Paradigm Shift in Orthognathic Surgery: Surgery First Orthognathic Approach and Aesthetic Two-jaw Surgery

Orthognathic surgery became more popular because people are more interested in facial profile changes and are more receptive to surgery. As people seek beauty as well as function in maxillofacial surgery, patient's aesthetic demand becomes higher. Considering these big changes, one of the major reasons is surgery-first orthognathic approach(SFOA), which removes pre-surgical orthodontic treatment. Pre-surgical orthodontic time has been a great barrier to patients in terms of time and social rehabilitation. By SFOA, patients can get surgery as soon as they make up their mind; Patients from abroad can get surgery and get back to their country; They can go back to their work more easily because their occlusion is more acceptable. Surgery first orthognathic approach is still developing in practice and principle. However, as it is based on patient's need, it will play a greater part in the field of orthognathic surgery. Surgery first orthognathic approach together with aesthetic two jaw surgery are expected to change the paradigm in orthognathic surgery.

Midfacial distraction osteogenesis of Crouzon syndrome with RED(Rigid External Distraction) system / 대한치과교정학회지

Crouzon syndrome is one of the craniofacial syndromes characterized by craniosynostosis, midfacial hypolpasia and ocular proptosis. Distraction osteogenesis is becoming important technique to treat craniofacial dysplaisa. It has many advantages compared with standard orthognathic surgery. Maxillary distraction osteogenesis after Le Fort III osteotomy with the RED system presents successful maxillary protraction to Crouzon syndrome patient with severe maxillary deficiency. It also allows remarkable improvement of facial esthetics and respiratory functions.

The comparison of landmark identification errors and reproducibility between conventional lateral cephalometric radiography and digital lateral cephalometric radiography / 대한치과교정학회지

The purpose of this study is to evaluate the reproducibility and errors in landmark identification of conventional lateral cephalometric radiography and digital lateral cephalometric radiography. Fifteen conventional lateral cephalometric radiographs and fifteen digital lateral cephalometric radiographs were selected in adults with no considerations on sex and craniofacial forms. Each landmark was identified and expressed as the coordinate (x, y). The landmarks were classified into 3 groups. The landmarks of the first identification was T1, identification after one week was T2, and identification after one month was T3. The mean and standard deviation of identification errors between replicates were calculated according to the x and y coordinates. The errors between first identification and second identification were expressed as T2-T1(x), T2-T1(y) and those between first identification and third identification were expressed as T3-T1(x), T2-T1(y). Each was divided into conventional lateral cephalometric radiography and digital lateral cephalometric radiography. The independent t-test was used for statistical analysis of identification errors for the evaluation of reproducibility. The results of this study were as follows; 1. Generally, the mean and standard deviation of landmark identification errors in digital lateral cephalometric radiography was smaller than those of conventional lateral cephalometric radiography. 2. Only a few landmarks showed statistically significant difference in identification error between conventional lateral cephalometric radiography and digital lateral cephalometric radiography. 3. The enhancement of image quality didn't guarantee decrease in landmark identification error and didn't affect tendency of landmark identification error.