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Objective:To investigate the effect of mandibular angle osteotomy on the morphological changes of mandible by using cone beam computed tomography (CBCT) scanning data and three-dimensional cephalometry.Methods:According to included and excluded criteria, the complete CBCT data of 20 female patients (aged 20-35 years with an average age of 25.5 years) from January 2016 to June 2018 who underwent curved mandibular angle osteotomy combined with splitting cortiectomy were selected. Seven items reflecting mandibular morphology before and after surgery were measured respectively. All the data were analyzed by the means of SPSS 12.0; linear correlation analysis and paired t test were used to evaluate the change of andibular morphology.Results:The measurement results of the mandible pre- and post-operative 10 days showed as follows: Go-Go decreased, both sides of Cd-Go, Go-Ri and MR-MA decreased, both sides of Go-Me became longer, both sides of Ar-Go-Me and MP-FH increased. The paired t-test results showed that there was significant difference before and after operation ( P<0.05), but there was no significant difference between the left and right measurement items ( P>0.05). Compared with that in 10 days after operation, the measurement items also changed 6 months after operation. There was no statistical difference between the above measurement items 6 months after surgery and 10 days after surgery ( P>0.05), and no statistical difference between the left and right sides ( P>0.05). Conclusions:The mandibular three-dimensional model which is reconstructed based on CBCT data, not only displays the three-dimensional anatomical structure that cannot be presented on X-ray film visually and comprehensively by means zoom, rotation and other operations, but also precisely and accurately shows the change of the shape of the mandible from the sagittal, coronal and horizontal plane with arbitrary cutting and rotation. The measurement of mandible is more accurate and reliable, and the surgical plan of mandibular angle osteotomy can be accurately planned preoperatively, and the operative effect can be quantitatively evaluated postoperatively.
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RESUMEN: Introducción: Las fracturas mandibulares producen serias comorbilidades, alteraciones en la función, calidad de vida entre otros. Existen distintas alternativas quirúrgicas en las fracturas favorables de ángulo mandibular, siendo las más utilizadas las técnicas de estabilización mediante miniplacas de titanio. No existe consenso sobre si es más efectivo y seguro utilizar una o dos miniplacas de titanio. Métodos: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. Resultados y conclusiones: Identificamos 7 revisiones sistemáticas que en conjunto incluyeron 17 estudios primarios, de los cuales 3 son ensayos aleatorizados. Concluimos que el tratamiento de estabilización mediante una miniplaca de titanio probablemente disminuye el riesgo de paresia facial. Por otro lado, el uso de una miniplaca podría aumentar el riesgo de dehiscencia de la herida quirúrgica, disminuir el riesgo de reintervención quirúrgica y podría resultar en poca o nula diferencia en el riesgo de maloclusión, pero la certeza de la evidencia es baja. No está claro si el uso de una en comparación con dos miniplacas de titanio reduce el riesgo de infección y parestesia ya que la certeza de la evidencia disponible es muy baja.
ABSTRACT: Introduction: Mandibular fractures produce severe comorbidities, functional alterations, changes in the quality of life, among others. There are different surgical alternatives for favorable mandibular angle fractures; the most used is the stabilization techniques using titanium miniplates. There is no consensus on which it is more effective and safe; use one or two titanium miniplates. Methods: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. Results and conclusions: We identified seven systematic reviews that included 17 primary studies, in which three were randomized trials. We conclude that stabilization treatment with a titanium miniplate probably reduces the risk of facial paresis. On the other hand, the use of a miniplate could increase the risk of dehiscence of the surgical wound, decrease the risk of reoperation, and could result in little or no difference in the risk of malocclusion, but the certainty of the evidence is low. It is not clear whether the use of one compared to two titanium miniplates reduces the risk of infection and paresthesia since the certainty of the available evidence is very low.
