Comparison of Postoperative Stability between Distraction Osteogenesis and Bilateral Sagittal Split Ramus Osteotomy in Mandibular Retrognathism

0.05). Mean follow up periods were 10.77 months for BSSRO group and 11.28 months for DO group, respectively. After mandibular advancement, mean positional changes in the condyle were 0.56+/-1.43 mm horizontally and 0.72+/-1.61 mm vertically for BSSRO group and 0.53+/-1.56 mm horizontally and 0.56+/-1.75 mm vertically for DO group, respectively. Mean change of distance from B point to Y-axis was -1.76+/-0.83 mm for BSSRO group and -2.14+/-1.82 mm for DO group, respectively. According to the condylar position and B point, there were no significant differences in postoperative stability between the two groups (P>0.05).CONCLUSION: There was no significant difference in postoperative stability between DO and BSSRO group according to condylar position and B point. Based on the results of the present study, it is hypothesized that DO would be a good treatment choice for severe mandibular retrognathism because DO could achieve more mandibular advancement and concurrent soft tissue elongation.

An Investigation of Hyoid Bone Position and Airway Space in Class III Malocclusion after Orthognathic Surgery

Initial Stability after Bilateral Sagittal Split Ramus Osteotomy Application in Patients with Mandibular Prognathism

Changes of Pharyngeal Airway Space after Mandibular Setback Surgery in Computed Tomography Images

Soft tissue changes in skeletal class II patients treated with bilateral sagittal split osteotomy advancement surgery

The purpose of this study was to examine the soft tissue changes in skeletal class II patients after mandibular advancement by bilateral sagittal split ramus osteotomy (BSSRO). In Asian population, the incidence of skeletal class II malocclusion is lower than that of skeletal class III malocclusion unlike the caucasians. This study was conducted to figure out the ratio at which hard tissue and soft tissue changes after mandibular advancement by analyzing cephalograms of 13 patients that have undergone the mandibular advancement surgery. As a result, change ratios of Li, B', Pog' according to the movement of li, B, Pog were found to be 0.59, 1.06, 0.82. Also, vertical height of vermilion zone (Si-Vb) and lower lip and chin (Si-Me') were measured to evaluate vertical changes. Vermilion zone showed tendency to decrease by 1.02 mm on the average postoperatively, whereas vertical length of lower lip and chin showed tendency to increase by 3.57 mm on the average.

CLINICAL STUDY OF SENSORY ALTERATIONS AFTER SAGITTAL SPLIT RAMUS OSTEOTOMY

The Evaluation of the Positional Change of the Mandibular Condyle after Bilateral Sagittal Split Ramus Osteotomy using Three Dimensional Computed Tomography in Skeletal Class Iii Patients

PURPOSE: This study was performed to evaluate three-dimensional positional change of the condyle using 3D CT after bilateral sagittal split ramus osteotomy (BSSRO) in skeletal class III patients. PATIENTS AND METHODS: Nine patients who underwent BSSRO for mandibular set-back in skeletal class III malocclusion without facial asymmetry were examined. Miniplates were used for the fixation after BSSRO. 3-D CT was taken before, immediately after, and 6 months after undergoing BSSRO. After creating 3D-CT images using V-works 4.0(TM) program, axial plane, coronal plane, < sagittal plane were configured. Three dimensional positional change, from each plane to the condyle, of the nine patients was measured before, immediately after, and 6 months after undergoing BSSRO. RESULTS: 1. The mean value of mandibular set-back for nine mandibular prognathism patients was 7.36 mm (+/- 2.42 mm). 2. In the axial view, condyle is rotated inward immediately after BSSRO (p < 0.05), comparing with preoperative but outward 6 months after BSSRO comparing with postoperative (p < 0.05). 3. In the axial view, condyle is moved laterally immediately after BSSRO (p < 0.05), comparing with preoperative but regressed 6 months after BSSRO comparing with preoperative (p < 0.05). 4. In the frontal < coronal view, there is changed immediately after and 6 months after BSSRO, comparing with preoperative but no statistical difference. CONCLUSION: These results indicate that three-dimensional positional change of the condyle in skeletal class III patients is observed lateral displacement < inward rotation immediate after BSSRO, but the condyle in 6 months after BSSRO tends to regress to preoperative position.

