Stability of intraoral vertical ramus osteotomies for mandibular setback
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Mandibular prognathism
Prognathism
Setback
Mandible (arthropod mouthpart)
Background: The aim of the present study is to evaluate the long-term postoperative skeletal stability after orthognathic surgery with counter-clockwise rotation (CCWR) or with clockwise rotation (CWR) of the maxillo-mandibular complex. Case Description: Three patients were submitted to orthognathic surgery associated with CCWR and CWR. Lateral cephalometric radiographs were obtained in centric relation for each patient, one day before surgery (T1), 1 week after surgery (T2) and 1 year after surgery (T3). Cephalometric angles analysed were: SN-OP, SN-A, SN-B, SN-Pg, and SN-Ar. Angular changes on occlusal plane (OP), condylar position, maxilar, mandibular, and pogonium prognathism were analysed. Maxilar, mandibular, and pogonium prognathism linear changes were also recorded in millimeters. Patients had no signs and symptoms of temporo-mandibular joints pathology. Patients 1 and 2 were submitted to orthognathic surgery with CCWR. Patient 1 presented an OP decrease on T2, from 6.37° to 4.01°. On T3, however, a 2.17° relapse was observed. Patient 2 presented an OP decrease on T2, from 8.14° to 3.45°. On T3, however, a 0.54° relapse was observed. Patient 3 was submitted to orthognathic surgery with CWR. It was observed an increase in OP angulation on T2, from 6.16° to 16.13°. On T3, however, it was observed a 7.57° relapse. Conclusions: Regarding OP stability following orthognathic surgery with CCWR and CWR, results of the present article are consistent with of some previous published studies. More cases should be followed and more research in this area are necessary to validate these approaches to avoid unsuccessful cases or to anticipate unwanted results.
Mandibular prognathism
Clockwise
Prognathism
Cephalometry
Cephalometric analysis
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Patients with mandibular prognathism have, for a number of years, been treated by orthognathic surgery and post-surgical changes in the facial profile have been widely reported. However, little is known about the influence of gender and age on the soft tissues. The aim of this study was to investigate changes in the soft tissue profile following orthognathic surgery and to evaluate gender and age differences in the ratios of soft-to-hard tissue change.
Prognathism
Mandibular prognathism
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Clinical evaluations were performed on 60 patients who had undergone orthognathic surgery in our clinic during the 10 years from 1977 to 1987.The results are summarized as follows:1. Patient number gradually increased in number.2. Male/female ratio was 1: 2.3.3. Average age of the patients was 21.1 years.4. 56 patients were diagnosed as having mandibular prognathism, 3 maxillo-mandibular asymmetry and 1 as maxillary prognathism.5. The surgical method used in most patients was the so-called Obwegeser-Dal Pont method.6. 8 patients underwent pre-and postoperative orthodontic treatment and 2 patients postoperative orthodontic treatment.7. Changes of the facial soft-tissue profile after surgical correction were evaluated as satisfactory.
Mandibular prognathism
Facial symmetry
Prognathism
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A case of acromegaly accompanied by pituitary adenoma in a 35-year-old male is reported. The patient presented with mandibular protrusion, malocclusion and articulate disorder. Prior to oral surgery, a pituitary adenoma was resected at the Department of Neurosurgery. Pre-operative orthodontic treatment was started after growth hormone and insulin-like growth factor I had returned to normal levels. Orthognathic surgery by sagittal split ramus osteotomy (SSRO) was performed, and good occlusion was obtained. Articulate function also improved after orthognathic surgery.