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Humans , Titanium , Dental Plaque , Mandibular FracturesABSTRACT
Objective Researching the influence on patients with different eating ways after the operation of mandibular angle osteotomy of inside oral cavity. Method By using the method of convenience sampling, 50 patients were chosen who had operation of mandibular angle osteotomy of inside oral cavity in orthopedic surgery department of our hospital from January 2017 to December 2017 and the number was arranged according to the order of hospitalization. Patients with singular member were divided into the month feeding group (liquid diet were fed with the injection syringe which linked leather hose of 4-5cm after 6 hours awakening after general anesthesia in operation); patients with even number were divided into the nasal feeding group (stomach tube was put in the operation and nasal feeding was provided after 6 hours awakening after general anesthesia in operation and 5 hours after the operation). In every group, there were 25 patients. Observation scale which was made by themselves was used to evaluate the patients in the two groups and comparison for difference was made in the two groups, including weight change, wound drainage amount, oral wound secretion, the aspects of choke and cough, and the comfortable sensation of eating. Results For weight, in nasal feeding group, (2.19 ± 0.48) kg were reduced and in month feeding group, (5.78 ± 0.58) kg were reduced; the difference had the statistical significance (t＝23.870, P<0.05). For wound drainage amount, in nasal feeding group, the number was (38.00 ± 11.00)ml and in month feeding group, the number was (65.00 ± 13.00) ml, the difference was statistically significant (t＝7.927, P<0.01). In the aspects of choke and cough, and wound secreta in oral cavity, in nasal feeding group, the number were 16% (4/25) and 44% (11/25) respectively which was superior to the month feeding group with the number of 44% (11/25) and 76% (19/25), the difference had the statistical significance (χ2＝4.667, 5.333, P<0.05). For the comfortable sensation of eating, in the two groups, there was no significant statistical difference (χ2＝0.764, P>0.05). Conclusion The nasal feeding way can improve recovery level for patients after the operation of mandibular angle osteotomy of inside oral cavity and it is worthy of promotion in clinic application.
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Biodynamics of mandibular angle fractures has been extensively discussed in the literature in search for the best way to fixate and expedite recovery of trauma patients. Pioneers like Michelet and Champy had the greatest impact on evolving of osteosynthesis in maxillofacial traumatology; they introduced their basic principles frequently used to describe the biomechanics of mandibular fixation. Their concept states when a physiologic load is applied on mandibular teeth a negative tension will be created at superior border and a positive pressure will appear at inferior border. These simple definitions are the basis for the advent of fixation modalities in mandibular angle fracture. This article sought to reassess these principals based on load location via finite elements method.
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Humans , Biomechanical Phenomena , Dental Stress Analysis , Finite Element Analysis , Fracture Fixation, Internal , Methods , Mandible , Mandibular Fractures , General Surgery , Tooth , PhysiologyABSTRACT
Objective@#Researching the influence on patients with different eating ways after the operation of mandibular angle osteotomy of inside oral cavity.@*Method@#By using the method of convenience sampling, 50 patients were chosen who had operation of mandibular angle osteotomy of inside oral cavity in orthopedic surgery department of our hospital from January 2017 to December 2017 and the number was arranged according to the order of hospitalization. Patients with singular member were divided into the month feeding group (liquid diet were fed with the injection syringe which linked leather hose of 4-5cm after 6 hours awakening after general anesthesia in operation); patients with even number were divided into the nasal feeding group (stomach tube was put in the operation and nasal feeding was provided after 6 hours awakening after general anesthesia in operation and 5 hours after the operation). In every group, there were 25 patients. Observation scale which was made by themselves was used to evaluate the patients in the two groups and comparison for difference was made in the two groups, including weight change, wound drainage amount, oral wound secretion, the aspects of choke and cough, and the comfortable sensation of eating.@*Results@#For weight, in nasal feeding group, (2.19±0.48) kg were reduced and in month feeding group, (5.78±0.58) kg were reduced; the difference had the statistical significance (t=23.870, P<0.05). For wound drainage amount, in nasal feeding group, the number was(38.00±11.00)ml and in month feeding group, the number was (65.00±13.00) ml, the difference was statistically significant (t=7.927, P<0.01). In the aspects of choke and cough, and wound secreta in oral cavity, in nasal feeding group, the number were 16% (4/25) and 44% (11/25) respectively which was superior to the month feeding group with the number of 44% (11/25) and 76% (19/25), the difference had the statistical significance (χ2=4.667, 5.333, P<0.05). For the comfortable sensation of eating, in the two groups, there was no significant statistical difference (χ2=0.764, P>0.05).@*Conclusion@#The nasal feeding way can improve recovery level for patients after the operation of mandibular angle osteotomy of inside oral cavity and it is worthy of promotion in clinic application.
