Mandibular morphology change due to mandibular angle osteotomy: a cone beam computed tomography-based three-dimensional cephalometry analysis / 中华医学美学美容杂志

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.

The influence of different eating ways on the postoperative rehabilitation of female patients with the operation of mandibular angle osteotomy of inside oral cavity / 中国实用护理杂志

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.

The influence of different eating ways on the postoperative rehabilitation of female patients with the operation of mandibular angle osteotomy of inside oral cavity / 中国实用护理杂志

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.

Clinical feasibility and efficiency of a 3-dimensional printed surgical template for mandibular angle osteotomy and mandibular angle splitting osteotomy.

Mandibular angle osteotomy (MAO) and mandibular angle splitting osteotomy (MASO) are the two main surgical approaches used to correct a square mandible for a desirable aesthetic appearance. However, there are concerns about the safety and accuracy of both procedures as they may lead to unsatisfactory results such as injury to the nerve. To achieve symmetry and security we designed and evaluated a 3-dimensional printed surgical template, which indicates the outer cortex splitting line of the MASO, and the curved cutting line of the MAO. We operated on 11 patients who had been diagnosed with broad mandibles using the assisted template. The mean duration of osteotomy, degree of numbness of the inferior alveolar nerve, and reduction in the width of the mandible (Go-Go) were recorded. The mandibular curve before and after operation was fitted to evaluate its accuracy. The results showed that mean duration of osteotomy and numbness of the nerve were reduced, and there was no significant difference between simulation and postoperatively. The mean (SD) reduction in the mandibular width was 15.2 (1.6)mm. The template facilitated accuracy and safety in both procedures.

Does intraoperative navigation improve the accuracy of mandibular angle osteotomy: Comparison between augmented reality navigation, individualised templates and free-hand techniques.

BACKGROUND: Augmented reality (AR)-based navigation surgery has evolved to be an advanced assisted technology. The aim of this study is to manifest the accuracy of AR navigation for the intraoperative mandibular angle osteotomy by comparing the navigation with other interventional techniques. METHODS: A retrospective study was conducted with 93 post-surgical patients with mandibular angle hypertrophy admitted at our plastic and reconstructive surgery department between September 2011 and June 2016. Thirty-one patients received osteotomy conducted using a navigation system based on augmented reality (AR group), 28 patients received osteotomy conducted using individualised templates (IT group) and the remaining 34 patients received osteotomy performed by free hand (free-hand group). The post-operative computed tomography (CT) images were reviewed and analysed by comparing with pre-surgical planning generated by three-dimensional (3D) software. The preparation time, cutting time, whole operating time and discrepancy in osteotomy lines were measured. RESULTS: The preparation time was much shorter for the free-hand group than that for the AR group and the IT group (P < 0.01). However, no significant difference in the whole operating time was observed among the three groups (P > 0.05). In addition, the discrepancy in osteotomy lines was lower for the AR group and in the IT group than for the free-hand group (P < 0.01). CONCLUSION: The navigation system based on AR has a higher accuracy, more reliability and better user friendliness for some particular clinical procedures than for other techniques, which has a promising clinical prospect.

Application of computer navigation assisted mandibular angle osteotomy / 中华医学美学美容杂志

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.

Cephalometric measurements of mandibular shape after mandibular angle osteotomy / 中华医学美学美容杂志

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.

Application of high-density porous polyethylene implant in chin augmentation in contour plastic surgery of low face / 中华医学美学美容杂志

Objective High-density porous polyethylene(Medpor)has been widely used in chin augmentation in recent years.The study aimed to observe the outcomes of clinical use of high-density porous polyethylene implant in chin augmentation in contour plastic surgery of low face.Methods From 2005 to 2008,149 cases of chin augmentations intraorally with Medpor implants combined with were collected.121 of them received bilateral mandibular angle osteotomy and 28 cases received bilateral mandibular angle osteotomy and bilateral malar reduction simultaneously.They wre all females aged from 17 to 46 years.The patients were followed up for 6 to 36 months(average 24 months)and photographs were taken before and after operations.Clinical outcomes were observed and analysed.Resuits 145 patients(97.3%)were satisfied with their chin and contour of low face.2 patients (1.3%)were not satisfied with the projection of their chin,and 1 of them were admitted to take out the implant and received sliding advancement genioplasty.1 patient(0.7 0A)felt the implants was too large to some extent and was admitted to modify the implant.1 patient(0.7%)received genioplasty 6months after operation because of the deviation of the implant.20 patients(13.4%)felt numbness of the lower lip which gradually disappeared 1 to 3 months postoperatively.Complications such as infection,edema and extrusion,break of the implant were not found during the following period.Conclusions Medpor is an excellent biomaterial with good biocompatibility.Simultaneously chin augmentation with Medpor combined with bilateral mandibular angle osteotomy intraorally shows a good result in contour plastic surgery of low face.