Mandibular prognathism
Prognathism
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Evaluate the electromyographic changes in the Masseter (MM) and Temporalis (TM) muscles during voluntary clenching of the teeth both before and after orthognathic surgery in patients aged 18 years and older and diagnosed with mandibular prognathism.Eleven patients with prognathism were included in the study, in all of whom the initial phase of orthodontic treatment had been completed. The orthognathic procedure to reduce prognathism comprised intraoral oblique sliding (or subsigmoid) osteotomy, after which intermaxillary fixation with ligaments in the maxilla and mandible was undertaken in all patients for 6 weeks post-surgery. Electromyographic activity was recorded during the baseline maximum voluntary contraction of the teeth, with the same measurement taken 3 and then 6 months after orthognathic surgery.Significant differences were found in the mean amplitude (17.0 vs 14.7, P = 0.020) and peak-to-peak amplitude (left [761.6 vs 457.0, P = 0.003] and right [676.9 vs 357.4, P = 0.007]) for the MM between the baseline score and 6 months after surgery. Likewise, significant differences were found in the mean amplitude (18.2 vs 25.6, P = 0.009) and peak-to-peak amplitude (left [856.4 vs 1594.2, P = 0.004] and right [804.4 vs 1813.4, P = 0.004]) for the TM between the baseline score and that taken 6 months post-surgery. Only 18.2% (2/11) presented orthodontic appliances problem in the 3 months post-surgery.Electromyographic activity was restored 6 months after the orthognathic surgery. From a clinical perspective, the results obtained confirm that orthognathic surgery has not only an esthetic but also a functional objective in terms of achieving equilibrium and occlusal harmony.
Prognathism
Mandibular prognathism
Dentofacial Deformity
Mandible (arthropod mouthpart)
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Mandibular prognathism
Prognathism
Cephalometry
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Citations (92)
Various techniques and modifications have been introduced in the treatment of mandibular prognathism. However, there are still few reports concerning long-term stability, especially using the intraoral vertical ramus osteotomy (IVRO) method. The purpose of this study was to investigate the long-term stability for correction of mandibular prognathism using IVRO. Twenty-five mandibular prognathism patients were treated by bilateral IVRO, and were evaluated cephalometrically by reference to the menton. A set of 3 standardized lateral cephalograms were obtained from each subject preoperatively (T1), immediately postoperatively (T2), and after 2 years postoperatively (T3). Relapse was defined as forward movement of menton after the 2-year follow-up. The mean setback of the menton was 12.8 mm in horizontal direction and 0.9 mm downward in vertical direction. The average follow-up was 33.9 months. The mean relapse was 1.3 mm (10.2% = 1.3 of 12.8) in forward direction and 0.6 mm in upward direction. There was no significant movement in the vertical direction. However, significant relapse was shown in the horizontal direction, even though the amount was small. The long-term stability of our present study suggested that IVRO is useful for correction of mandibular prognathism.
Mandibular prognathism
Prognathism
Setback
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The purpose of this study was to investigate clinical application of SIS for mandibular prognathism with SIS (Severity Indicator of Soft tissue profile) to make differential diagnosis for orthognathic surgery.The results were as follows:1. As for the relationship between the frequency of orthognathic surgery and SIS value, the frequency of orthognathic surgery increased when SIS value decreased.2. SIS was significantly more negative in the orthognathic surgery group (P<0.001) than in the nonsurgery group. A severer concave profile was shown in this group.From the above, it was possible to use SIS for numerical analysis of soft tissue profile and to make accurate differential diagnosis for orthognathic surgery.
Mandibular prognathism
Prognathism
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Prognathism
Mandibular prognathism
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This study was designed to investigate the patient's recognition of changes in facial profile due to orthognathic surgery. The results of questionnaires were summarized and analyzed in relation to cephalometric data.The subjects consisted of forty-three posttreatment patients (13 males and 30 females) with mandibular prognathism, , who had undergone orthognathic surgery at Hiroshima University Dental Hospital. In this study, patient's recognition of improvement in facial profile was summarized in relation to morphologic changes associated with orthognathic surgery by means of Spearman's correlation analysis.The results were as follows:1. Before treatment, eighty-eight percent of patients were anxious about disharmony of the facial profiles, and the degree of anxiousness was severe in half of them. As for facial areas, the lower lip and chin were their greatest concern.2. After treatment, eighty-four percent of patients recognized improvement in facial profile, and sixty-three percent of patients assessed that their profiles were improved more substantially than expected before treatment. As for facial parts, more than seventy percent of patients mainly recognized improvement in lower lip and chin.3. The patient's recognition of improvement in facial profile, especially chin, exhibited a significantly positive correlation with the amount of mandibular setback during treatment.These results suggested that most patients assessed that improvement in facial profile was achieved by orthognathic surgery. It is shown that their recognition of improvement in their facial profiles is significantly correlated with the amount of mandibular setback.
Mandibular prognathism
Prognathism
Cephalometry
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