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Objective To observe the clinical effect of platelet-rich fibrin (PRF) on prevention of postoperative hemorrhage and facial traumatic swelling in patients with mandibular angle osteotomy.Methods Twenty-five patients with mandibular angle hypertrophy were included in this study from January 2014 to November 2015.Split face comparative study was carried out to use the left and right sides as the experimental side and the control side,respectively.The PRF in the experimental side was placed in the mandibular osteotomy,while the control side was placed in platelet-poor plasma (PPP).After operation,the drainage volume and facial swelling degree were measured.Results The drainage volume of the experimental group (PRF group) was (20.35 ±7.40) ml,the control group (PPP group) was (43.23±11.96) ml,and the difference was statistically significant (P＜0.05).There was no such case without swelling in postoperative third day.The facial swelling score on the experimental side was (1.19±0.40),the control side was (2.62±0.64),and two groups of postoperative facial swelling scores were significantly different (P＜0.05).Conclusions The PRF can reduce postoperative bleeding and facial swelling after mandibular angle osteotomy.
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@#Dento-maxillofacial deformity refers to an abnormal relationship of the volume or shape of the upper and lower jaw bones with the other bones of the craniofacial area. Its correction mainly involves hard tissues, such as the jaws and teeth. In recent years, digital techniques based on virtual surgery, real-time navigation, and 3D printing have developed rapidly in the area of craniomaxillofacial surgery. Digital technology has advantages for preoperative diagnosis, surgical plan formulation, surgical simulation, intraoperative navigation, effect prediction, doctor-patient communication, and young physician training. The Department of Orthognathic and TMJ Surgery of West China Hospital of Stomatology, Sichuan University, has conducted digitized diagnosis and treatment of dento-facial deformities since 2008 and has established a digital center for the treatment of dentofacial deformities based on equipment such as spiral CT, dental arch laser scanners, facial 3D cameras, virtual surgery software, 3D printers, and sleep-breathing monitoring. The result is a diagnostic and treatment protocol for dentofacial deformity specific to the characteristics of the population of West China. This article combines the latest domestic and foreign literature and comprehensively introduces the application of digital technology for the diagnosis and treatment of dental and maxillofacial deformities.
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0bjective@#To establish a three-dimensional finite element model of mandible and study the transverse displacement of proximal segment after Bilateral Sagittal Split Ramus Osteotomy (BSSRO) with different retrogression amounts during mastication.@*Methods@#DICOM data of a skull model were processed with MIMICS and ANSYS software, reconstructing the 3D model including the teeth and temporomandibular joint in order to simulate BSSRO and evaluate the transverse displacement of proximal segment with different retrogression amounts during mastication.@*Results@#The mean of proximal segment width change were 2.955 mm and 3.490 mm, when retrogression amounts of distal segmentwere 3 mm and 8 mm, respectively.No significant difference between the two groups were found (P=0.131). Meanwhile the displacement color scale of the 3D finite element models showed that the apparent transverse displacement distribution of the proximal segment was measured around the gonial area, decreased from the exterior to the interior.@*Conclusions@#The mandibular angle width was significantly expanded right after BSSRO. The masticatory muscle system and single cortical fixation system played an important role in expanding the width of proximal segment. However there was no correlation between the widening effect and retrogression amounts of distal segment of mandible.
