Evaluation of facial soft tissue thickness in asymmetric mandibular deformities after orthognathic surgery.

OBJECTIVES: The purpose of this study was to compare differences in facial soft tissue thickness in three-dimensional (3D) images before and after orthognathic surgery in patients with skeletal Class III malocclusion and to obtain a better understanding of the relationship between hard and soft tissue changes after surgery. MATERIALS AND METHOD: The present retrospective study included 31 patients with skeletal Class III malocclusion with mandibular chin deviation greater than 4 mm who had undergone cone-beam computed tomography before and 6 months after surgery. Seven bilateral points were established. Measurements were taken from software-generated multiplanar reconstructions. The predictor variables were timing (pre- and postoperatively) and side (deviated vs. nondedicated). A regression model and correlation analysis were conducted for statistical analysis. RESULTS: The difference of bilateral facial soft tissue thickness was statistically significantly different between deviated and nondeviated sides (P < 0.05), with lower values observed on the deviated side. The soft tissue thickness has become nearly symmetric at local regions of the lower thirds of the face after orthognathic surgery. However, most measurements showed a negative correlation between changes in soft tissue thickness and changes in bone tissues. CONCLUSIONS: Skeletal Class III malocclusion with facial asymmetry is accompanied by differences in soft tissue thickness when comparing Dev and N-Dev sides of the posterior region of the mandible, where soft tissues are thinner on the Dev side. Soft tissue thickness can compensate for or camouflage the underlying asymmetric mandible. In addition, the asymmetric soft tissue thickness on the lower third of the face can be partially improved by orthognathic surgery, but the amount of soft tissue thickness change is not consistent with that of hard tissue positional change.

Teeth extraction with endotracheal intubation under general anesthesia in special needs patients-a retrospective analysis / 口腔疾病防治

Objective@#To discuss the demand and security of tooth extraction under general anesthesia with endotracheal intubation for the special needs patients.@*Methods@#From January 2014 to December 2015, the cases of tooth extraction under general anesthesia were collected to analyse the demand and security of tooth extraction with general anesthesia.@*Results@#54 patients were recruited in the study in which 11 were with serious limitation of mouth opening, 10 were with serious cardiovascular disease risk, 2 were with history of epilepsy, 13 were with serious dental phobia, and 18 were incoordination patients. All the operations were performed successfully and safely, and all the scores of post anesthetic discharge scoring system exceeded 9 points. No developed complications were showed in 1 day, 1 week, 1 month follow-up.@*Conclusion @#Tooth extraction under general anesthesia with endotracheal intubation is a safe way for special needs patients.

[Comparison of two different flap designs in removal of impacted wisdom tooth].

PURPOSE: The purpose of this study was to compare the effect of two different flap designs on surgical removal of impacted mandibular third molars. METHODS: Four hundred patients who required removal of impacted mandibular third molars were included in the study. They were divided into group A and group B randomly. Patients in group A received distal incision flap and group B underwent angular incision flap. The effect of flap design on surgical time, incidence of dry socket, pain, swelling and trismus was evaluated postoperatively. Data analysis was carried out with SPSS 13.0 software package. RESULTS: The surgical time was longer in group A than in group B 3 days postoperatively. Facial swelling and trismus were less in group A than in group B 3 days postoperatively. There was no significant difference in two groups 7 days postoperatively. CONCLUSIONS: The distal incision flap design can release facial swelling and trismus in surgical removal of impacted mandibular third molars.

[Study of three-dimensional model on biomechanical characteristics of mandibular fractures in different site].

OBJECTIVE: To determine the biomechanical characteristics of mandibular fractures in different site. METHODS: Nine adult mandibular specimens were measured precisely. The data was used to establish a three-dimensional model. When mandibular was under functional loading, the bending and torsion moment as well as shear force of angle, body and symphyseal fracture was calculated. The data were analyzed by Origin 6.0 software. RESULTS: Angle fracture had relatively high positive bending moment and high shear force. Body fracture had positive as well as negative bending moment and the highest torsion moments. Symphyseal fracture had only negative bending moment and relatively low shear force. CONCLUSION: Angle, body and symphyseal fractures each have a biomechanics characteristic. These biomechanics characteristic should have an important meaning in the treatment of mandibular fractures and instructing patient how to bite correctly.