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Surgical Correction of Maxillofacial Skeletal Deformities. J Oral Maxillofac Surg 2023; 81:E95-E119. [PMID: 37833031 DOI: 10.1016/j.joms.2023.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
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Steybe D, Poxleitner P, Metzger MC, Schmelzeisen R, Russe MF, Fuessinger MA, Brandenburg LS, Voss PJ, Schlager S. Analysis of the accuracy of computer‐assisted
DCIA
flap mandibular reconstruction applying a novel approach based on geometric morphometrics. Head Neck 2022; 44:2810-2819. [DOI: 10.1002/hed.27196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/27/2022] [Accepted: 08/31/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- David Steybe
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Philipp Poxleitner
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Marc C. Metzger
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Rainer Schmelzeisen
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Maximilian F. Russe
- Department of Diagnostic and Interventional Radiology Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg Freiburg Germany
| | - Marc Anton Fuessinger
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Leonard S. Brandenburg
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Pit J. Voss
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Stefan Schlager
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
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Motivations and Concerns of Preorthognathic Surgery Patients. J Craniofac Surg 2022; 33:e719-e722. [PMID: 35261360 DOI: 10.1097/scs.0000000000008623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 02/18/2022] [Indexed: 02/05/2023] Open
Abstract
PURPOSE This study aims to investigate motivations, ways of gaining information, and concerns for orthognathic surgery of patients with skeletal dentomaxillofacial deformities before receiving the treatment, and to explore directions for improvement in doctor-patient communications in the clinical practice. METHODS Presurgical patients were asked to fill out a questionnaire about their basic information, the approaches via which they knew about the surgery, as well as their motivations and concerns for the surgery. RESULTS One hundred ninety two questionnaires were included in the analysis in total. Patients (females: males = 2.69:1) with an average age of 23.79 ± 4.36 mainly regarded facial esthetics (103, 53.65%) as a primary concern. Although about 80.20% of patients accessed medical information through the Internet, it was still an irreplaceable way to know through consulting specialists. CONCLUSIONS The majority of patients were young, unmarried women without a stable income. For most patients, the primary motivation to receive the surgery was an improvement in facial esthetics and the biggest concern was the operation effect. Access to medical information through the Internet has become very important access to medical knowledge.
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Sobol DL, Hopper JS, Ettinger RE, Dodson TB, Susarla SM. Does the use of a piezoelectric saw improve neurosensory recovery following sagittal split osteotomy? Int J Oral Maxillofac Surg 2021; 51:371-375. [PMID: 34332833 DOI: 10.1016/j.ijom.2021.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/28/2021] [Accepted: 07/09/2021] [Indexed: 11/16/2022]
Abstract
Neurosensory disturbance of the inferior alveolar nerve (IAN) is an adverse effect associated with sagittal split osteotomies (SSO). The purpose of this work was to evaluate neurosensory recovery of the IAN when SSOs were performed with piezoelectric (PZ) versus reciprocating (RP) saws. This was a prospective split-mouth study of patients undergoing bilateral SSO using a PZ saw on one side and an RP saw on the other. The primary outcome of interest was neurosensory recovery, as assessed using the functional sensory recovery (FSR) scale defined by the UK Medical Research Council. Descriptive, bivariate, and regression statistics were computed. Twenty patients (40 SSOs) with a mean age of 19.9 ± 3.2 years were included. The mean mandibular movement did not differ significantly (P = 0.50) between the PZ and RP groups. All patients achieved FSR within 1 year of surgery (range 34-249 days). The median time to FSR overall was comparable between the PZ and RP groups (94.5 days and 101.5 days, respectively; P = 0.20). However, at the time FSR was achieved, PZ SSO sites were more likely to have higher neurosensory scores when compared to RP SSO sites (hazard ratio 2.3, 95% confidence interval 1.1-4.9, P = 0.04).