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Objective@#To design the aesthetic new gonion and osteotomy line for patients with prominent mandibular angle patients using computer-aided techniques, and to investigate the application of three-dimensional digital planning in gonioplasty.@*Methods@#From April 2016 to April 2017, 14 female patients with prominent mandibular angle underwent preoperative surgical design and surgical simulation using digital technology. Gonioplasty was performed under the guide of surgical templates, preoperative, surgical simulation and postoperative data were measured including bilateral mandibular angles, the height of ramus(Co-Go) and the length of mandibular body(Go-Me). Paired t test was used to compare the differences between surgical simulation and postoperative measurements.@*Results@#Gonioplasty was performed in 14 patients successfully, and all were satisfied with their facial outcomes. The mandibular angle was improved from 113.86°±4.11° to 124.52°±1.26° on the left side, and 114.30°±4.01° to 124.29°±1.24° on the right side respectively. The average ratio of Go-Me/Co-Go was 2.011 on both sides after operation, which was very close to surgical planning. No significant differences were found between surgical planning and postoperative measurements with respect to mandibular angle or the ratio of Go-Me/Co-Go on both sides(P>0.05). The deviations between them were 1.00°±0.68° and 0.058±0.038 on the left side, and 0.85°±0.63° and 0.072±0.053 on the right side respectively.@*Conclusions@#Computer-assisted gonioplasty could improve the efficiency and accuracy of surgery, reduce the risk of surgical complications, and attain higher patients′ satisfaction.
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Objective To investigate the contouring plastic effect of the digital navigation techniques assisted mandibular angle osteotomy,thereby providing surgical reference and evaluation basis for improving the accuracy,efficacy and safety of surgery.Methods From March 2015 to March 2017,15 female cases of the digital navigation aided intral-oral mandibular angle osteotomy in the past 2 years were collected and compared to the pre-operational image and digital design.Results The postoperative effect of navigation-assisted mandibular angle osteotomy was well matched to that of preoperative design.The mandibular angle was smooth and bilateral symmetrical with no obvious complication occurred.Conclusions Navigation-assisted techniques can solve the problem of limited exposure of intra-oral approach and significantly improve the accuracy,effectiveness and safety in mandibular angle osteotomy.
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The aim of this study was to determine the carotid bifurcation level in relation with the hyoid bone and mandibular angle. Common carotid artery is the largest artery in the neck, and it gives off two terminal branches, namely external and internal carotid arteries. The bifurcation level of it shows variations, however it is usually situated at the level of C4 vertebra or at the upper border of thyroid cartilage. On the other hand, carotid bifurcation may be situated as low as T3 vertebra, or as high as the level of hyoid bone. In this study, conventional angiographic images of 112 patients were used. The distances of carotid bifurcation to hyoid bone and mandibular angle were measured on those images. In addition, right and left side difference was determined. The distance of carotid bifurcation level to the mandibular angle was measured as 21.26 ± 8.57 mm on the right and 20.25 ± 8.75 mm on the left side in males, and 19.72 ± 8.89 on the right, and 18.5 ± 9.25 mm on the left side in females. Distance between the carotid bifurcation level and hyoid bone ranged 1.94 ± 12.69 mm in female and 3.04 ± 9.00 mm in male on the left side. Having information about the level of carotid bifurcation is important in surgical and radiological procedures for determining the appropriate surgical procedure, and to prevent complications. We believe that the results of this study will shed light to planning of all interventions concerning common carotid artery.
El objetivo de este estudio fue determinar el nivel de bifurcación carotídea en relación con el hueso hioides y el ángulo de la mandíbula. La arteria carótida común es la arteria más grande del cuello, y tiene dos ramas terminales, las arterias carótidas externa e internas. El nivel de bifurcación muestra variaciones, sin embargo suele situarse a nivel de la cuarta vértebra cervical o en el margen superior del cartílago tiroideo. Por otro lado, la bifurcación carotídea puede estar situada tan baja como a nivel de la tercera vértebra torácica, o tan alta como a nivel del hueso hioides. En este estudio se utilizaron imágenes angiográficas convencionales de 112 pacientes. Se midieron las distancias de la bifurcación carotídea con el hueso hioides y el ángulo de la mandíbula en esas imágenes. Además, se determinó la diferencia entre los lados derecho e izquierdo. La distancia entre el nivel de bifurcación carotídea y el ángulo de la mandíbula se midió, siendo de 21,26 ± 8,57 mm a la derecha y 20,25 ± 8,75 mm en el lado izquierdo, en los hombres, y 19,72 ± 8,89 a la derecha y 18,5 ± 9,25 mm a la izquierda en mujeres. La distancia entre el nivel de bifurcación de la carótida y el hueso hioides osciló entre 1,94 ± 12,69 mm en mujeres y, 3,04 ± 9,00 mm en hombres, en el lado izquierdo. La información sobre el nivel de bifurcación carotídea es importante en los procedimientos quirúrgicos y radiológicos para determinar el procedimiento quirúrgico apropiado y prevenir complicaciones. Creemos que los resultados de este estudio arrojarán luz a la planificación de las intervenciones relacionadas con la arteria carótida común.
