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Muacevic A, Adler JR, Rajenthiran A, Thirunavukkarasu R. The Versatility of Extraoral Vertical Ramus Osteotomy for Mandibular Prognathism: A Prospective Study. Cureus 2022; 14:e32673. [PMID: 36660517 PMCID: PMC9845803 DOI: 10.7759/cureus.32673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Orthognathic surgery simply means alignment of the jaws. The aim of orthognathic surgery is to normalize the relationship of the jaws between themselves and the rest of the craniofacial complex. Mandibular prognathism is a common clinical problem all over the world. Currently, sagittal ramus osteotomy is the primary choice for correcting most cases of mandibular retrognathism and prognathism. The surgical option for extreme cases of mandibular prognathism is extraoral vertical ramus osteotomy (EVRO) or intraoral vertical ramus osteotomy (IVRO) or inverted L osteotomy. AIM The aim of this study was to evaluate the versatility of EVRO for mandibular prognathism. MATERIALS AND METHODS Ten patients with the chief complaint of mandibular prognathism with no history of keloid tendency were included in the study. EVRO was done for all patients. The parameters based on which the outcome of the surgical procedure was assessed were time taken for the surgical procedure, facial harmony both in frontal and profile views postoperatively, and intraoperative and postoperative complications, and assessment of the postoperative results was done through orthopantomogram (OPG) and 3D CT scan. RESULTS The time taken for the entire surgical procedure, starting from incision to closure, varied between 80 and 94 minutes with the average time taken for the surgery being 90 ± 8.80 minutes. It was found that there was a statistically significant difference between preoperative (M = 53.4, SD = 5.854) and postoperative evaluation (M = 47.5, SD = 5.039) of the posterior nasal spine to nasion 1 (PNS-N 1) horizontal plane (HP) (mm) with p < 0.001. Similarly, there was a statistically significant difference between preoperative (M = 81.4, SD = 2.716) and postoperative evaluation (M = 74.4, SD = 3.627) of mandible body length (mm) with p < 0.001. However, no statistically significant difference exists between the preoperative and postoperative evaluation of anterior nasal spine (ANS) to PNS (mm) and ramus height Ar-Go (mm). CONCLUSION EVRO is an acceptable surgical procedure owing to the fact that it is relatively simple to carry out, its lack of complications, and its good results.
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Peleg O, Mahmoud R, Shuster A, Arbel S, Kleinman S, Mijiritsky E, Ianculovici C. Vertical Ramus Osteotomy, Is It Still a Valid Tool in Orthognathic Surgery? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10171. [PMID: 36011805 PMCID: PMC9407762 DOI: 10.3390/ijerph191610171] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/13/2022] [Accepted: 08/14/2022] [Indexed: 06/15/2023]
Abstract
The purpose of this study is to evaluate mandibular osteotomy procedures during orthognathic surgery, with an emphasis on the complications of the two leading procedures: intraoral vertical ramus osteotomy (IVRO) and sagittal split osteotomy (SSO). We conducted a retrospective cohort study by extracting the records of patients who underwent either IVRO or SSO procedures during orthognathic surgery in a single center between January 2010 and December 2019. A total of 144 patients were included (median age of 20.5 years, 52 males). The IVRO:SSO ratio was 118:26 procedures. When referring to all surgeries performed, IVRO procedures were associated with shorter hospitalization than the SSO procedures, while the overall durations of surgery and follow-up periods were comparable. In contrast, when referring only to bimaxillary procedures, the duration of the IVRO bimaxillary procedures was significantly shorter than the SSO bimaxillary procedures. There were 53 complications altogether. Postoperative complications consisting of skeletal relapse, temporomandibular joint dysfunction, sensory impairment, and surgical-site infection were significantly fewer in the IVRO group. Both types of osteotomies have acceptable rates of complications. IVRO appears to be a safer, simpler, though less acceptable procedure in terms of patient compliance.
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Affiliation(s)
- Oren Peleg
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel
| | - Reema Mahmoud
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel
| | - Amir Shuster
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel
- Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6423906, Israel
| | - Shimrit Arbel
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel
| | - Shlomi Kleinman
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel
| | - Eitan Mijiritsky
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel
| | - Clariel Ianculovici
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel
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Huang L, Tang S, Yan J, Liu Y, Piao Z. Three-dimensional analysis of mandible ramus morphology and transverse stability after intraoral vertical ramus osteotomy. Surg Radiol Anat 2022; 44:551-558. [PMID: 35303119 PMCID: PMC8960638 DOI: 10.1007/s00276-022-02912-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/21/2022] [Indexed: 11/28/2022]
Abstract
Objectives The purpose of this study was to investigate short- and long-term postoperative changes of both morphology and transverse stability in mandibular ramus after intraoral vertical ramus osteotomy (IVRO) in patients with jaw deformity using three-dimensional (3D) orthognathic surgery planning treatment software for measurement of distances and angles. Study design This retrospective study included consecutive patients with skeletal Class III malocclusion who had undergone intraoral vertical ramus osteotomy and computed tomography images before (T0), immediately after (T1), and 1 year after (T2) surgery. Reference points, reference lines and evaluation items were designated on the reconstructed 3D surface models to measure distances, angles and volume. The average values at T0, T1, T2 and time-dependent changes in variables were obtained. Results After surgery, the condylar length, ramal height, mandibular body length and mandibular ramus volume were significantly decreased (P < 0.01), while clinically insignificant change was observed from T1 to T2. The angular length was increased immediately after surgery (P < 0.05), but it was decreased 1 year after surgery (P < 0.05). Lateral ramal inclination showed significant increase after surgery (P < 0.05) and maintained at T2. Conclusion Changes in the morphology of the mandibular ramus caused by IVRO do not obviously bring negative effect on facial appearance. Furthermore, despite position and angle of mandibular ramus changed after IVRO, good transverse stability was observed postoperatively. Therefore, IVRO technique can be safely used without compromising esthetic results.
