This article describes a case we experienced in which good postsurgical facial profiles were obtained for a patient with jaw deformities associated with facial asymmetry, by implementing surgical planning with SimPlant OMS. Using this method, we conducted LF1 osteotomy, intraoral vertical ramus osteotomy (IVRO), sagittal split ramus osteotomy (SSRO), mandibular constriction and mandibular border genioplasty. Not only did we obtain a class I occlusal relationship, but the complicated surgery also improved the asymmetry of the frontal view, as well as of the profile view, of the patient. The virtual operation using three-dimensional computed tomography (3D-CT) could be especially useful for the treatment of patients with jaw deformities associated with facial asymmetry.
Adult ; Facial Asymmetry ; complications ; diagnostic imaging ; surgery ; Genioplasty ; Humans ; Imaging, Three-Dimensional ; Jaw Abnormalities ; complications ; diagnostic imaging ; surgery ; Male ; Mandible ; abnormalities ; diagnostic imaging ; surgery ; Occlusal Splints ; Oral Surgical Procedures ; methods ; Osteotomy, Le Fort ; Osteotomy, Sagittal Split Ramus ; Patient Care Planning ; Surgery, Computer-Assisted ; Tomography, X-Ray Computed

Bimaxillary transverse width discrepancies are commonly encountered among patients with dentofacial deformities. Skeletal discrepancies should be diagnosed and managed appropriately with possible surgical corrections. Transverse width deficiencies can present in varieties of combinations involving the maxilla and mandible. We observed that in a significant proportion of cases, the maxilla is normal, and the mandible showed deficiency in the transverse dimension after pre-surgical orthodontics. We designed novel osteotomy techniques to enhance mandibular transverse width correction, as well as simultaneous genioplasty. Chin repositioning along any plane is applicable concomitant with mandibular midline arch widening. When there is a requirement for larger widening, gonial angle reduction may be necessary. This technical note focuses on key points in management of patients with transversely deficient mandible and the factors affecting the outcome and stability. Further research on the maximum amount of stable widening will be conducted. We believe that developing evidence-based additional modifications to existing conventional surgical procedures can aid precise correction of complex dentofacial deformities.

Objectives: Although a few studies have investigated the relationship between kidney and oral function (number of remaining teeth), their results remain inconclusive. Therefore, this study aimed to investigate the relationship between kidney function and oral health in community-dwelling healthy elderlies and examine the factors associated with kidney function. Materials and Methods: We used cross-sectional data from the Shimane prefecture cohort recruited by the Center for Community-Based Health Research and Education in 2019. We collected clinical data on dental status, background factors and kidney function (estimated glomerular filtration rate [eGFR], mL/min/1.73 m2 and creatinine levels, mg/dL). Results: The study enrolled 481 participants, whose mean age was 66.7±7.4 years, and 223 (46.4%) participants were men. Multivariate analysis revealed significant correlations between eGFR (B=0.17, P=0.04), creatinine (B=–0.54, P<0.01), and the number of remaining teeth. The number of remaining teeth was associated with creatinine and eGFR, which are indicators of kidney function. Conclusion This study suggests that preserving the teeth may prevent decline in kidney function. Dental professionals should provide instructions and professional care to reduce the risk of systemic diseases such as kidney dysfunction.

Objectives: Traumatic optic neuropathy (TON), a relatively rare condition, can cause visual functional impairment and permanent functional damage.Surgeons should be familiar with its diagnostic criteria and treatment to effectively manage cases of facial trauma with TON. We investigated the feasibility of navigation-assisted endoscopic trans-nasal optic nerve decompression (ETOND) to treat TON in maxillofacial trauma patients. Patients and Methods: We retrospectively analyzed data from the clinical investigation of four consecutive patients, two males and two females with an average age of 75 years, with midfacial fractures and TON between April 2021 and September 2023. All patients had swelling and subcutaneous periorbital hemorrhage accompanied by optic nerve canal and zygomaticomaxillary complex fractures on the affected side. Three patients had lacerations on the lateral eyebrow or upper eyelid. All patients were evaluated by an ophthalmologist for visual impairment; two patients could see hand motion at a 30 cm distance, one patient could perceive light, and one did not have any loss of visual acuity. Among the four patients, three had visual impairment immediately after the injury, and one showed delayed impairment. Results: The patients were treated with navigation-assisted ETOND conducted by an endoscopic rhinologist. Three of the ETONDs were performed along with open reduction and internal fixation (ORIF); the other ETOND was delayed. Orbital reconstruction was performed in three patients. Steroid therapy was administered to two patients, one pre-operatively and one post-operatively. The two patients with pre-operative vision loss showed improved visual acuity post-operatively, and the two patients with no pre-operative visual impairment had no vision loss associated with ORIF for their midfacial fractures. No patient had post-operative complications. Conclusion Navigation-assisted ETOND can be performed easily by endoscopic rhinologists; and prompt examination, diagnosis, and treatment are important in patients with facial trauma and TON.