Changes in hyoid bone and tongue positions, and oral cavity volume after mandibular setback by sagittal split ramus osteotomy

Treatment of transverse deficiency of maxilla with sarpe in cleft palate

Patients who have repaired cleft lip and palate generally undergo restriction of maxillary growth. Concave facial profile is often exhibited with relatively normalized mandible. Horizontal and sagittal deficiency of the maxilla could cause anterior and posterior crossbites. In growing patients, orthodontic and orthopedic treatment is acceptable with maxillary expansion and protraction. However, surgical approach has to be accompanied with orthodontic treatment in skeletally matured patients. We used SARPE and BSSRO to expand the constricted maxilla and retract the mandible in a patient who had cleft palate repaired in infancy. Through SARPE, orthodontic treatment and BSSRO, we sufficiently expanded the maxillla and improved facial profile.

Treatment of transverse deficiency of maxilla with sarpe in cleft palate

Patients who have repaired cleft lip and palate generally undergo restriction of maxillary growth. Concave facial profile is often exhibited with relatively normalized mandible. Horizontal and sagittal deficiency of the maxilla could cause anterior and posterior crossbites. In growing patients, orthodontic and orthopedic treatment is acceptable with maxillary expansion and protraction. However, surgical approach has to be accompanied with orthodontic treatment in skeletally matured patients. We used SARPE and BSSRO to expand the constricted maxilla and retract the mandible in a patient who had cleft palate repaired in infancy. Through SARPE, orthodontic treatment and BSSRO, we sufficiently expanded the maxillla and improved facial profile.

A Case Report of the Facial Asymmetry by Infantile Maxillofacial Surgery

Changes in Tongue Position, Airway Width, Gonial Angle, Lower Facial Height after Bilateral Sagittal Split Ramus Osteotomy in Mandibular Prognathic Patients

INTRODUCTION: In patients with mandibular prognathism, Bilateral Sagittal Split Ramus Osteotomy(BSSRO) combined with orthodontic treatment reduces oral volume and influences tongue and other surrounding tissues. Purpose of this study was to analyze post-operative tongue position and airway dimension, as well as mandibular changes in vertical, horizontal, and angular dimensions. MATERIALS AND METHODS: Height of dorsum of tongue, width of airway, gonial angle and lower facial height of mandibular prognathic patients who visited Kangdong Sacred Heart Hospital from Jan. 2001 to Dec. 2006 were anaylzed via pre-operative and post-operative cephalograms. T-test was used to compare pre-operative and post-operative measurements. Also, correlations among pre-operative measurements of the patients were analyzed. RESULTS AND CONCLUSION: A significant correlation was shown between ANS-Xi-PM area and location of dorsum of tongue in pre-operative patients. A significant superior movement of tongue and decrease of airway width was observed in post-operative patients. Also the upper gonial angle decreased significantly.

Clincal analysis of skeletal stability after BSSRO for correction of skeletal class III malocclusion patients with anterir open bite

This study was conducted to patients visited oral maxillo-facial surgery, KNUH and the purpose of the study was to assess skeletal and dento-alveolar stability after surgical-orthodontic correction treated by skeletal Class III malocclusion patients with open bite versus non-open bite. This retrospective study was based on the examination of 40 patient, 19 males and 21 females, with a mean age 22.3 years. The patients were divided into two groups based on open bite and non-open bite skeletal Class III malocclusion patients. The cephalometric records of 40 skeletal Class III malocclusion patients (open bite: n = 18, non-open bite: n = 22) were examined at different time point, i.e. before surgery(T1), immediately after surgery(T2), one year after surgery(T3). Bilateral sagittal split ramus osteotomy was performed in 40 patients. Rigid internal fixation was standard method used in all patient. Through analysis and evaluation of the cephalometric records, we were able to achieve following results of post-surgical stability and relapse. 1. There was no significant statistical differences between open bite and non-open bite with skeletal Class III malocclusion patients in maxillary occlusal plane angle of pre-operative stage(p>0.05). 2. Mean vertical relapses of skeletal Class III malocclusion patients with open bite were 0.02+/-1.43mm at B point and 0.42+/-1.56mm at Pogonion point. In skeletal Class III malocclusion patients with non-open bite, 0.12+/-1.55mm at B point and 0.08+/-1.57mm at Pogonion point. There was no significant statistical differences between open bite and non-open bite with skeletal Class III malocclusion patients in vertical relapse(p>0.05). 3. Mean horizontal relapses of skeletal Class III malocclusion patients with open bite were 1.22+/-2.21mm at B point and 0.74+/-2.25mm at Pogonion point. In skeletal Class III malocclusion patients with non-open bite, 0.92+/-1.81mm at B point and 0.83+/-2.11mm at Pogonion point. There was no significant statistical differences between open bite and non-open bite with skeletal Class III malocclusion patients in horizontal relapse(p>0.05). 4. There were no significant statistical differences between open bite and non-open bite with skeletal Class III malocclusion patients in post-surgical mandibular stability(p>0.05). and we believe this is due to minimized mandibular condylar positional change using mandibular condylar positioning system and also rigid fixation using miniplate 5. Although there was no significant relapse tendency observed at chin points, according to the Pearson correlation analysis, the mandibular relapse was influenced by the amount of vertical and horizontal movement of mandibular set-back(p=0.05, r>0.304).