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Affiliation(s)
- Luo Huang
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Key Laboratory of Oral Medicine, Department of Oral and Maxillofacial Surgery, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, No. 39 Huangsha Avenue, Guangzhou, 510150, China
| | - Shan Tang
- Stomatology Department, Zhujiang Hospital of Southern Medical University, Guangzhou, 510282, China
| | - Jing Yan
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Key Laboratory of Oral Medicine, Department of Oral and Maxillofacial Surgery, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, No. 39 Huangsha Avenue, Guangzhou, 510150, China
| | - Yaoran Liu
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Key Laboratory of Oral Medicine, Department of Oral and Maxillofacial Surgery, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, No. 39 Huangsha Avenue, Guangzhou, 510150, China
| | - Zhengguo Piao
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Key Laboratory of Oral Medicine, Department of Oral and Maxillofacial Surgery, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, No. 39 Huangsha Avenue, Guangzhou, 510150, China.
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Effect of a digital guide on the positional accuracy of intermaxillary fixation screw implantation in orthognathic surgery. J Plast Reconstr Aesthet Surg 2022; 75:e15-e22. [PMID: 35367159 DOI: 10.1016/j.bjps.2022.02.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 01/27/2022] [Accepted: 02/17/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Intermaxillary fixation screw (IMFS) implantation is a common procedure in orthognathic surgery (OGS) performed to the temporary maxillary-mandibular fixation and stable bite relationships. The study aims to assess the accuracy of IMFS implantation with a digital guide to reduce the occurrence of root damage. METHODS This prospective study involved 40 patients undergoing OGS at the Affiliated Hospital of Qingdao University from August 2017 to May 2021. The patients were randomly divided into two groups according to whether the IMFS implantation was with or without digital guide (20 patients in the experimental group and 20 controls). The digital guides used in the experimental group were designed according to a virtual implantation plan and printed using stereolithography. In the control group, IMFSs were directly implanted by a surgeon based on clinical experience. Postoperatively, cone-beam computed tomography was performed to compare root proximity of IMFSs between the two groups and verify the accuracy of IMFS placement. RESULTS In the experimental group, there was no case of root damage, the incidence of the periodontal ligament (PDL) injured was 22.1%, and 77.9% IMFSs were placed without contacting adjacent anatomic structures. In the control group, the incidence of root damage had been up to 20.8%, 31.7% IMFSs injured the PDL, and only 47.5% IMFSs were placed between the roots (P < 0.001). CONCLUSION IMFSs can be placed more accurately with surgical guides, reducing the incidence of root and PDL damages.
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Batbold M, Lim SH, Jeong SR, Oh JS, Kim SJ, Kim YJ, Cho JH, Kang KH, Kim M, Hong M, Sung SJ, Kim YH, Park JH, Baek SH. Vertical bony step between proximal and distal segments after mandibular setback is related with relapse: A cone-beam computed tomographic study. Am J Orthod Dentofacial Orthop 2022; 161:e524-e533. [DOI: 10.1016/j.ajodo.2021.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/01/2021] [Accepted: 10/01/2021] [Indexed: 11/01/2022]
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Li DTS, Wang R, Wong NSM, Leung YY. Postoperative stability of two common ramus osteotomy procedures for the correction of mandibular prognathism: A randomized controlled trial. J Craniomaxillofac Surg 2021; 50:32-39. [PMID: 34627665 DOI: 10.1016/j.jcms.2021.09.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/23/2021] [Accepted: 09/30/2021] [Indexed: 01/18/2023] Open
Abstract
The aim of this randomized controlled trial was to compare the skeletal stability between sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO) in the treatment of mandibular prognathism. Patients presenting with mandibular prognathism and scheduled for orthognathic surgery were randomized into either the SSRO group or the IVRO group. Changes at B-point were assessed by serial tracing of lateral cephalograms, which were taken preoperatively, and at 2 weeks, 6 months, 1 year, and 2 years postoperatively. Ninety-eight patients were recruited, with 49 patients in each group. Between 2 weeks and 6 months postoperatively, there was significantly more surgical relapse in the horizontal direction (anterior movement) in the SSRO group when compared with the IVRO group (1.83 mm (SD 2.91 mm) vs 0.49 mm (SD 2.32 mm); p = 0.019). At 2 years, there was more surgical relapse in the horizontal direction in the SSRO group than in the IVRO group (0.27 mm (SD 0.34 mm) vs 0.10 mm (SD 0.29 mm); p = 0.014). There were also more absolute changes (irrespective of direction) at B-point in the SSRO group than in the IVRO group at postoperative 6 months, 1 year, and 2 years (p = 0.016, 0.049, and 0.045, respectively). The amounts of change at B-point as percentages of total mandibular setback were 1.3% and 3.5% in the IVRO group and SSRO group, respectively. There were no differences in vertical changes between the two groups at any time points. In conclusion, the horizontal stability at B-point was shown to be superior in the IVRO group compared with the SSRO group in the correction of mandibular prognathism during the 2-year follow-up. Although the exact clinical importance of this difference is unknown at this time, this possible benefit may be an important key factor when deciding which osteotomy technique to employ for mandibular setback.