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Affiliation(s)
- D L Sobol
- Craniofacial Center, Seattle Children's Hospital, Divisions of Oral and Maxillofacial Surgery and Plastic and Craniofacial Surgery, Seattle, WA, USA; Department of Surgery, Division of Plastic Surgery, University of Washington School of Medicine, Seattle, WA, USA
| | - J S Hopper
- Craniofacial Center, Seattle Children's Hospital, Divisions of Oral and Maxillofacial Surgery and Plastic and Craniofacial Surgery, Seattle, WA, USA
| | - R E Ettinger
- Craniofacial Center, Seattle Children's Hospital, Divisions of Oral and Maxillofacial Surgery and Plastic and Craniofacial Surgery, Seattle, WA, USA; Department of Surgery, Division of Plastic Surgery, University of Washington School of Medicine, Seattle, WA, USA
| | - T B Dodson
- Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, WA, USA
| | - S M Susarla
- Craniofacial Center, Seattle Children's Hospital, Divisions of Oral and Maxillofacial Surgery and Plastic and Craniofacial Surgery, Seattle, WA, USA; Department of Surgery, Division of Plastic Surgery, University of Washington School of Medicine, Seattle, WA, USA; Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, WA, USA.
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Baba N, Moroi A, Yoshizawa K, Iguchi R, Ueki K. Evaluation of recovery period in lower lip hypoesthesia after bilateral sagittal split osteotomy using trigeminal somatosensory evoked potential. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:378-385. [PMID: 33926841 DOI: 10.1016/j.oooo.2021.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 01/20/2021] [Accepted: 02/09/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Bilateral sagittal split osteotomy (BSSO) is one of the most frequently used treatments for jaw deformity worldwide. However, lower lip hypoesthesia is a postoperative complication of BSSO. Trigeminal somatosensory evoked potential can be used to evaluate neural pathway abnormalities by measuring latency. The purposes of this study were to measure latency before and after BSSO and to examine the relationship between latency and the duration of hypoesthesia recovery. STUDY DESIGN AND METHODS This observational retrospective case-control study analyzed data recorded from 2013 to 2018. We divided the patient data into 5 groups according to recovery time. Using the latency obtained in trigeminal somatosensory evoked potential as the main outcome, we examined the relationship between hypoesthesia recovery time and latency. RESULTS The group with unresolved postoperative hypoesthesia 6 months after surgery had significantly greater latency values extension than the group without postoperative hypoesthesia. CONCLUSION By measuring the degree of prolongation of latency before and after surgery, it is possible not only to indicate the presence of hypoesthesia but also to predict the hypoesthesia recovery period.
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Affiliation(s)
- Naana Baba
- Department of Oral and Maxillofacial Surgery, Division of Medicine, Graduate Faculty of Interdisciplinary Research University of Yamanashi, Chuo-shi, Yamanashi, Japan.
| | - Akinori Moroi
- Department of Oral and Maxillofacial Surgery, Division of Medicine, Graduate Faculty of Interdisciplinary Research University of Yamanashi, Chuo-shi, Yamanashi, Japan
| | - Kunio Yoshizawa
- Department of Oral and Maxillofacial Surgery, Division of Medicine, Graduate Faculty of Interdisciplinary Research University of Yamanashi, Chuo-shi, Yamanashi, Japan
| | - Ran Iguchi
- Department of Oral and Maxillofacial Surgery, Division of Medicine, Graduate Faculty of Interdisciplinary Research University of Yamanashi, Chuo-shi, Yamanashi, Japan
| | - Koichiro Ueki
- Department of Oral and Maxillofacial Surgery, Division of Medicine, Graduate Faculty of Interdisciplinary Research University of Yamanashi, Chuo-shi, Yamanashi, Japan
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Aslanidou K, Xie R, Christou T, Lamani E, Kau CH. Evaluation of temporomandibular joint function after orthognathic surgery using a jaw tracker. J Orthod 2020; 47:140-148. [PMID: 32114874 DOI: 10.1177/1465312520908277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE It has been reported that temporomandibular joint (TMJ) function after orthognathic surgery differs from normal patients. Dysfunction of the joints occurs often even in the general public, with an incidence in the range of 20%-25%. Population-based studies among adults report that approximately 10%-15% have symptoms of pain and 5% of them had a perceived need for treatment. To date, no studies have reported on the evaluation of TMJ function after orthognathic surgery through the use of four-dimensional jaw tracking. DESIGN AND SETTING This study evaluated TMJ function using such a device and information from a TMJ questionnaire. Sixteen orthognathic surgery patients and 17 controls were included in this study. Four-dimensional jaw tracking information was obtained using the SiCAT JMT device. Clinical signs and jaw function were evaluated. RESULTS Within the limitations of the study, the following results were seen using the SICAT JMT+ jaw tracking device: (1) no significant differences were found in any of the millimetric measurements between the surgery patients and controls; (2) no significant difference was found in subjective reported symptoms of pain, clicking, crepitation, locking, stiffness, headaches and migraines between the groups; and (3)there was a significant difference in the popping of the joints for surgery and non-surgery groups. CONCLUSION Jaw tracking did not detect significant differences in jaw function, but some clinical symptoms were present.
