No abstract available.
Orthognathic Surgery ; Books ; Orthognathic Surgical Procedures ; Cephalometry

After bimaxillary orthognathic surgery for correction of facial deformity, the factors influencing stability of bone segment are the amount of bone segment, surgical technique, fixation technique, rotation of proximal segment. The aim of this study is to analyze the significance of the factors influencing skeletal relapse after bimaxillary orthognathic surgery. From March 1994 to march 2003, 11 patients who underwent bimaxillary procedures without genioplasty or any other orthognathic surgical procedures were included for sample. Lateral cephalograms were analyzed before surgery, 1 month and 12 months after surgery respectively. Vertical, horizontal, angular and dental measurements were obtained from each tracing using the horizontal and vertical reference lines. The mean amount of bone movement and relapse was 7.03mm, 2.44mm (35%) respectively at pogonion and 3.41mm, 0.6mm (18%) respectively at point A. After statistical analysis of collected data, the amount of skeletal movement, fixation technique were significantly related to relapse, but rotation of proximal segment, surgical procedures were not significantly related to relapse. Then we suggest that when operation is planned, 20-30% overcorrection was recommended at the time of bimaxillary surgery.
Congenital Abnormalities ; Genioplasty ; Humans ; Orthognathic Surgery* ; Orthognathic Surgical Procedures ; Recurrence

OBJECTIVE: We compared the skeletal and dental changes that resulted from the use of two methods of intermaxillary fixation (IMF)-miniscrews and surgical archwire-in 74 adult patients who had Class III malocclusion and were treated with the same orthognathic surgical procedure at a hospital in Korea. METHODS: All the patients underwent Le Fort I osteotomy and bilateral sagittal split ramus osteotomy with rigid fixation. They were divided into two groups according to the type of IMF used-group 1 underwent surgical archwire fixation and group 2 underwent orthodontic miniscrew fixation. In a series of cephalograms for each patient, we compared vertical and horizontal tooth-position measurements: (a) immediately after surgery (T0), (b) 3 months after surgery (T1), and (c) 6 months after surgery (T2). Cephalometric changes within each group were examined using one-way analysis of variance (ANOVA) while the independent samples t-test procedure was used to compare the two groups. RESULTS: After surgery, the maxillary incisors tended to be proclined in both groups although there were no significant differences. Incisor overbite increased significantly in both groups from T0 to T1, and the miniscrew group (group 2) showed slightly greater overbite than the archwire group (group 1). CONCLUSIONS: This study suggest that the use of orthodontic miniscrews and orthodontic surgical archwire for IMF in adult patients results in similar skeletal and dental changes.
Adult* ; Humans ; Incisor ; Korea ; Malocclusion ; Orthognathic Surgery* ; Orthognathic Surgical Procedures ; Osteotomy ; Osteotomy, Sagittal Split Ramus ; Overbite

BACKGROUND: In Asian countries, patients with a square-shaped lower face want a narrow chin as well as improvements in the mandibular angle contour, which is called a "V-line shape." Currently, various surgical techniques have been developed for mandibuloplasty. METHODS: We have developed an extended, long, curved ostectomy, which starts from the inferior mandibular margin below the lateral incisor to the angle, using reciprocating and oscillating saws. We also used a small round bur to grind the outer cortex of the chin and ramus. A total of 243 patients were included in this study from 2012 to 2014. RESULTS: To analyze aesthetic outcomes, we compared mandibular angles and gonial-gonial (G-G) distances on preoperative three-dimensional computed tomography scans with postoperative images. Mandibular measurements demonstrated significant increments in angle degrees on the right (115.2degrees+/-11.1 vs 129.3degrees+/-11.5, P<0.05) and left sides (112.2degrees+/-10.2 vs 130.4degrees+/-11.3, P<0.05). The G-G distance was reduced postoperatively from 123.7 mm+/-7.9 to 110.0 mm+/-3.5 (P<0.05). CONCLUSIONS: In this study, we demonstrate the effectiveness of our technique and assume that we can improve frontal shape and lateral contour with its use.
Asian Continental Ancestry Group ; Chin* ; Humans ; Incisor ; Mandible ; Mandibular Osteotomy ; Orthognathic Surgery ; Orthognathic Surgical Procedures

