ABSTRACT
Objectives: This retrospective study aimed to determine the angulation changes of the proximal segment following bilateral sagittal split osteotomy (BSSO) setback and its correlation with the amount of immediate postoperative surgical movement. The correlation between postoperative relapse of the distal and proximal segment at six months postoperatively was also evaluated. Materials and methods: The CBCT-generated lateral cephalometric images of 39 patients who underwent BSSO setback with or without Le Fort I osteotomy were evaluated preoperatively (T0), immediately postoperative (T1), and six months postoperatively (T2). Results: The mean surgical setback was 7.28 ± 4.45 mm at B point. The proximal segment's immediate postoperative mean posterior rotation was 2.13 ± 3.59 degrees. Six months after the operation, the mean distal segment relapse was 0.89 ± 3.03 mm at B point. The proximal segment relapse was 0.81 ± 1.63 degrees. A significant moderate correlation was found (P < 0.05) between the surgical movement and the immediate postoperative proximal segment rotation and between the surgical movement and the distal segment relapse. A significant correlation was found between the distal segment relapse and the average and left proximal segment relapse. There was no significant correlation between immediate postoperative proximal segment rotation and distal segment relapse. Conclusion: The immediate postoperative posterior rotation of the proximal segment had a negligible effect on mandibular relapse. The amount of surgical movement, on the other hand, was more related to distal segment relapse. The intraoperative proximal segment rotation should thus be minimized in cases with a significant surgical setback.
ABSTRACT
Germectomy is a surgical method most typically performed in young adults. The indications for treatment are controversial. The purpose of this review was to determine the correct indications for germectomy and to discuss the advantages and disadvantages of the procedure. We reviewed the surgical techniques (anesthetic methods, patient preparation, and flap designs) and complications. Germectomy for orthodontic purposes is a common indication for surgical removal of tooth germ among young patients. Several studies have supported removal at an earlier age to produce fewer surgical complications. Several surgical techniques have been described in the literature.
ABSTRACT
PURPOSE: We evaluated the relationship between mandibular third molar roots (M3Ms) and surrounding cortical bone using cone beam computed tomography (CBCT) and panoramic findings. We studied (a) the location of mandibular third molar roots in relation with cortical bone in terms of contact, penetration, and perforation on CBCT; (b) the relationship between characteristics of a root in panoramic findings and the CBCT image (entire and segmentally); and (c) the relationship of the root plane in panoramic findings vs. CBCT. MATERIAL AND METHODS: One hundred five teeth with 224 roots of mandibular third molar from 73 patients were evaluated by using cone beam computed tomography and panoramic image. RESULT: The relationships were assessed using 105 images of impacted M3Ms: 104/105 (99%) showed cortical bone involvement (30.4% penetration and 68.6% perforation). The more apical the segment, the higher the proportion of perforation. Most (79.9%) of the M3M roots involved a lingual cortex with 46.9% penetration and 49.2% perforation. The panoramic signs of segmental root images-viz. clear and blurred-were not associated with cortical penetration or perforation. Panoramic signs of individual root images-in the same and different planes-could be used to predict root plane M3M roots. The same appearance in the panoramic image was significantly related to the same plane of the root in CBCT (p-value 0.048). CONCLUSION: These findings could contribute to enhanced radiological assessment and surgical planning.
