ABSTRACT
Background@#Many studies on maintaining the condyle in a normal or anatomical position during orthognathic surgery have been conducted to stabilize surgical outcomes and prevent iatrogenic temporomandibular joint complications. The aim of this study is to evaluate the changes in condylar positions after orthognathic surgery using virtual surgical planning via the balanced orthognathic surgery (BOS) system. @*Methods@#Postoperative changes in condylar position were retrospectively evaluated in 22 condyles of 11 patients with skeletal class III malocclusion who underwent orthognathic surgery using virtual surgical planning via the BOS system. The center point coordinates of the condylar head before and after orthognathic surgery were analyzed using voxel-based registration. @*Results@#Changes in the condylar position mainly occurred downward in the y-axis (−1.09 ± 0.62 mm) (P < 0.05). The change in the x-axis (0.02 ± 0.68 mm) and z-axis (0.01 ± 0.48 mm) showed no significant difference between before and after orthognathic surgery. @*Conclusion@#These results indicate that the changes in the condylar positions after orthognathic surgery using virtual surgical planning via the BOS system mainly occurred downward in the y-axis, with slight changes in the x- and z-axes. The change in the condylar position after orthognathic surgery using the BOS system is clinically acceptable.
ABSTRACT
Computer Assisted Simulation Surgery (CASS) is a reliable method that permits oral and maxillofacial surgeons to visualize the position of the maxilla and the mandible as observed in the patient. The purpose of this report was to introduce a newly developed strategy for proximal segment management according to Balanced Orthognathic Surgery (BOS) protocol which is a type of CASS, and to establish the clinical feasibility of the BOS protocol in the treatment of complex maxillo-facial deformities. The BOS protocol consists of the following 4 phases: 1) Planning and simulation phase, 2) Modeling phase, 3) Surgical phase, and 4) Evaluation phase. The surgical interventions in 80 consecutive patients were planned and executed by the BOS protocol. The BOS protocol ensures accuracy during surgery, thereby facilitating the completion of procedures without any complications. The BOS protocol may be a complete solution that enables an orthognatic surgeon to perform accurate surgery based on a surgical plan, making real outcomes as close to pre-planned outcomes as possible.
Subject(s)
Humans , Congenital Abnormalities , Head , Mandible , Maxilla , Methods , Oral and Maxillofacial Surgeons , Orthognathic SurgeryABSTRACT
The purpose of this study was to evaluate the result after 2-phase surgical-orthodontic treatment without preoperative orthodontic treatment for the skeletal Cl III malocclusion patient and to obtain an adequate protocol on the bases of this result. This retrospective study of ten patients who underwent 2-phase treatment were done to evaluate 1) the surgical stability and relapse pattern 2) the facial esthetics 3) the TMJ problem 4) the total time of the treatment. Results were followed : 1) The horizontal relapse of the mandible was 26.8% and didn't show significant differences compared to the conventional 3-phase treatment. But, it was considered that this amount of relapse was the sum of true relapse and autoratation of mandible due to decreased vertical dimension during orthodontic treatment. 2) It was estimated that there's no difference on the ratio of anterior facial height between the subjects and the normal patients. On the horizontal analysis, the mandible of the subjects was located more anteriorly than that of the normal patients. This result showed that there was a need for the accurate preoperative esthetic evaluation and the additional methods for reducing the relapse due to the occlusal interference. 3) Wide variation was noted on the TMJ symptoms of the subjects, however, it was estimated that there's no significant differencees of symptoms compared to that of the conventional 3-phase treatment on literatures. 4) The average of the overall period of treatment was 20.8 months and we obtained reduction of the treatment time compaired to 3-phase treatment on many literatures. Most of the results of this study were similar to the findings of the 3-phase treatment(preoperative orthodontic-orthognathic surgery-postoperative orthodontic), but total time of the treatment was shorter in patients with 2-phase treatment than in those with the conventional 3-phase treatment. With 2-phase treatment, we experienced many advantages compared to the conventional method considering that it was favarable conditions for the teeth, it had the flexibility for the treatment, and it could be the adequate treatment approach for the stomatognathic system. Although this retrospective pilot study had some limitations, due to small samples, the authors would hope that it could serve as a guide for the future reaearches, and the clinical applications.