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Affiliation(s)
- Dion Tik Shun Li
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong
| | - Rui Wang
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong
| | - Natalie Sui Miu Wong
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong
| | - Yiu Yan Leung
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong.
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Jung S, Choi Y, Park JH, Jung YS, Baik HS. Positional changes in the mandibular proximal segment after intraoral vertical ramus osteotomy: Surgery-first approach versus conventional approach. Korean J Orthod 2020; 50:324-335. [PMID: 32938825 PMCID: PMC7500571 DOI: 10.4041/kjod.2020.50.5.324] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/21/2020] [Accepted: 06/02/2020] [Indexed: 12/02/2022] Open
Abstract
Objective To compare postoperative positional changes in the mandibular proximal segment between the conventional orthognathic surgery (CS) and the surgery-first approach (SF) using intraoral vertical ramus osteotomy (IVRO) in patients with Class III malocclusion. Methods Thirty-eight patients with skeletal Class III malocclusion who underwent bimaxillary surgery were divided into two groups according to the use of preoperative orthodontic treatment CS group (n = 18) and SF group (n = 20). Skeletal changes in both groups were measured using computed tomography before (T0), 2 days after (T1), and 1 year after (T2) the surgery. Three-dimensional (3D) angular changes in the mandibular proximal segment, condylar position, and maxillomandibular landmarks were assessed. Results The mean amounts of mandibular setback and maxillary posterior impaction were similar in both groups. At T2, the posterior portion of the mandible moved upward in both groups. In the SF group, the anterior portion of the mandible moved upward by a mean distance of 0.9 ± 1.0 mm, which was statistically significant (p < 0.001). There were significant between-group differences in occlusal changes (p < 0.001) as well as in overjet and overbite. However, there were no significant between-group differences in proximal segment variables. Conclusions Despite postoperative occlusal changes, positional changes in the mandibular proximal segment and the position of the condyles were similar between CS and SF, which suggested that SF using IVRO achieved satisfactory postoperative stability. If active physiotherapy is conducted, the proximal segment can be adapted in the physiological position regardless of the occlusal changes.
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Affiliation(s)
- Seoyeon Jung
- Department of Dental Education, Yonsei University College of Dentistry, Seoul, Korea
| | - Yunjin Choi
- Department of Statistics, University of Seoul, Seoul, Korea
| | - Jung-Hyun Park
- Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, Seoul, Korea
| | - Young-Soo Jung
- Department of Oral and Maxillofacial Surgery, Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea
| | - Hyoung-Seon Baik
- Department of Orthodontics, Yonsei University College of Dentistry, Seoul, Korea
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Ahn YS, Choi SH, Lee KJ, Jung YS, Baik HS, Yu HS. Stability of bimaxillary surgery involving intraoral vertical ramus osteotomy with or without presurgical miniscrew-assisted rapid palatal expansion in adult patients with skeletal Class III malocclusion. Korean J Orthod 2020; 50:304-313. [PMID: 32938823 PMCID: PMC7500573 DOI: 10.4041/kjod.2020.50.5.304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/03/2020] [Accepted: 04/25/2020] [Indexed: 01/02/2023] Open
Abstract
Objective The aim of this study was to evaluate the stability of bimaxillary surgery involving bilateral intraoral vertical ramus osteotomy performed with or without presurgical miniscrew-assisted rapid palatal expansion (MARPE) in adult patients with skeletal Class III malocclusion. Methods A total of 40 adult patients with skeletal Class III malocclusion were retrospectively divided into two groups (n = 20 each) according to the use of MARPE for the correction of transverse maxillomandibular discrepancy during presurgical orthodontic treatment. Serial lateral cephalograms and dental casts were analyzed until 6 months after surgery. Results Before presurgical orthodontic treatment, there was no significant differences in terms of sex and age between groups. However, the difference of approximately 3.1 mm in the maxillomandibular intermolar width was statistically significant (p < 0.001). Two days after surgery, the mandible had moved backward and upward without any significant intergroup difference. Six months after surgery, the maxillary intercanine (2.7 ± 2.1 mm), interpremolar (3.6 ± 2.4 mm), and intermolar (2.0 ± 1.3 mm) arch widths were significantly increased (p < 0.001) relative to the values before presurgical orthodontic treatment in the MARPE group; these widths were maintained or decreased in the control group. However, there was no significant difference in surgical changes and the postsurgical stability between the two groups. No significant correlations existed between the amount of maxillary expansion and postsurgical mandibular movement. Conclusions MARPE is useful for stable and nonsurgical expansion of the maxilla in adult patients with skeletal Class III malocclusion who are scheduled for bimaxillary surgery.