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Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Carotid Arteries/anatomy & histology , Hyoid Bone/anatomy & histology , Mandible/anatomy & histology , Angiography, Digital Subtraction , Carotid Arteries/diagnostic imaging , Hyoid Bone/diagnostic imaging , Mandible/diagnostic imagingABSTRACT
A patient, who underwent partial masseter muscle resection and mandibular angle reduction at a plastic surgery clinic, visited this hospital with major complaints of trismus and dysesthesia. A secondary angle formation due to a wrong surgical method was observed via clinical and radiological examinations, and the patient complained of trismus due to the postoperative scars and muscular atrophy caused by the masseter muscle resection. The need for a masseter muscle resection in square jaw patients must be approached with caution. In addition, surgical techniques must be carefully selected in order to prevent complications, and obtain effective and satisfactory surgery results.
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Humans , Cicatrix , Jaw , Masseter Muscle , Methods , Muscular Atrophy , Paresthesia , Surgery, Plastic , TrismusABSTRACT
OBJECTIVES: This paper proposes Han's ratio as an objective and quantitative comparative result obtained from pre and postoperative data in patients with a mandibular angle reduction. MATERIALS AND METHODS: Thirty patients, 12 men and 18 women, who visited the Department of Oral and Maxillofacial Surgery with the chief complaints of skeletal mandibular prognathism and prominent mandibular angle were selected. The subjects were classified into 3 groups according to the types of surgical procedures involved. Group A consisted of patients who underwent mandibular angle resection and mandibular setback. Group B was comprised of patients with mandibular angle resection, mandibular setback and genioplasty. Group C consisted of patients with mandibular angle resection, mandibular setback, Le Fort I osteotomy, and genioplasty. The landmarks placed in pre and postoperative frontal photographs were used to obtain the Han's ratio in each group. The Han's ratios were compared pre- and postoperation and according to the surgical techniques applied. RESULTS: Of the 3 groups who had undergone a mandibular angle resection, all showed a statistically significant increase in Han's ratio. On the other hand, there was no statistically significant difference based on the surgical techniques used. CONCLUSION: The ratio of the lateral lower face proposed in this study is a potential indicator of postoperative esthetic enhancement in mandibular angle reduction surgery.
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Female , Humans , Male , Genioplasty , Hand , Methods , Orthognathic Surgery , Osteotomy , Plastics , Prognathism , Surgery, OralABSTRACT
Objective To analyze the difference of soft and hard tissues between beautiful face and ordinary face in young Han women for providing data basis for modification of lower facial contour.Methods 38 cases of young Han women were selected with craniofacial spiral CT scanning,three-dimensional reconstruction and histomorphometry of the mandibular angle region (12 cases of beautiful face and 26 cases of ordinary face).Results The difference of bony bigonial breadth,lower face width,angle of mandibular angle,mandibular branch width and height,the distance between the mandibular angle point and pogonion in mandibular angle region had statistical significance (P ＜ 0.05);the difference of mandibular angle thickness had no statistical significance (P＞0.05);the difference of masseter muscle length,width and thickness had statistical significance (P ＜ 0.05).Conclusions In clinical lower facial contour modification practice,we can refer to the data of soft and hard tissue of mandibular angle region of beautiful face,combining with the specific circumstances of the pursuit of beautiful people and select the appropriate surgical approach for lower facial contour modification.
