“…Sygouros et al 9 assessed the pre-op and post-op diameter changes of the piriform aperture as the anterior skeletal change, the inter-zygomatic width alterations (Jugale "J" distance defined as the intersection between the arch of zygomatic process and horizontal line passing through the nasal floor) as the mid-maxillary width changes, and the alterations in the distance between the anterior points of pterygoid plates, as for the posterior skeletal changes. In this study true anterior skeletal expansion both with and without PMD was achieved.…”