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Affiliation(s)
- Katarina Aslanidou
- Department of Orthodontics, University of Alabama Birmingham, Birmingham, AL, USA
| | - Rongbing Xie
- Department of Orthodontics, University of Alabama Birmingham, Birmingham, AL, USA
| | - Terpsithea Christou
- Department of Orthodontics, University of Alabama Birmingham, Birmingham, AL, USA
| | - Ejvis Lamani
- Department of Orthodontics, University of Alabama Birmingham, Birmingham, AL, USA
| | - Chung H Kau
- Department of Orthodontics, University of Alabama Birmingham, Birmingham, AL, USA
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Ghorbani F, Gheibollahi H, Tavanafar S, Eftekharian HR. Improvement of Esthetic, Functional, and Social Well-Being After Orthognathic Surgical Intervention: A Sampling of Postsurgical Patients Over a 10-Year Period From 2007 to 2017. J Oral Maxillofac Surg 2018; 76:2398-2403. [DOI: 10.1016/j.joms.2018.04.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 04/04/2018] [Accepted: 04/24/2018] [Indexed: 11/26/2022]
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Neurosensory Disturbances After Bilateral Sagittal Split Osteotomy Using Piezoelectric Surgery: A Systematic Review. J Oral Maxillofac Surg 2018; 77:380-390. [PMID: 30055164 DOI: 10.1016/j.joms.2018.06.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 06/19/2018] [Accepted: 06/19/2018] [Indexed: 11/21/2022]
Abstract
PURPOSE The objective of the present systematic review was to test the hypothesis of no difference in neurosensory disturbances (NSDs) after bilateral sagittal split osteotomy (BSSO) with piezoelectric surgery compared with conventional techniques. MATERIALS AND METHODS A PubMed (Medline), Embase Library, and Cochrane Library search in combination with a manual search of relevant journals was conducted from January 2000 to November 2017. Randomized controlled trials and controlled trials in humans were considered. Primary outcome measures (assessment of neuro-sensitivity by subjective and objective evaluations) and secondary outcome measures (NSD risk factors, patient-reported outcome measures, complications, operating time, and intraoperative bleeding) were considered. RESULTS The search provided 241 studies of which 5 eligible studies were included. Meta-analysis was not possible because of considerable heterogeneity. Two studies were characterized by a moderate risk of bias and 3 were characterized by a high risk of bias. Piezoelectric surgery substantially decreased NSDs as evaluated by subjective tests. NSD after BSSO varied from 1.8 to 23.0% with piezoelectric surgery and from 7.3 to 52.0% with conventional techniques after 2 to 12 months. Furthermore, piezoelectric surgery seemed to considerably decrease the frequency of intraoperative bleeding in bimaxillary procedures and decrease the risk of an unfavorable split of the mandible and macroscopic damage of the inferior alveolar nerve. CONCLUSIONS The hypothesis of no difference in NSD after BSSO with piezoelectric surgery compared with conventional techniques could be neither confirmed nor rejected owing to insufficient knowledge. However, piezoelectric surgery seems to decrease the risk of NSDs after BSSO compared with conventional techniques. Long-term randomized controlled trials comparing the 2 treatment modalities by standardized subjective and objective electrophysiologic tests are needed before one treatment modality can be considered superior to another.