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Affiliation(s)
- Yoon-Soo Ahn
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea
| | - Sung-Hwan Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea.,BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Korea
| | - Kee-Joon Lee
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea
| | - Young-Soo Jung
- Department of Oral and Maxillofacial Surgery, Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea
| | - Hyoung-Seon Baik
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea
| | - Hyung-Seog Yu
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea
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Rokutanda S, Yamada SI, Yanamoto S, Sakamoto H, Furukawa K, Rokutanda H, Yoshimi T, Nakamura T, Morita Y, Yoshida N, Umeda M. Anterior relapse or posterior drift after intraoral vertical ramus osteotomy. Sci Rep 2020; 10:3858. [PMID: 32123263 PMCID: PMC7052185 DOI: 10.1038/s41598-020-60838-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 02/18/2020] [Indexed: 11/10/2022] Open
Abstract
This study aimed to evaluate the factors contributing to postoperative anterior relapse or posterior drift of the distal segment after intraoral vertical ramus osteotomy. A retrospective cohort study was conducted which included 31 patients who underwent setback surgery for mandibular prognathism by the intraoral vertical ramus osteotomy technique. Uni- and multivariate analyses were performed to determine the association of potential explanatory variables (sex, age, magnitude of setback, differences in setback magnitude between sides (right/left), duration of splint use, Angle’s classification of malocclusion, mandibular angle, and tightness of occlusion of the molars) with positional changes in the distal segment. The setback magnitude was only significant factor affecting (P = 0.015) for posterior drift, with significant posterior in setback magnitudes of less than 7.25 mm. Posterior drift after intraoral vertical ramus osteotomy is less likely if setback magnitude exceeds 7.25 mm. For setbacks less than 7.25 mm, posterior drift should either be carefully corrected postoperatively, or an alternative surgical technique should be used. The setback magnitude showed a significant association with the risk of posterior drift following intraoral vertical ramus osteotomy, and the determined cut-off value may serve as a predictor for postoperative outcomes.
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Affiliation(s)
- Satoshi Rokutanda
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8588, Japan. .,Department of Oral and Maxillofacial Surgery, Juko Memorial Nagasaki Hospital, 1-73 Akunoura Town, Nagasaki city, Nagasaki, 850-0063, Japan.
| | - Shin-Ichi Yamada
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matumoto City, Nagano, 390-8621, Japan
| | - Souichi Yanamoto
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8588, Japan
| | - Hiroshi Sakamoto
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8588, Japan
| | - Kohei Furukawa
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8588, Japan
| | - Hiromi Rokutanda
- Department of Orthodontics and Dentofacial Orthopedics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8588, Japan
| | - Tomoko Yoshimi
- Department of Orthodontics and Dentofacial Orthopedics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8588, Japan
| | - Takuya Nakamura
- Department of Orthodontics and Dentofacial Orthopedics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8588, Japan
| | - Yukiko Morita
- Department of Orthodontics and Dentofacial Orthopedics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8588, Japan
| | - Noriaki Yoshida
- Department of Orthodontics and Dentofacial Orthopedics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8588, Japan
| | - Masahiro Umeda
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8588, Japan
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Chen CM, Ko ECC, Cheng JH, Tseng YC. Correlation between changes in the gonial area and postoperative stability in the treatment of mandibular prognathism. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 120:414-418. [PMID: 30664955 DOI: 10.1016/j.jormas.2018.12.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 12/07/2018] [Accepted: 12/20/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The present study was to investigate the relationship between the post-operative area of the gonial region (lateral and frontal) and post-operative relapse. MATERIAL AND METHODS Thirty-seven patients, treated for mandibular prognathism were followed with serial lateral cephalograms [pre-operatively (T1), immediately after surgery (T2), and at least 2 years post-operatively (T3)]. The surgical changes (T21), post-operative stability (T32) and 2-year surgical change (T31) were evaluated by the Student's t-test. Pearson's correlation coefficient analysis was used to determine the correlations between the cephalometric parameters. Multiple linear regression analysis was used to assess the association between the risk factors and post-operative relapse. RESULTS The immediate post-operative changes (T21), mean setback of the Me was 12.3 mm and the frontal gonial area (T2) was increased by 138.7 mm2. The final post-operative changes (T31), lateral gonial area was significantly reduced by 190.5 mm2. CONCLUSION Relapse was significantly correlated with the amount of setback. However, changes in the area of the gonial region (lateral and frontal) showed weak correlation with relapse. Multiple regression analysis also showed poor predictability of relapse. In conclusion, the results of this study showed that significant changes in the area of the gonial region (lateral and frontal) did not affect the maintenance of post-operative stability.