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Objective Cephalometry has been used to measure the changes of mandibular shape before and after the surgery.The aim of this study was to evaluate the effect of mandibular angle osteotomy.Methods A lot of 42 cases with complete data were selected,cephalometric analysis were performed before operation and one week and 6 months after surgery,respectively.Furthermore,the data of six months postoperatively were compared to those of the beauty people reported in the literature.Results At one week after surgery,the average distance between the gonions decreased (17.70± 8.46) mm,the average length of the mandibular ramus reduced (5.84±3.26) mm,the average mandibular body length increased (4.61±2.74) mm,the average gonial angle increased (14.78±6.65)°,and the average mandibular plane angle increased (10.29±3.82)° (P＜0.05).At six months postoperatively,the first three linear measurements increased (3.68±2.91) mm,(1.66±2.51) mm and (2.10±2.37) mm,respectively;however,the last two angular measurements reduced (2.86±3.02)°and (1.77±2.62)° respectively.The data of six months postoperatively were compared to those of the beauty people reported in the literature,and there were statistically differences between the linear measurements,but no statistically differences between the angular measurements.Conclusions Re duction mandibuloplasty can modificate mandibular contouring three-dimensionally.Despite bone regeneration resuhs in linear or angular measurements change,postoperative angular shape is predominantly maintained,and so the patients can reach the level of beauty papulation.
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Objective To explore the clinical effect of endoscopic-assisted intraoral reduction mandibuloplasty.Methods From January 2010 to December 2014,a total of 186 patients with prominent mandibular angles underwent one stage long-curved ostectomy combined with splitting corticectomy through an intraoral approach with endoscopic assistence according to preoperative design for reduction mandible three-dimensionally,and achieved reduced width of the lower face with smooth curve of mandibular edge.The distance between both gonions was measured and the complications recorded to evaluate the clinical effect of the surgery during follow-up.Results All the 186 patients had no complications of bleeding and infection.The mean distance between both gonions measurement was (117.3±2.5) mm before surgery and (102.6±2.3) mm after operation;it was reduced (14.1 ±2.4)mm.After 1 month to 2 years of follow up,the width of the lower face was reduced in the frontal view and the mandibular angle appeared natural and inconspicuous in the lateral view.The patients were satisfied with both their frontal and lateral appearances.Conclusions Intraoral approach mandibular ostectomy with endoscopic-assisted allows surgeons to perform accurate,safe and reproducible ostectomies and to recontour mandible symmetrically and reduce the complications.
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OBJECTIVES: We compared the transbuccal and transoral approaches in the management of mandibular angle fractures. MATERIALS AND METHODS: Sixty patients with mandibular angle fractures were randomly divided into two equal groups (A, transoral approach; group B, transbuccal approach) who received fracture reduction using a single 2.5 mm 4 holed miniplate with a bar using either of the two approaches. Intraoperatively, the surgical time and the ease of surgical assess for fixation were noted. Patients were followed at 1 week, 3 months, and 6 months postoperatively and evaluated clinically for post-surgical complications like scarring, infection, postoperative occlusal discrepancy, malunion, and non-union. Radiographically, the interpretation of fracture reduction was also performed by studying the fracture gap following reduction using orthopantomogram tracing. The data was tabulated and subjected to statistical analysis. A P-value less than 0.05 was considered significant. RESULTS: No significant difference was seen between the two groups for variables like surgical time and ease of fixation. Radiographic interpretation of fracture reduction revealed statistical significance for group B from points B to D as compared to group A. No cases of malunion/non-union were noted. A single case of hypertrophic scar formation was noted in group B at 6 months postsurgery. Infection was noted in 2 patients in group B compared to 6 patients in group A. There was significantly more occlusal discrepancy in group A compared to group B at 1 week postoperatively, but no long standing discrepancy was noted in either group at the 6 months follow-up. CONCLUSION: The transbuccal approach was superior to the transoral approach with regard to radiographic reduction of the fracture gap, inconspicuous external scarring, and fewer postoperative complications. We preferred the transbuccal approach due to ease of use, minimal requirement for plate bending, and facilitation of plate placement in the neutral mid-point area of the mandible.
