck performed an osteotomy at the Le Fort I level to facilitate the removal of nasopharyngeal polyps [

FAQs

What was the aim of the study?

To evaluate anatomical characteristics of the skull base and the pterygomaxillary junction (PMJ) in relation to the orbit in individuals with skeletal deformities and cleft lip and palate (CLP).

How were the patients grouped and what imaging was used?

Patients were classified into four groups (Class I, II, III, and CLP) and analyzed using cone-beam computed tomography (CBCT) scans.

What clinically relevant outcome did the study emphasize for Le Fort I osteotomy?

The study highlighted anatomical differences in the PMJ among groups, emphasizing that these variations are clinically relevant for preoperative planning to reduce the risk of unfavorable fractures and ophthalmic complications.

Sep 30, 2026

Uploaded by Anna Hans