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Affiliation(s)
- C-M Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Oral and Maxillofacial Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - E C-C Ko
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Oral and Maxillofacial Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - J-H Cheng
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Y-C Tseng
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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Safety and Stability of Postponed Maxillomandibular Fixation After Intraoral Vertical Ramus Osteotomy. J Craniofac Surg 2018; 29:2226-2230. [PMID: 30320697 DOI: 10.1097/scs.0000000000005025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The purpose of this study was to evaluate the postoperative safety and long-term stability of bimaxillary orthognathic patients with postponed maxillomandibular fixation (MMF) after intraoral vertical ramus osteotomy.A total of 61 patients (21 male and 40 female patients; average age [SD], 21.7 [4.7]) were enrolled. All patients underwent maxillary LeFort I osteotomy and bilateral intraoral vertical ramus osteotomy for mandibular prognathism. During the hospital stay, postoperative airway compromise was observed and patients underwent MMF with wire at the second postoperative day. Stability was evaluated by measuring the position at each period: preoperative (T0), 2-day postoperative (T1), and 1-year postoperative.Postoperative dyspnea and respiratory distress were absent in all patients. The mean number of refixations in physiotherapy was 0.62 (0.86) and the mean duration of physiotherapy was 11.6 (5.5) days. The mean amount of mandibular setback was 12.56 (5.76) mm and menton movement 0.98 (2.36) mm superiorly (T1). The mean mandibular relapse at Pog was 0.87 (1.96) mm anteriorly. Menton showed 1.11 (1.41) mm superiorly movement 1-year postoperatively (T2).Despite its many advantages, intraoral vertical ramus osteotomy requires a period of MMF which can lead to early discomfort and airway-related emergency. In this study, the physiotherapy procedure and postoperative long-term stability in the postponed MMF group were not different from those of an immediate MMF group studied previously. It therefore constitutes a viable option for oral breathers and other compromised patients.
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Park JC, Lee J, Lim HJ, Kim BC. Rotation tendency of the posteriorly displaced proximal segment after vertical ramus osteotomy. J Craniomaxillofac Surg 2018; 46:2096-2102. [PMID: 30318326 DOI: 10.1016/j.jcms.2018.09.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 09/24/2018] [Indexed: 11/30/2022] Open
Abstract
Intraoral Vertical Ramus Osteotomy (IVRO) is one of the operative techniques used for orthognathic surgery. The aim of this study was to assess the posterior displacement of the proximal segment in patients undergoing IVRO at 1-year follow-up. In total, 52 hemimandibles from 26 patients who underwent IVRO in whom the proximal segment was posteriorly displaced without overlap with the distal segment at immediate post-operation (Imm) (30 cases, experimental group), and 26 patients in whom the proximal segment was not posteriorly displaced with overlap with the distal segment (Imm) (22 cases, control group) under three-dimensional computed tomography (3D CT) were included in the study. To analyze the movement of segments, the positions of the mid condyle point (MCP) and angle of condyle line (Con) were determined and the movement of the ramus angle (posterior edge of proximal segments) was measured at the proximal segment. Regression of the proximal segment in sagittal direction of the MCP was observed in both groups and all directions of the ramus angle in the experimental group, and only sagittal direction in the control group. In conclusion, posterior displacement of the proximal segment after IVRO showed tendency to regress its original position.
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Affiliation(s)
- Jong Chan Park
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon, Republic of Korea
| | - Jun Lee
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon, Republic of Korea
| | - Hun Jun Lim
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon, Republic of Korea
| | - Bong Chul Kim
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon, Republic of Korea.
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Jeong JH, Choi SH, Kim KD, Hwang CJ, Lee SH, Yu HS. Long-Term Stability of Pre-Orthodontic Orthognathic Bimaxillary Surgery Using Intraoral Vertical Ramus Osteotomy Versus Conventional Surgery. J Oral Maxillofac Surg 2018; 76:1753-1762. [DOI: 10.1016/j.joms.2018.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 02/12/2018] [Accepted: 02/12/2018] [Indexed: 11/28/2022]
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Kung A, Leung Y. Stability of intraoral vertical ramus osteotomies for mandibular setback: a longitudinal study. Int J Oral Maxillofac Surg 2018; 47:152-159. [DOI: 10.1016/j.ijom.2017.09.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/20/2017] [Accepted: 09/12/2017] [Indexed: 11/28/2022]
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Correction of Malocclusion by Botulinum Neurotoxin Injection into Masticatory Muscles. Toxins (Basel) 2018; 10:toxins10010027. [PMID: 29301317 PMCID: PMC5793114 DOI: 10.3390/toxins10010027] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 12/29/2017] [Accepted: 12/31/2017] [Indexed: 12/17/2022] Open
Abstract
Botulinum toxin (BTX) is a neurotoxin, and its injection in masticatory muscles induces muscle weakness and paralysis. This paralytic effect of BTX induces growth retardation of the maxillofacial bones, changes in dental eruption and occlusion state, and facial asymmetry. Using masticatory muscle paralysis and its effect via BTX, BTX can be used for the correction of malocclusion after orthognathic surgery and mandible fracture. The paralysis of specific masticatory muscles by BTX injection reduces the tensional force to the mandible and prevents relapse and changes in dental occlusion. BTX injection in the anterior belly of digastric and mylohyoid muscle prevents the open-bite and deep bite of dental occlusion and contributes to mandible stability after orthognathic surgery. The effect of BTX injection in masticatory muscles for maxillofacial bone growth and dental occlusion is reviewed in this article. The clinical application of BTX is also discussed for the correction of dental malocclusion and suppression of post-operative relapse after mandibular surgery.