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Savoldelli C, Chamorey E, Bettega G. Computer-assisted teaching of bilateral sagittal split osteotomy: Learning curve for condylar positioning. PLoS One 2018; 13:e0196136. [PMID: 29694423 PMCID: PMC5918964 DOI: 10.1371/journal.pone.0196136] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 04/07/2018] [Indexed: 11/17/2022] Open
Abstract
Bilateral sagittal split osteotomy (BSSO) is a widely-performed procedure in orthognathic surgery for the correction of dentofacial deformity. Condylar positioning is a critical step during BSSO to maximize functional and morphological results. The unsuitable positioning of condyles represents one of the causative mechanisms that may induce temporomandibular joint noxious effects after BSSO. Repositioning devices can assist surgeons in maintaining the preoperative condylar position; however, empirical repositioning methods based on experience gained are still commonly used. Trainee learning curves are difficult to assess. The aim of this study was to evaluate the relevance of computer-assisted surgery in the acquisition of condylar positioning skills. Forty-eight patients underwent BSSO performed by six maxillofacial trainees (four junior residents and two senior experienced residents). A condyle positioning system (CPS) was used by a senior surgeon to record a condylar position score during the procedure. Firstly, scores were recorded when the trainee manually positioned the condyle without access to the CPS score (phase 1) and then when the trainee positioned the condyle and performed osteosynthesis with visual access to the CPS score (phase 2). Six parameters describing condylar three-dimensional motions were assessed: translational motion from top to bottom (TB), back to front (BF), and left to right (LR), axial rotation (AR), sagittal rotation (SR), frontal rotation (FR), and a total score (TS). There were no significant differences between junior and senior residents in condyle positioning without access to the CPS. Condyles were significantly better positioned during phase 2 with access to the CPS (p<0.001). Over time, use of the CPS (phase 2) produced significantly quicker improvements in scores (p = 0.042). For those teaching surgeries to trainees, computer-assisted devices can potentially result in more rapid learning curves than traditional "observations-imitation" models. Use of a CPS by trainees facilitated condylar repositioning that resulted in an accurate occlusal result and avoidance of adverse effects on the temporomandibular joint.
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Affiliation(s)
- Charles Savoldelli
- Department of Oral and Maxillofacial Surgery, Head and Neck Institute, University Hospital of Nice, Nice, France
| | | | - Georges Bettega
- Department of Oral and Maxillofacial surgery, Centre Hospitalier Annecy-Genevois, Metz-Tessy, France.,Plastic and Maxillofacial Surgery Department, Grenoble University Hospital, BP, Grenoble, France
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Guarini D, Gracia B, Ramírez-Lobos V, Noguera-Pantoja A, Solé-Ventura P. Laser Biophotomodulation in Patients with Neurosensory Disturbance of the Inferior Alveolar Nerve After Sagittal Split Ramus Osteotomy: A 2-Year Follow-Up Study. Photomed Laser Surg 2017; 36:3-9. [PMID: 29022844 DOI: 10.1089/pho.2017.4312] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To evaluate the effect of the application of photobiomodulation in a 2-year follow-up period in patients who have been intervened with a sagittal ramus split osteotomy and present neurosensory disturbance of the inferior alveolar nerve. BACKGROUND Photobiomodulation is a common clinical tool in dentistry, for its beneficial effects have been shown in surgical and periodontal wound healing, reducing of swelling and pain, neurosensory recovery, and treatment of temporomandibular joint disorders. METHODS This is a 2-year follow-up study with an experimental (Laser) group (n = 33) that received photobiomodulation, and a control (Sham) group (n = 9), placebo. All patients from the Laser group received laser applications (continuous wave of 0.353 W/cm2, 27 J in 270 sec per session) on days 1, 2, 3, 5, 10, 14, 21, and 28 after surgery. Neurosensory disturbance was evaluated with five tests: Visual Analog Scale (VAS) for pain and sensitivity, sensitivity threshold test, two-point discrimination, and thermal discrimination. All tests were performed before (24 h before surgery) and after surgery (24 h, 28 days, 60 days, 6 months, 1 year, 2 years, more than 2 years). Participants and evaluator were blinded to intervention. Variables were described with absolute frequencies, percentages, and medians. Ordinal and dichotomous variables were compared with Mann-Whitney's and Fisher's tests, respectively. RESULTS Clinical improvement was observed during the follow-up period for the Laser group; general VAS for sensitivity was normal in 11 participants from the Laser group at 2 years postsurgery (40.74%), while no participants from the Sham group achieved this (p = 0.0341). Twenty-three participants recovered initial values for two-point discrimination (69.7%) after 2 years of follow-up (p = 0.0025) as well as sensitivity threshold test. General VAS for pain was normal in 31 patients from the Laser group after 2 years of follow-up (93.94%, p = 0.0254). CONCLUSIONS Photobiomodulation was effective for neurosensory recovery on sample studied.