Subject(s)
Humans , Esthetics , Hope , Malocclusion , Mandible , Pilot Projects , Pliability , Recurrence , Retrospective Studies , Stomatognathic System , Temporomandibular Joint , Tooth , Vertical DimensionABSTRACT
The aim of this study were to measure and compare the stress level on three type brackets and each other material (stainless steel, ceramic) with tipping and torquing forces by using the finite element analysis and to design bioniechanically favorable brackets. For this study, three kinds of brackets were selected(A:Transcend-RMO, B:Signature-Unitek, C:PAW plain archwire appliance-applied for a patent in Yonsei University). The slot size of bracket was 0.022inch and the size of archwire was 0.0175x0.025inch and taper shaped archwire was used in PAW. Loading force in tipping was 4.27N and torquing force was 32.858N applied by archwire torsion with 19.7degree and 113 degree in C type bracket. The conclusions were that (1) The finite element method proved to be a useful tool in the stress analysis of orthodontic bracket subjected to various forces. (2) With tipping, the stresses were concentrated at the gingival wall of the wire slot where it meets the mesial bracket surface and the incisal wall of the wire slot where it meets the distal bracket surface and with torquing, the stresses were concentrated at the junction of the gingival or incisal wall and base of the slot. (3) The maximum stress value was higher in torquing force than tipping force and therefore it is desirable to design on the basis of torquing force. (4) It was considered that the change in material might be affect on the diminish of stress value in the place of stess concentration. (5) The maximum stress value was highest on PAW bracket when the tipping and torquing force was applied and therefore it would be desirable to use mechanically favorable material on PAW bracket.
Subject(s)
Finite Element Analysis , Orthodontic Brackets , SteelABSTRACT
This study was undertaken to investigate the midline having the least difference between the right and left structures among the lines that had been used in the study of the craniomaxillofacial asymmetry. The sample of this study consisted of twenty six Korean girls(average 18.9 years old) having normal facial appearance and occlusion. On the frontal cephalometric films of the sample, we divided the whole craniomaxillifacial area into four portions, i.e., cranial, upper facial, lower facial, and dental portion. So, we have found the midlines having the least difference in the whole craniomaxillofacial area itself, and in the each divided four portions, furtherly in the other portions from aimed portion. The findings were as follow: 1. In the whole craniomaxillofacial area, the connecting line between crista galli and anterior nasal spine and the perpendicular bisecting line between right and left foramen rotundums were suitable for the midline. 2. In the cranial portion, established all six lines were suitable for midlines. In the other portions, the perpendicular bisection line between both condylion, the line passing the contact point between right and left mandibular central insisiors among the perpendicular lines between right and left mandibular central incisial tips were suitable midlines for evaluating the asymmetry of cranial portion. 3. In the upper facial portion, the perpendicular bisecting line between right and left zygions was the most suitable midline. In the other portions, the line between the crista galli and the most superior point of the odontoid process, the perpendicular bisecting line between right and left gonions, the perpendicular bisecting line between right and left condylions, and perpendicular bisecting line between right and left foramens rotundum were suitable midlines for evaluating the asymmetry of the upper facial portion 4. In the dental portion, the perpendicular bisecting lines between right and left buccal cusps of both maxillary first molars and between right and left mandibular first molars were suitable midlines. In the other portions, the perpendicular bisecting line between right and left landmarks crossing the lesser wing of the sphenoid bone and orbit, the perpendicular bisecting line between right and left mental foramens, and the connecting line between crista galli and prosthion were suitable midlines for evaluating the asymmetry of dental portion. 5. In the lower facial portion, the perpendicular bisecting lines between right and left condylions and between right and left gonions were suitable midlines. In the other portions, the line between the crista galli and anterior nasal spine, the perpendicular bisecting line between right and left foramen rotundums, and the perpendicular bisecting lines between right and left buccal cusps of both mandibular first molars and between right and left maxillary first molars were suitable midlines for evaluating the asymmetry of the lower facial portion.
Subject(s)
Molar , Odontoid Process , Orbit , Sphenoid Bone , SpineABSTRACT
The purpose of this study was to help examining force system, optimal treatment, and prevention of relapse. Orthodontic force was generated by electromagnets, therefore duration could be freely controlled, and applied for 4 days in dogs. Force magnitude was 200gm and 50gm. duration was contious and intermittent. Intermittent duration was divided into 2 kinds of types in on/off, 1 mininute/1 minute, 10 seconds/1 minute. The results were as follows: 1. In the intermittent group to which force was applied for 10 seconds and ceased for 1 minute, osteoclast was not observed. 2. In the intermittent group to which 200gm of force was applied for 1 minute and ceased for 1 minute, there was blood circulation in periodontal space on pressure side, but mild hyalinized zone was observed. 3. More number of total osteoclast was counted in the pressure side of continous group to which 200gm of force was applied than in any other groups. 4. More number of frontal osteoclast was counted in the pressure side of intermittent group to which 200gm was applied for 1 minute and ceased for 1 minute than in any other groups. 5. On tension side, less periodontal space widening, more new bone and secondary cementum formation were observed in the intermittent group to which force was applied for 1 minute and ceased for 1 minute than in the continous group.