Treating dentofacial deformities secondary to condylar resorption is a remarkable clinical challenge. Combined orthodontic treatment and orthognathic surgery is currently the main treatment scheme and is often integrated with temporomandibular joint surgery or conservative treatment according to the severity of condylar resorption. This paper discussed the etiology, clinical features, imaging features, treatment options, and prophylaxis of condylar resorption.
Bone Resorption ; Dentofacial Deformities ; Humans ; Mandibular Condyle ; Orthognathic Surgery ; Orthognathic Surgical Procedures ; Temporomandibular Joint

Orthognathic surgical procedures are designed to correct congenital or acquired dentofacial deformities, achieve cosmetic improvement of the face and dentition. Several investigations have shown that orthognathic surgery influences both the soft and hard tissues in the maxillofacial region, including the tongue and pharyngeal airway. This study was performed to evaluate the changes in the hyoid bone and tongue position, and pharyngeal airway space after mandibular setback osteotomy in 25 patients with mandibular prognathism by means of cephalometric analysis. Lateral cephalograms were obtained at pre-operation(T0) and 2-4days later the operation(T1) and 6 months post-operative follow-up(T2). In this study, we found that there were significant changes in position of hyoid bone and tongue and width of pharyngeal airway space after mandibular setback osteotomy(T1) in persons with mandible prognathism. and except of hyoid bone this change remained stable at 6 months follow up(T2). Especially in analysis with the amount of mandible set back; The cases where the amount of mandible set back was 6~7mm under, there was no significant change in hyoid bone movement. But above 6~7mm there was significant change. The cases where the amount of mandible set back was 11~12mm under, there was no significant change in tongue and pharyngeal airway space width. But above 11~12mm, there was significant change.]]>
Dentition ; Dentofacial Deformities ; Humans ; Hyoid Bone ; Mandible ; Orthognathic Surgery ; Orthognathic Surgical Procedures ; Osteotomy ; Prognathism ; Tongue

Orthognathic surgery for the correction of dentofacial deformities is a common elective procedure. It's possible to occur many complication during the operations and especially, an excesseive bleeding of those may be fatal and so a tranfusion is performing for the prevention and management of that. The most notable of these for reduction of blood loss is the utilization of induced hypotensive anesthetic technique to reduce the mean arterial pressure between 55 and 60 mmHb. Another method for dealing with blood loss following orthognathic surgery is the transfusion of blood obtained as an autologous tranfusion or from banked blood. Some of the disadvantage of banked blood are overcome with the use of predeposited autologous transfusion. But currently, surgeons try so that even autologous transfusion may not transfuse the patients. We made a comparative study of hematologic change and transfusion requirement based on a series of 200 patients who had an orthognathic surgical procedure at Chonbuk National University during the period 2001-2005. This study is to make a comparative analysis of an post-operative hematologic (Hemoglobin, Hematocrit, Red blood cell) change and duration of the procedure under induced hypotensive anesthesia in healthy orthognathic patients.]]>
Anesthesia ; Arterial Pressure ; Dentofacial Deformities ; Hematocrit ; Hemorrhage ; Humans ; Jeollabuk-do ; Orthognathic Surgery ; Orthognathic Surgical Procedures