Objectives: Traumatic optic neuropathy (TON), a relatively rare condition, can cause visual functional impairment and permanent functional damage.Surgeons should be familiar with its diagnostic criteria and treatment to effectively manage cases of facial trauma with TON. We investigated the feasibility of navigation-assisted endoscopic trans-nasal optic nerve decompression (ETOND) to treat TON in maxillofacial trauma patients. Patients and Methods: We retrospectively analyzed data from the clinical investigation of four consecutive patients, two males and two females with an average age of 75 years, with midfacial fractures and TON between April 2021 and September 2023. All patients had swelling and subcutaneous periorbital hemorrhage accompanied by optic nerve canal and zygomaticomaxillary complex fractures on the affected side. Three patients had lacerations on the lateral eyebrow or upper eyelid. All patients were evaluated by an ophthalmologist for visual impairment; two patients could see hand motion at a 30 cm distance, one patient could perceive light, and one did not have any loss of visual acuity. Among the four patients, three had visual impairment immediately after the injury, and one showed delayed impairment. Results: The patients were treated with navigation-assisted ETOND conducted by an endoscopic rhinologist. Three of the ETONDs were performed along with open reduction and internal fixation (ORIF); the other ETOND was delayed. Orbital reconstruction was performed in three patients. Steroid therapy was administered to two patients, one pre-operatively and one post-operatively. The two patients with pre-operative vision loss showed improved visual acuity post-operatively, and the two patients with no pre-operative visual impairment had no vision loss associated with ORIF for their midfacial fractures. No patient had post-operative complications. Conclusion Navigation-assisted ETOND can be performed easily by endoscopic rhinologists; and prompt examination, diagnosis, and treatment are important in patients with facial trauma and TON.

Objectives: Traumatic optic neuropathy (TON), a relatively rare condition, can cause visual functional impairment and permanent functional damage.Surgeons should be familiar with its diagnostic criteria and treatment to effectively manage cases of facial trauma with TON. We investigated the feasibility of navigation-assisted endoscopic trans-nasal optic nerve decompression (ETOND) to treat TON in maxillofacial trauma patients. Patients and Methods: We retrospectively analyzed data from the clinical investigation of four consecutive patients, two males and two females with an average age of 75 years, with midfacial fractures and TON between April 2021 and September 2023. All patients had swelling and subcutaneous periorbital hemorrhage accompanied by optic nerve canal and zygomaticomaxillary complex fractures on the affected side. Three patients had lacerations on the lateral eyebrow or upper eyelid. All patients were evaluated by an ophthalmologist for visual impairment; two patients could see hand motion at a 30 cm distance, one patient could perceive light, and one did not have any loss of visual acuity. Among the four patients, three had visual impairment immediately after the injury, and one showed delayed impairment. Results: The patients were treated with navigation-assisted ETOND conducted by an endoscopic rhinologist. Three of the ETONDs were performed along with open reduction and internal fixation (ORIF); the other ETOND was delayed. Orbital reconstruction was performed in three patients. Steroid therapy was administered to two patients, one pre-operatively and one post-operatively. The two patients with pre-operative vision loss showed improved visual acuity post-operatively, and the two patients with no pre-operative visual impairment had no vision loss associated with ORIF for their midfacial fractures. No patient had post-operative complications. Conclusion Navigation-assisted ETOND can be performed easily by endoscopic rhinologists; and prompt examination, diagnosis, and treatment are important in patients with facial trauma and TON.

Objectives: Orthognathic surgery is a surgical procedure performed by intraoral approach with established and safe techniques; however, excessive blood loss has been reported in rare cases. In response, investigative efforts to identify methods to reduce the amount of blood loss have been made.Among such methods, the administration of tranexamic acid was reported to reduce the amount of intraoperative blood loss. However, few studies to date have reported the effect of tranexamic acid in orthognathic surgery under hypotensive anesthesia. The present study aimed to investigate the effect of the administration of tranexamic acid on intraoperative blood loss in patients undergoing bimaxillary (maxillary and mandibular) orthognathic surgery under hypotensive anesthesia. Patients and Methods: A total of 156 patients (mean age, 27.0±10.8 years) who underwent bimaxillary orthognathic surgery under hypotensive anesthesia performed by the same surgeon between June 2013 and February 2022 were included in this study. The following data were collected from the medical records of each patient: background factors (age, sex, and body mass index), use of tranexamic acid, surgical procedures, previous medical history, duration of surgery, American Society of Anesthesiology physical status findings before surgery, intraoperative blood loss as a primary outcome, in–out balance, and blood test results. Descriptive statistics were calculated for statistical analysis, and a t-test and the chi-squared test were used for between-group comparisons. Group comparisons were performed after 1:1 propensity score matching to adjust for confounding factors. Statistical significance was set at P<0.05. Results: Comparison between the groups based on the use of tranexamic acid revealed a significant difference in operation time. Propensity score matching analysis revealed that intraoperative blood loss was significantly lower in the tranexamic acid group. Conclusion The administration of tranexamic acid was effective in reducing intraoperative blood loss in patients undergoing bimaxillary orthognathic surgery under hypotensive anesthesia.