No abstract available.
Maxilla ; Orthognathic Surgery

surgery but in Le Fort II osteotomy, the standardization of prognostic value is essential in treatment planning to achieve satisfactory postoperative results. According to previous reports, the ratio of soft tissue change to hard tissue movements varies as to different surgical methods and different facial regions. But there are few report about the ratio of soft tissue change to hart tissue movement following Le Fort II osteotomy. So we tried to develop standarized soft tissue surgical treatment objective. We have followed up 16 patients, who had received Le Fort II osteotomy by one operator from 1990 to 1996, one year postoperatively. In cephalometrics, we used Frankfort line as horizontal reference line, and vertical reference line as one drawn from Sella to horizontal line perpendicularly. The landmarks are G to soft tissue G, N on reference line to soft tissue N, ANS to Pn and A to Sn. The results are as follows. 1. The value of soft tissue change to hard tissue movement showed positive correlation, having statistical significancy at G, N2, N3 point. 2. At G, N2, N3 point, the ratio of soft tissue change to hard tissue movement was 0.51, 0.98 and 0.80 respectively and showed statistical significancy, while at N1, ANS, A point, that was 0.72, 0.49 and 0.26 but didn't showed statistical significance. 3. This result shows much the same change of the soft tissue change to hard tissue movement on the upper nasomaxilla, and less the same change on the lower maxilla and so the Le Fort II osteotomy can be recommended as a reliable effective operation method for correction of nasomaxillary retrusion.]]>
Humans ; Maxilla ; Orthognathic Surgery ; Osteotomy

A surgical approach involving the retromolar trigone, posterolateral maxilla, and pterygoid region is the most challenging in the field of maxillofacial surgery. The upper cheek flap (Weber-Ferguson incision) with subciliary extension and the maxillary swing approach have been considered as alternatives; however, neither approach provides sufficient exposure of the pterygoid region and the anterior portion of the mandibular ramus. In this report, we describe two cases in which a lower cheek flap approach was used for complete tumor resection in the retromolar trigone and the anterior mandibular ramus. This approach allows full exposure of the posterolateral maxilla and the pterygoid region as well as the retromolar trigone without causing major sensory disturbances to the lower lip. A mental nerve anastomosis after tumor resection was performed in one patient and resulted in approximately 90% sensory recovery in the lower lip. The lower cheek flap approach provides adequate exposure of the posterolateral maxilla, including the pterygoid, retromolar trigone, and mandibular ramus areas. If the mental nerve can be anastomosed during flap approximation, postoperative sensory disturbances to the lower lip can be minimized.
Cheek* ; Humans ; Lip ; Maxilla* ; Surgery, Oral

Humans ; Maxilla ; Maxillary Sinus ; surgery ; Paranasal Sinuses

surgery because their positional change may leads to postoperative skeletal relapse as well as TM joint problem. Various condylar positioning devices, therefore, have been introduced and utillzed in orthognathic surgery. Even though most of them provided us with improvement of surgical results, we also found some problems including limited indication, etc. For more accurately repositioning the maxilla and the mandible and its wide versatility, a newly designed maxilla and condylar positioning device based on the fixed part of cranium is introduced.]]>
Joints ; Mandible ; Maxilla ; Orthognathic Surgery ; Recurrence ; Skull

Bone Cysts ; Cysts ; Endoscopy ; Humans ; Maxilla/surgery* ; Maxillary Sinus/surgery*