The study on vertical stability of anterior open bite patients after bssro

PURPOSE: The purpose of this study was to investigate the vertical stability after BSSRO surgery in skeletal class III malocclusion patients with mild anterior open bite and to present a method to increase the stability. MATARIALS AND METHODS: 36 patients, 11 male and 25 female, who received BSSRO surgery with the diagnosis of skeletal class III with anterior open bite at the Department of Oral and Maxillofacial Surgery in Samsung Medical Center, from January 2002 to August 2003, were selected for this study. The patients were between 18 to 45 years of age. Preoperative and postoperative (immediate, 6 months, and 1 year after operation) lateral cephalograms were compared to evaluate the vertical stability by measuring the distance of nasion-menton, mandibular plane angle, and overbite. RESULTS: The nasion-menton distance decreased by 1.65mm immediately after the operation in comparison to the preoperative value. This distance further decreased by 0.60 mm at 6 months and 1.06 mm at 1 year after the operation. The mandibular plane angle increased after the operation and further increased at 6 months and 1 year. The amount of overbite increased by the operation was 2.34mm and an additional increase of 0.70mm at 6 months and 0.94 mm at 1 year were shown. CONCLUSION: Clinically, none of the patients showed relapse of anterior open bite and the vertical stability is highly influenced by orthodontic treatment after the operation. In this study, BSSRO surgery is considered to be a rather reliable procedure that restores stability to skeletal class III malocclusion patients with slight anterior open bite.

The effect of early removal of the fixation plates and active mouth opening exercise on the temporomandibular dysfunction after mandibular setback surgery

Morphologic study for sagittal split ramus osteotomy using 3-D image in mandibular prognathism

Stability after surgical correction of mandibular prognathism using bilateral saggital split ramus osteotomy and fixation with Poly-L/DL-Lactide copolymer screws (biosorbTMFX)

Neurosensory deficit after orthognathic surgery

AIMS:This study was designed to determine the incidence of altered sensation in patients undergoing orthognathic surgery. METHOD: Seventy two patients who underwent orthognathic surgery between January, 1999 and December, 1999 constituted the study group. Seven patients were excluded because of lack of follow up. Sixty five patients were followed using objective and subjective neurologic testing during the period immediately following operation, 1 month, 2 months, 6 months, and 1 year postoperatively. Age ranged from 17 to 38 years, with a mean of 24.5 years. Male patients were 21, female 44. Twenty eight bilateral sagittal splitting ramus osteotomy(BSSRO) of mandible were performed, 35 BSSRO with genioplasty, 2 genioplasties. Information on the degree of intraoperative nerve encounter was obtained from the surgical reports in 47 patients and was divided into the following three categories: (1) the nerve was not encountered in 23 patients; (2) the nerve was exposed in 11 patients; (3) the nerve was exposed and repositioned from the proximal segment in 13 patients. RESULTS: Four patients reported altered nerve sensation of lower lip and/or chin(6.2%) at final follow up. Two patients underwent BSSRO and the other two patients BSSRO with genioplasty. Three of the patients underwent nerve exposure during the operation. CONCLUSION: We suggest that the nerve exposure during the operation might be partly responsible for nerve dysfunction after orthognathic surgery.

A clinical study on the effects of bilateral sagittal split ramus osteotomy on the postoperative condylar positional changes in the mandibular prognathism

Neurosensory Recovery Of The Inferior Alveolar Nerve After Bilateral Sagittal Split Osteotomy