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García y Sánchez JM, Gómez Rodríguez CL, Romero Flores J. Surgical Management of Laterognathia in Orthofacial Surgery. J Maxillofac Oral Surg 2017; 16:365-373. [PMID: 28717296 PMCID: PMC5493542 DOI: 10.1007/s12663-015-0870-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 11/11/2015] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Each year around the world, various surgical procedures are carried out with the goal of correcting laterognathia; both the intraoral vertical ramus osteotomy (IVRO) and bilateral sagittal split ramus osteotomy (OSB) have been the most used techniques in mandibular surgery. These techniques have advantages and disadvantages; for example the advantages of the OSB include: increased coefficient of friction between bony segments, for both the forward and the retroposition, as well as decrease in the time of intermaxillary fixation (IMF). Disadvantages include injury to the inferior alveolar nerve (IAN), hemorrhage, bad split, among others. The advantages of IVRO include decrease of possibility of injury to the IAN, ease of implementation of the technique, a lower incidence of hemorrhage and the short duration of the surgical procedure. Their disadvantages include: lower coefficient of friction between bony segments, requires a relatively long period of IMF. The combination between the techniques of mandibular osteotomy for the correction of minor 10 mm laterognathia is the ideal treatment, since it avoids potential recurrence. MATERIALS AND METHODS We describe two cases of patients with laterognathia greater than 6 mm associated with maxilla deformity, which were treated with combined osteotomies. At Maxillofacial Surgery Service, Specialty Hospital, National Medical Center XXI Century, we describe the advantages and disadvantages, pre and postoperative nosocomial, by comparing them with the reports of the literature. CONCLUSION The combination of techniques in the correction of laterognathias greater than 4 mm (smaller than 10 mm) is the ideal treatment, eliminating problems of articular compression, recurrence and damage to the alveolar nerve.
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Affiliation(s)
- J. M. García y Sánchez
- Maxillofacial Surgery Service, Specialty Hospital, National Medical Center XXI Century, Instituto Mexicano del seguro Social (IMSS), Avenida Cuahtemoc, #330, colonia Doctores, Mexico, Distrito Federal Mexico
| | - C. L. Gómez Rodríguez
- Maxillofacial Surgery Service, Specialty Hospital, National Medical Center XXI Century, Instituto Mexicano del seguro Social (IMSS), Avenida Cuahtemoc, #330, colonia Doctores, Mexico, Distrito Federal Mexico
| | - J. Romero Flores
- Maxillofacial Surgery Service, Specialty Hospital, National Medical Center XXI Century, Instituto Mexicano del seguro Social (IMSS), Avenida Cuahtemoc, #330, colonia Doctores, Mexico, Distrito Federal Mexico
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Skeletal and dental stability after intraoral vertical ramus osteotomy: a long-term follow-up. Int J Oral Maxillofac Surg 2017; 46:72-79. [DOI: 10.1016/j.ijom.2016.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 07/08/2016] [Indexed: 11/18/2022]
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Relationship between Frontal Gap and Postoperative Stability in the Treatment of Mandibular Prognathism. BIOMED RESEARCH INTERNATIONAL 2016; 2016:7046361. [PMID: 27774457 PMCID: PMC5059647 DOI: 10.1155/2016/7046361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 08/28/2016] [Accepted: 09/08/2016] [Indexed: 11/17/2022]
Abstract
Objectives. To investigate the correlation between frontal gaps and skeletal stability after intraoral vertical ramus osteotomy (IVRO) for correction of mandibular prognathism. Materials and Methods. Thirty-three patients with frontal gaps after IVRO-based mandibular prognathism correction were included. Three lateral and frontal cephalometric radiographs were obtained: preoperatively (T1), immediately postoperatively (T2), and 2 years postoperatively (T3). Two linear measurements (menton [Me] and frontal gap) were compared from T1 to T3 (T21: immediate surgical changes; T32: postoperative stability; T31: 2-year surgical change). Data were analyzed using Pearson's correlation coefficient and multiple linear regression. Results. The T21 mean surgical horizontal change in the Me position was 12.4 ± 4.23 mm. Vertically, the mean downward Me movement was 0.6 ± 1.73 mm. The mean frontal gaps were 4.7 ± 2.68 mm and 4 ± 2.48 mm in the right and left gonial regions, respectively. Postoperative stability (T32) significantly correlated with the amount of setback. Frontal gaps did not have a significant effect on postoperative stability. However, multiple regression model (R2 = 0.341, P = 0.017) showed value predictability, especially in the amount of setback. Conclusion. Frontal gaps occur after IVRO but have no significant effect on long-term postoperative skeletal stability. The primary risk factor for postoperative relapse remains the amount of mandibular setback.