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Humans , Cicatrix , Cicatrix, Hypertrophic , Follow-Up Studies , Mandible , Operative Time , Postoperative Complications , Prospective StudiesABSTRACT
Objective To observe the temporomandibular joint spaces changes after the plastic surgery of combined zygoma with mandibular angel.Methods We randomly selected 59 patients with prominent zygoma and mandibular angle,screening periodontal disease,TMJ pain and partial jaw.Bilateral zygomatic arch coarctation,jaw edge of the mandibular angle ostectomy and the mandibular body outer panel split were used.All patients accepted CT scan and three-dimensional reconstruction before operation,10 days after operation and 6 months after operation,and then image analysis softwares were used to measure the line distance of corresponding angle (0°,60°,120°,and 180°)at the TMJ sagittal plane.The 0° (EE 'pitch) and 60° (AA'pitch) represented for pre-space,the 60° and 120° (PP'pitch) was upper-space,the 120° and 180° (SS'pitch) was posterior-space.Results 0° and 60° had the same change trend,which slightly increased at 10 days after operation.The difference before operation and 10 days,6 months after operation were not statistically significant (P ＞ 0.05);120° and 180° had the same change trend,which increased at 10 days after operation.The difference between before operation and 10 days after operation was statistically significant (P ＜ 0.05),but the difference between before operation and 6 months after operation was not statistically significant (P＞ 0.05).Conclusions In the short term after plastic surgery of zygoma combined with mandibular angel,the TMJ upper and posterior spaces are changed,and the interspace reduced.This may indicate that the TMJ has compensatory ability,and short-term changes can return to normal.
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Objective To design safe and beautiful curved osteotomy line for mandibular angle osteotomy .Methods Expo‐sing 150 cases(300 sides) of mandible tube in the mandible bone of adults;Observing the characteristics of the movement of man‐dibular canal;measuring the distance from the critical dot of mandibular canal to marginal mandibular ;observing the positional rela‐tionship between mandibular foramen and the inferior alveolar arch;designing the curved osteotomy line based on observations to meet the individual needs .Results T he distance betw een the key points of mandibular canal A1 ,B1 ,C1 ,and D1 ,E1 and the mandib‐ular edge come as (14 .02 ± 2 .23)mm ,(21 .06 ± 3 .90)mm ,(14 .08 ± 3 .68)mm ,(13 .60 ± 2 .80)mm ,(14 .55 ± 3 .34)mm ,respective‐ly ;the maximum width each were (10 .05 ± 4 .00)mm ,(15 .06 ± 2 .88)mm ,(8 .08 ± 3 .88)mm ,(6 .09 ± 3 .45)mm ,(7 .06 ± 3 .56) mm ;the probability that mandibular foramen and inferior alveolar of the bow was located in the same plane falls on 96% ;the rear end of the point A of the osteotomy line should not be higher than the plane of the lower jaw holes ,the front point of three osteoto‐my line C ,D ,E ,fall respectively on the point intersection where the vertical line led downward via the edge of the ramus ,the man‐dibular teeth M2 ,P4 met the marginal mandibular .Conclusion The design of curved osteotomy line for mandibular angle osteotomy meets the individual needs ,in line with the anatomical features and aesthetic requirements which takes the advantages as easy‐opera‐tion with clear signs ,high security and preferable effect after operation .
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Objective To study a safe means of mandibular angle plasty of bone cutting and its clinical efficay.Methods Through grinding bone oblique trapezoidal incisure,mandibular angle wide deformity was then corrected according to the cutting trace on bone cutting method.Results Of 260 cases of torture beauty,185 cases were followed-up,in which 181 (97.84％) cases were satisfied with the results,and 1 case got satisfaction after facial liposuction; other 1 case did not accepted further treatment advice of bone cutting processing because her mandibular angle was too wide.Two cases of bone wax reaction occured and got satisfaction after treatment.Conclusions Mandibular angle plasty by combined grinding with cutting makes it easy for positioning and bone cutting; bone cutting arc becomes more fluent with good exposure of its posterior horn.It can prevent mandibular fracture induced by bone cutting that does not reach the designated position.Therefore,this procedure is relatively simple and safe.