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Background: The posterosuperior maxillary region poses a challenge in orthognathic surgery due to its complex three-dimensional anatomy. The pterygomaxillary suture (PMS) is a key landmark for various procedures. Understanding its anatomical relationships is essential to improving surgical precision. Methods: A retrospective analysis of CBCT images from 120 patients aged 18–70 years at Ankara Medipol University was conducted. Patients were categorized into skeletal Classes I, II, and III according to the ANB angle. Linear and angular measurements of the PMS and adjacent structures were performed. The statistical analysis included the Shapiro–Wilk, Independent t-test, Mann–Whitney U test, and regression analysis (p < 0.05). Results: There were clear differences between the skeletal groups. Class II and III patients had a lesser lateral PMS–baseline intersection distance (IV–VI) and Class II had a lesser medial PMS–baseline perpendicular distance (VV′) compared to Class I (p < 0.05). Additionally, the angle V–IV–VI was significantly narrower in Class II and III groups, indicating altered PMS orientation in these skeletal patterns. Conclusions: PMS morphology, including thickness, width, and angulation, is influenced by skeletal pattern. A preoperative CBCT assessment and individualized surgical planning are essential to ensure the safety and accuracy of Le Fort I osteotomies, especially in Class II and III patients.

ObjectiveTo evaluate changes in the masseter muscle after orthognathic surgery using electromyography (EMG), ultrasonography (US), and ultrasound elastography (USE) in individuals with skeletal class III anomaly over long-term follow-up and compare with a control group.Materials and methodsThe study group included 29 patients with class III dentofacial deformities scheduled to undergo orthodontic treatment and orthognathic surgery. The control group included 20 individuals with dental class I occlusion. Assessment of the masseter muscles using EMG, US, and USE was performed before orthognathic surgery (T1) and at postoperative 3 months (T2) and 1 year (T3) in the study group, and at a single time point in the control group. All assessments were performed at rest and during maximum clenching. Masseter muscle activity, dimension, and hardness were analyzed.ResultsElectromyographic activity of the masseter muscle during maximum clenching was increased at postoperative 1 year but did not reach control group values. On ultrasonography, the masseter muscle showed minimal changes in dimension at postoperative 1 year compared to preoperative values and remained below control group values. The postoperative increase in masseter muscle hardness at rest and during maximum clenching persisted at postoperative 1 year.ConclusionThe results of this study suggest that after orthognathic surgery, additional interventions and much longer follow-up are needed to ensure better muscle adaptation to the new occlusion and skeletal morphology.Clinical relevanceAll assessment methods are useful for comprehensively evaluating changes in the masticatory muscles after orthognathic surgery.

PurposeVariations in nasal wall anatomy are crucial in patients with dentofacial deformities undergoing Le Fort I osteotomy. These structural variations heighten the potential for complications during surgical procedures. Hence, the study focused on evaluating the differences in the lateral nasal wall anatomy across different skeletal Classes.MethodsThis study evaluated 86 patients aged 18–43 years with different skeletal Classes. In the axial images acquired from coronal sections, two angulations and the linear distances of the lateral nasal wall were measured in Class I, II, and III patients. The measurement between the piriform opening and the most anterior point of the greater palatine foramen was evaluated in three parts regarding the osteotomy line. Differences between the skeletal patterns were analyzed using an independent sample t-test and Mann–Whitney U test with a significance level of 0.05. The intra-class correlation coefficient was calculated for inter-observer and intra-observer agreement.ResultsThere was a statistically significant difference between Class I and Class II subjects regarding the anterior lateral nasal wall (p = 0.011) and anterior nasal thickness (a) (0.004). There was a significant difference between Class I and Class III patients regarding anterior nasal thickness (a) (p < 0.001) and total lateral nasal wall length (p < 0.001).ConclusionFor instance, the measurements of Class III and Class II patients were relatively different from those of the Class I patients. Therefore, preoperative Cone-Beam Computed Tomographic analysis should be performed for each patient prior to Le Fort I osteotomy to ensure that the procedure is performed safely.

Osteochondromas rarely affect the mandibular condyle. An unusual case of an osteochondroma occurring in the left mandibular condyle in a 40-year-old man who presented with mandibular deviation and malocclusion is reported; this represents the 37th documented case in the English-language literature. The tumor was resected through condylectomy. Four-year follow-up assessments revealed satisfactory function and occlusion, without evidence of recurrence of the tumor.

Temporomandibular joint (TMJ) ankylosis is characterized by the formation of bony or fibrous mass, which replaces the normal articulation and limitation of mouth opening. This study aims to determine the efficacy of arthroplasty and interpositional fascia flap in the treatment of unilateral and bilateral TMJ ankylosis in three young adult men. Our operative protocol for unilateral and bilateral TMJ ankylosis entailed resection of ankylotic mass, intraoral ipsilateral and bilateral arthroplasty, interpositional tissue transfer to the TMJ with temporalis superficial fascia flap, maxillomandibular fixation, and early mobilization and aggressive physiotherapy. Early postoperative initial exercise, physiotherapy, and strict follow-up play an important role in preventing postoperative adhesions. The temporalis superficial facia flap is an autogenous graft that has the advantages of close proximity to the TMJ minimal surgical morbidity, and successful clinical results. It was found to be a valuable option for TMJ ankylosis reconstruction.

Maxillofacial trauma is the main cause of emergency admittance to dental clinics. Mental retardation and epileptic status are important factors in an increase in the risk of dental injuries. Tooth avulsion, which is the total displacement of a tooth out of its socket, is an infrequently observed entity. Maxillary central incisors are the most commonly affected teeth. The case of a patient with severe dental injury resulting from an epileptic attack is presented. He had several teeth avulsed and displacement of a tooth into the soft tissue of the chin.

A case report of an ameloblastic fibrodentinoma (AFD) in a 21-year-old female patient is presented. This rare, benign tumor was surgically treated. The histological findings and follow-up are presented.

A case report of an ameloblastic fibrodentinoma (AFD) in a 21-year-old female patient is presented. This rare, benign tumor was surgically treated. The histological findings and follow-up are presented.