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Ann HR, Jung YS, Lee KJ, Baik HS. Evaluation of stability after pre-orthodontic orthognathic surgery using cone-beam computed tomography: A comparison with conventional treatment. Korean J Orthod 2016; 46:301-9. [PMID: 27668193 PMCID: PMC5033769 DOI: 10.4041/kjod.2016.46.5.301] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 07/14/2016] [Accepted: 07/22/2016] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the skeletal and dental changes after intraoral vertical ramus osteotomy (IVRO) with and without presurgical orthodontics by using cone-beam computed tomography (CBCT). METHODS This retrospective cohort study included 24 patients (mean age, 22.1 years) with skeletal Class III malocclusion who underwent bimaxillary surgery with IVRO. The patients were divided into the preorthodontic orthognathic surgery (POGS) group (n = 12) and conventional surgery (CS) group (n = 12). CBCT images acquired preoperatively, 1 month after surgery, and 1 year after surgery were analyzed to compare the intergroup differences in postoperative three-dimensional movements of the maxillary and mandibular landmarks and the changes in lateral cephalometric variables. RESULTS Baseline demographics (sex and age) were similar between the two groups (6 men and 6 women in each group). During the postsurgical period, the POGS group showed more significant upward movement of the mandible (p < 0.05) than did the CS group. Neither group showed significant transverse movement of any of the skeletal landmarks. Moreover, none of the dental and skeletal variables showed significant intergroup differences 1 year after surgery. CONCLUSIONS Compared with CS, POGS with IVRO resulted in significantly different postsurgical skeletal movement in the mandible. Although both groups showed similar skeletal and dental outcomes at 1 year after surgery, upward movement of the mandible during the postsurgical period should be considered to ensure a more reliable outcome after POGS.
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Affiliation(s)
- Hye-Rim Ann
- Department of Orthodontics, College of Dentistry, Yonsei University, Seoul, Korea
| | - Young-Soo Jung
- Department of Oral and Maxillofacial Surgery, Oral Science Research center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Kee-Joon Lee
- Department of Orthodontics, College of Dentistry, Yonsei University, Seoul, Korea.; The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hyoung-Seon Baik
- Department of Orthodontics, College of Dentistry, Yonsei University, Seoul, Korea.; The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
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Choi SH, Yoo HJ, Lee JY, Jung YS, Choi JW, Lee KJ. Stability of pre-orthodontic orthognathic surgery depending on mandibular surgical techniques: SSRO vs IVRO. J Craniomaxillofac Surg 2016; 44:1209-15. [DOI: 10.1016/j.jcms.2016.07.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 06/15/2016] [Accepted: 07/18/2016] [Indexed: 11/28/2022] Open
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Choi SH, Cha JY, Park HS, Hwang CJ. Intraoral Vertical Ramus Osteotomy Results in Good Long-Term Mandibular Stability in Patients With Mandibular Prognathism and Anterior Open Bite. J Oral Maxillofac Surg 2016; 74:804-10. [DOI: 10.1016/j.joms.2015.09.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 09/22/2015] [Accepted: 09/27/2015] [Indexed: 10/22/2022]
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Major factors contributing to anterior and posterior relapse after intraoral vertical ramus osteotomy. J Craniomaxillofac Surg 2016; 44:413-20. [PMID: 26897301 DOI: 10.1016/j.jcms.2016.01.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 12/10/2015] [Accepted: 01/14/2016] [Indexed: 11/22/2022] Open
Abstract
The aim of this retrospective cohort study was to investigate the factors contributing to mandibular relapse after intraoral vertical ramus osteotomy (IVRO) while controlling for possible confounders. Forty-seven patients who underwent bimaxillary surgery were divided into three groups according to the direction of horizontal mandibular relapse: a stable group (group S), a posterior relapse group (group P), and an anterior relapse group (group A). Lateral cephalograms were analysed 1 month before and at 7 days and 12 months after surgery. One month before surgery, the pogonion in group A was positioned about 13 mm more anteriorly than in group P (P < 0.05). Immediately after surgery, the mandibles in groups A and S had moved about 6 mm more posteriorly than in group P. At 12 months, both the mandibles (point B) and the maxillae (point A) had moved posteriorly in group P (P < 0.05). A multivariate linear regression analysis showed that the amount of setback was the one key factor predicting postoperative mandibular changes 12 months after IVRO. As the amount of setback decreased, mandibular posterior horizontal relapse increased after IVRO. These findings suggest that the amount of setback can be a key factor predicting postoperative mandibular relapse.