OBJECTIVE: There is no universally accepted method for determining the ideal sagittal position of the maxilla in orthognathic surgery. The purpose of this study was to compare how well the Delaire's cephalometric analysis correlated with postoperatively findings in patients who underwent orthognathic surgery planned using other cephalometric analyses, as well as to evaluate the feasibility of the Delaire's cephalometric analysis in predicting the ideal sagittal position of the maxilla and chin. METHODS: In the study, 35 patients with skeletal Class III malocclusion were involved and met the criteria. Treatment plans were developed using photographs, 3-D photographs, radiographs, and standard cephalometric measurements. The Delaire's cephalometric analysis data, like the phase measurements (∠C1-L1 and ∠C1-L2) of the sagittal positions of the maxillary and the chin separating the reference line (L1) of NP point and the reference line (L2) of Me point, were analyzed using Dolphin Imaging software. At the same time, the analyses on standard measurements were also performed. Four orthognathic doctors, 4 orthodontic doctors and 4 college students from non-medical majors were selected as aesthetic evaluators to assess the patients' profile aesthetic by visual analogue scale (VAS). The results through the Delaire's cephalometric analysis were statistically compared with that through standard methods. RESULTS: The mean of ∠C1-L1 was 83.93°±2.99° and∠C1-L2 was 89.08° ±2.48° for males postoperatively, and 85.67° ±3.60° and 88.30° ±4.20° for females postoperatively. Compared with the reference values of Chinese goodlooking people, there was no significant difference of NP point, whereas there was a significant difference of Me point. The postoperative aesthetic scores were: the mean was 6.71±0.25 of upper jaws, 6.81±0.30 of chins and 6.90±0.29 of the overall for males; and 7.19±0.22, 7.26±0.34 and 7.39±0.29 for females. Compared with preoperative scores, there was a significant improvement. Furthermore, the scores of chins and the overall scores were related to the sagittal position of the chins. CONCLUSION Compared with standard cephalometric analysis, the Deliare's cephalometric analysis well unravel the preoperative deformity and the final esthetic sagittal positions of maxillary and chin in the present sample, and could be a useful tool for the planning of surgery-first approach in orthognathic surgery.
Cephalometry ; Chin ; Feasibility Studies ; Female ; Humans ; Male ; Mandible ; Maxilla ; Orthognathic Surgery ; Orthognathic Surgical Procedures

The maxillofacial skeleton is the basis of the contour of the face. Orthognathic surgery and facial contouring surgery change jaw tissue and affect facial appearance in different manners. Orthognathic surgery is the main method to correct dental and maxillofacial deformities. It changes the shape of the jaw and improves the occlusal relationship by changing the three-dimensional position of the jaw. Facial contouring surgery mainly adopts the method of "bone reduction", which changes the "amount"of the jawbone by cutting a part of the bone tissue to improve the facial appearance, generally without changing oral function. The combined use of orthognathic surgery and facial contouring surgery is becoming increasingly common in clinical practice. This also requires oral and maxillofacial surgeons to have a holistic consideration of the comprehensive correction of maxillofacial bone deformity, and to perform comprehensive analysis of jaw deformities and jaw plastic surgery to achieve the most ideal results. The author's team has been engaged in the clinical work of orthognathic surgery and facial contouring surgery and accumulated rich clinical experience in the comprehensive correction of maxillofacial bone deformity. In this article, the indications, treatment goals, treatment modes, treatment methods, and key points in the surgical operations of comprehensive maxillofacial bone surgery were summarized.
Face/surgery* ; Facial Bones ; Humans ; Maxillofacial Abnormalities ; Orthognathic Surgery ; Orthognathic Surgical Procedures

Orthognathic surgery, which involve osteotomy and repositioning of the maxillomandibular complex, has recently emerged as a crucial method of correcting dentofacial deformities. The optimal placement of the maxillomandibular complex holds utmost significance during orthognathic surgery because it directly affects the surgical outcome. To accurately achieve the ideal position of the maxillomandibular complex, with the rapid advancements in digital surgery and 3D-printing technology, orthognathic surgery has entered an era of "Precision Surgery" from the pervious "Empirical Surgery." This article provides comprehensive insights into our extensive research and exploration of the treatment modality known as "precision orthognathic surgery" over the years. We also present the technical system and application in"Ortho+X" treatment modality to offer valuable references and assistance to our colleagues in the field.
Orthognathic Surgery ; Orthognathic Surgical Procedures ; Printing, Three-Dimensional ; Surgery, Computer-Assisted