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Affiliation(s)
- Daniela Guarini
- 1 School of Dentistry, Universidad de Los Andes , Santiago, Chile
| | - Benjamín Gracia
- 1 School of Dentistry, Universidad de Los Andes , Santiago, Chile
| | - Valeria Ramírez-Lobos
- 1 School of Dentistry, Universidad de Los Andes , Santiago, Chile .,2 School of Medicine and School of Dentistry, Universidad de Los Andes , Santiago, Chile
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Cottrell DA, Farrell B, Ferrer-Nuin L, Ratner S. Surgical Correction of Maxillofacial Skeletal Deformities. J Oral Maxillofac Surg 2017; 75:e94-e125. [DOI: 10.1016/j.joms.2017.04.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Alolayan AB, Leung YY. Resolution of neurosensory deficit after mandibular orthognathic surgery: A prospective longitudinal study. J Craniomaxillofac Surg 2017; 45:755-761. [DOI: 10.1016/j.jcms.2017.01.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 01/03/2017] [Accepted: 01/30/2017] [Indexed: 11/30/2022] Open
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Is Low-Level Laser Therapy Effective for Treatment of Neurosensory Deficits Arising From Sagittal Split Ramus Osteotomy? J Oral Maxillofac Surg 2017; 75:2085-2090. [PMID: 28495411 DOI: 10.1016/j.joms.2017.04.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 03/25/2017] [Accepted: 04/01/2017] [Indexed: 12/19/2022]
Abstract
PURPOSE This study investigated the effectiveness of low-level laser therapy (LLLT) for treating neurosensory impairment after bilateral sagittal split osteotomy (BSSO). MATERIALS AND METHODS This randomized, double-blinded, split-mouth trial included patients requiring BSSO. After surgery, 1 side of each patient was randomly assigned to laser therapy and the other side served as the control. At 24, 48, and 72 hours after surgery, LLLT was accomplished by intraoral application of a 660-nm laser around the surgical site (200 mW, 10 seconds, 2 J, 1.5 J/cm2) followed by extraoral irradiation by an 810-nm laser (200 mW, 10 seconds, 2 J, 7 J/cm2) along the distribution of the inferior alveolar nerve. Subsequently, extraoral irradiation was repeated 2 times per week for 3 weeks along the path of the inferior alveolar nerve, lower lip, and chin. On the control side, the treatment was similar to the laser side but with laser simulation. The main outcome was assessing nerve damage by a "2-point discrimination test" before and up to 60 days after surgery. RESULTS The sample consisted of 16 patients. No significant difference was found between the laser and control sides before and after surgery and on postoperative days 15 and 30 (P > .05). The 2-point discrimination distance was significantly shorter on the laser side than on the control side on postoperative days 45 and 60 (P < .05). CONCLUSION LLLT was effective in the treatment of neurosensory disturbances arising from BSSO. Therefore, LLLT can be recommended to accelerate the recovery of sensory aberrations in patients undergoing BSSO.
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Roychoudhury S, Nagori SA, Roychoudhury A. Neurosensory disturbance after bilateral sagittal split osteotomy: A retrospective study. J Oral Biol Craniofac Res 2015; 5:65-8. [PMID: 26258016 DOI: 10.1016/j.jobcr.2015.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Accepted: 04/28/2015] [Indexed: 11/26/2022] Open
Abstract
AIM To retrospectively evaluate neurosensory disturbance (NSD) after bilateral sagittal split osteotomy (BSSO). MATERIAL AND METHODS A retrospective review was carried out to assess inferior alveolar nerve function in patients treated by BSSO from 2010 to 2013. All patients included in the study were assessed using objective (cotton swabs and pin prick testing) and subjective testing (questionnaire) for inferior alveolar nerve function after a minimum of 1 year of follow-up. Medical records of the patients were used to assess the incidence of NSD in the immediate post-operative period. RESULTS 15 patients (30 sides) had undergone BSSO during the specified time period. On subjective testing, NSD was reported in 22 operated sides (73.3%) in the immediate post-operative period, while 4 operated sides (13.3%) reported persistent NSD. On objective testing, immediate post-operative NSD was seen in 20 operated sides (66.7%). After a minimum of 1 year follow-up, recovery was seen in 18 operated sides while persistent NSD was seen in 2 operated sides (6.7%). CONCLUSION NSD of the inferior alveolar nerve is a common complication after BSSO in the immediate post-operative period. However in a long term, nerve function usually recovers.