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Stability of Pre-Orthodontic Orthognathic Surgery Using Intraoral Vertical Ramus Osteotomy Versus Conventional Treatment. J Oral Maxillofac Surg 2015; 74:610-9. [PMID: 26259691 DOI: 10.1016/j.joms.2015.07.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 07/03/2015] [Accepted: 07/15/2015] [Indexed: 11/22/2022]
Abstract
PURPOSE Postoperative skeletal and dental changes were evaluated in patients with mandibular prognathism who underwent mandibular setback surgery using an intraoral vertical ramus osteotomy (IVRO) with and without presurgical orthodontic treatment. MATERIAL AND METHODS This retrospective cohort study included consecutive patients with skeletal Class III malocclusions who underwent IVRO. Patients treated with pre-orthodontic orthognathic surgery (POGS) were compared with patients treated with conventional surgery (CS) with presurgical orthodontics (control) using lateral cephalograms (taken preoperatively, 7 days postoperatively, and 12 months postoperatively). Predictor (group and timing), outcome (cephalometric measurements over time), and other (ie, baseline characteristics) variables were evaluated to determine the differences in postoperative horizontal and vertical positional changes of the mandible, such as point B. Baseline demographics were similar between the groups (N = 37; CS group, n = 17; POGS group, n = 20). The data were analyzed with an independent t test, the Mann-Whitney U test, the Fisher exact t test, Pearson correlation analysis, and simple linear regression analysis. RESULTS The mean setback of the mandible at point B was similar, but the mandible of the POGS group, particularly the distal segment, moved superiorly during the postoperative period in conjunction with the removal of premature occlusal contacts (P < .001). In the CS group, the mandible had significantly more backward movement 12 months after surgery compared with the POGS group (P < .01). In the POGS group, horizontal and vertical postsurgical changes were linearly correlated with the amount of setback and vertical movement of the mandible. CONCLUSIONS Mandibular setback surgery using IVRO without presurgical orthodontics leads to considerably different postoperative skeletal and dental changes compared with conventional treatment, with more superior movement being observed at point B during the 1-year postoperative period.
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Postoperative stability for surgery-first approach using intraoral vertical ramus osteotomy: 12 month follow-up. Br J Oral Maxillofac Surg 2014; 52:539-44. [DOI: 10.1016/j.bjoms.2014.03.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 03/14/2014] [Indexed: 11/17/2022]
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Halvorsen ET, Beddari IY, Schilbred Eriksen E, Boe OE, Wisth PJ, Loes S, Moen K. Relapse and stability after mandibular setback surgery one year postoperatively: a retrospective study. J Oral Maxillofac Surg 2014; 72:1181.e1-11. [PMID: 24831939 DOI: 10.1016/j.joms.2014.02.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 02/17/2014] [Accepted: 02/18/2014] [Indexed: 11/15/2022]
Abstract
PURPOSE A retrospective evaluation was performed of dentoalveolar and skeletal stability 1 year after mandibular setback surgery using intraoral vertical subcondylar osteotomy (IVSO) combined with intermaxillary fixation. PATIENTS AND METHODS Twenty-eight patients (16 men, 12 women) with skeletal Angle Class III malocclusions were included. Mean age at start of treatment was 23.9 years. All patients underwent combined surgical and orthodontic treatment. Dental casts and cephalometric measurements were performed for each patient before orthodontic treatment and at 8 weeks and 1 year after surgery. RESULTS Treatment changes from 8 weeks to 1 year after surgery were small but significant for the angular relationship between the maxilla and the mandible in the sagittal plane (ANB) (mean difference, -0.5 mm; P = .021), Wits appraisal (mean difference, -0.7 mm; P = .044), the inclination of the mandible in relation to the nasion-sella line (ML-NSL) (mean difference, -0.8 mm; P = .010), and the inclination of the lower incisors in relation to the nasion-point B line (Li-NB) (mean difference, -0.6 mm; P < .001). These findings for cephalometric values indicated a small skeletal relapse in sagittal and vertical relations. No significant dentoalveolar relapse occurred according to the dental cast evaluations. CONCLUSION The results clearly show that orthodontic treatment combined with IVSO provides a stable dental and skeletal result 1 year after treatment.
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Affiliation(s)
- Eirik Torjuul Halvorsen
- Consultant Orthodontist, Section for Orthodontics, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Ingri Yddal Beddari
- Consultant Orthodontist, Section for Orthodontics, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Elisabeth Schilbred Eriksen
- Resident Orthodontist, Section for Orthodontics, Department of Clinical Dentistry, University of Bergen, Bergen, Norway.
| | - Olav Egil Boe
- Associate Professor, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Per Johan Wisth
- Professor Emeritus, Section for Orthodontics, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Sigbjorn Loes
- Associate Professor and Consulting Oral and Maxillofacial Surgeon, Department of Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Ketil Moen
- Consultant Oral and Maxillofacial Surgeon, Section for Oral and Maxillofacial Surgery, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
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