INTRODUCTION: In orthognathic surgery, internal fixation has been usually done with titanium plates and screws. Recently, Biodegradable plates and screws have been frequently used but the reports of long term results of postoperative stability are rare, especially after maxillary reposition in orthognathic surgery. OBJECTIVE: In order to clarify the clinical utility of self-reinforced bioresorbable poly-70L / 30DL-Lactide miniplates & screws in maxillary fixation after LeFort I osteotomy, this study examined the postsurgical changes in maxilla and complications of biodegradable plates and screws. STUDY DESIGN: Nineteen patients who had undergone maxillary internal fixation using biodegradable plates and screws were evaluated radiographically and clinically. A comparison study of the changes in maxilla position after surgery in all 19 patients was performed with 1-week, 1-month, 3-months, 6-months and/or 1-year postoperative lateral cephalograms by tracing. Complication of the biodegradable plates and screws was evaluated by follow-up roentgenograms and clinical observation. And one-way ANOVA test was used for statistical analysis. RESULTS: The position of the maxillary bone was stable after surgery and was not changed significantly from 1 week to 1 year after operation. And we could not find any complication of biodegradable plates and screws. CONCLUSIONS: Internal fixation of the maxilla after LeFort I osteotomy using self-reinforced biodegradable plates and screws is a reliable method for maintaining postoperative position of the maxilla after LeFort I osteotomy.
Follow-Up Studies ; Humans ; Maxilla ; Orthognathic Surgery ; Osteotomy* ; Titanium

When we establish treatment planning of facial asymmetry, we must predict each asymmetrical element that will be changed upon coronal, axial, sagittal plane. At the visual point, prediction of the change of coronal plane is most important. It is important difference between Rt. and Lt. mandibular angle belonging to posterior coronal plane, as well as anterior coronal plane, such as upper and lower incisor, or midline of chin point. Several methods for control bulk of mandibular angle are additional angle shaving after osteotomy, grinding contact area between proximal and distal segment for decrease the volume, or bone graft for increase the volume. But, at the point of bimaxillary surgery, transverse position of posterior maxilla is an important factor for control it. So, we would report transverse movement of posterior maxilla for decrease asymmetry on the posterior coronal plane of face, that is, asymmetry of mandibular angular portion.
Chin ; Facial Asymmetry* ; Incisor ; Maxilla* ; Orthognathic Surgery* ; Osteotomy ; Transplants

Although orthognathic surgery has been performed at the maxilla and the mandibular ramus to obtain a normal functional occulsion and aesthetic improvement of the face, deformities of the chin and disproportion of the soft tissue have been left. Mandibular set-back or advancement usually leaves soft tissue redundancy or deficiency along with its displacement. We have combined genioplasty with orthognathic surgery after intermaxillary fixation through a separate incision to get aesthetic improvement in the chin area in 28 patients. The authors obtained the aesthetic profile of the chin and lower lip according to various soft tissue analysis as follows: 1) The depth of the mentolabial fold 2) The distance from the E-line to labrale inferius (LI) 3) N-ANS/ANS-Me The soft tissue disproportion and residual deformities which were not usually corrected by the orthognathic surgery alone could be improved by combining it with genioplasty.
Chin ; Congenital Abnormalities ; Genioplasty* ; Humans ; Lip ; Maxilla ; Orthognathic Surgery

Facial asymmetry can be classified into the rolling-dominant type (R-type), translation-dominant type (T-type), yawing-dominant type (Y-type), and atypical type (A-type) based on the distorted skeletal components that cause canting, translation, and yawing of the maxilla and/or mandible. Each facial asymmetry type represents dentoalveolar compensations in three dimensions that correspond to the main skeletal discrepancies. To obtain sufficient surgical correction, it is necessary to analyze the main skeletal discrepancies contributing to the facial asymmetry and then the skeletal-dental relationships in the maxilla and mandible separately. Particularly in cases of facial asymmetry accompanied by mandibular yawing, it is not simple to establish pre-surgical goals of tooth movement since chin deviation and posterior gonial prominence can be either aggravated or compromised according to the direction of mandibular yawing. Thus, strategic dentoalveolar decompensations targeting the real basal skeletal discrepancies should be performed during presurgical orthodontic treatment to allow for sufficient skeletal correction with stability. In this report, we document targeted decompensation of two asymmetry patients focusing on more complicated yaw-dependent types than others: Y-type and A-type. This may suggest a clinical guideline on the targeted decompensation in patient with different types of facial asymmetries.
Chin ; Facial Asymmetry* ; Humans ; Mandible ; Maxilla ; Orthognathic Surgery ; Tooth Movement