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Affiliation(s)
- Sunanda Roychoudhury
- Professor & Head, Department of Orthodontics & Dentofacial Orthopaedics, Shree Bankey Bihari Dental College, Masuri Canal, Ghaziabad UP India
| | - Shakil Ahmed Nagori
- Ex-Resident, Department of Oral & Maxillofacial Surgery, CDER, All India Institute of Medical Sciences, New Delhi 110029 India
| | - Ajoy Roychoudhury
- Professor & Head, Department of Oral & Maxillofacial Surgery, CDER, All India Institute of Medical Sciences, New Delhi 110029 India
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Jung HD, Kim SY, Park HS, Jung YS. Orthognathic surgery and temporomandibular joint symptoms. Maxillofac Plast Reconstr Surg 2015; 37:14. [PMID: 26029683 PMCID: PMC4446569 DOI: 10.1186/s40902-015-0014-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 04/22/2015] [Indexed: 11/13/2022] Open
Abstract
The aim of this article is to review temporomandibular joint symptoms as well as the effects of orthognathic surgery(OGS) on temporomandibular joint(TMJ). The causes of temporomandibular joint disease(TMD) are multifactorial, and the symptoms of TMD manifest as a limited range of motion of mandible, pain in masticatory muscles and TMJ, Joint noise (clicking, popping, or crepitus), myofascial pain, and other functional limitations. Treatment must be started based on the proper diagnosis, and almost symptoms could be subsided by reversible options. Minimally invasive options and open arthroplasty are also available following reversible treatment when indicated. TMD manifesting in a variety of symptoms, also can apply abnormal stress to mandibular condyles and affect its growth pattern of mandible. Thus, adaptive developmental changes on mandibular condyles and post-developmental degenerative changes of mandibular condyles can create alteration on facial skeleton and occlusion. The changes of facial skeleton in DFD patients following OGS have an impact on TMJ, masticatory musculature, and surrounding soft tissues, and the changes of TMJ symptoms. Maxillofacial surgeons must remind that any surgical procedures involving mandibular osteotomy can directly affect TMJ symptoms, thus pre-existing TMJ symptoms and diagnoses should be considered prior to treatment planning and OGS.
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Affiliation(s)
- Hwi-Dong Jung
- Department of Oral & Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, South Korea
| | - Sang Yoon Kim
- Private Practice Vienna VA; Former resident Harvard Oral & Maxillofacial Surgery, Boston, MA USA
| | - Hyung-Sik Park
- Department of Oral & Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, South Korea
| | - Young-Soo Jung
- Department of Oral & Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, South Korea
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Jędrzejewski M, Smektała T, Sporniak-Tutak K, Olszewski R. Preoperative, intraoperative, and postoperative complications in orthognathic surgery: a systematic review. Clin Oral Investig 2015; 19:969-77. [PMID: 25804886 PMCID: PMC4434857 DOI: 10.1007/s00784-015-1452-1] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Accepted: 03/11/2015] [Indexed: 11/30/2022]
Abstract
Objectives The aim of this study was to determine whether orthognathic surgery is associated with any complications, and what type of complications may occur. Materials and methods Data were obtained using PubMed (MEDLINE), ISI Web of Knowledge, Ovid, Cochrane Library, Embase Library, and an additional manual search. The titles and abstracts of the electronic search results were screened and evaluated by two observers for eligibility according to the inclusion and exclusion criteria. Results A total of 1924 articles were identified, and we retained 44 articles for the final analysis. The Prisma diagram flowchart demonstrates our selection scheme. For the purpose of this study, the Cochrane data extraction form was modified. One review author extracted data from the included studies, and the second author checked all of the forms. The hierarchy of evidence classification from the UK NHS Centre for Reviews and Dissemination was used to assess the level of evidence for the retrieved studies. Conclusions An evaluation of the obtained studies revealed the existence of a large number of varied complications associated with orthognathic surgery procedures. Clinical relevance Oral and maxillofacial surgeons, orthodontists, and the surgical team need to prevent such complications during preoperative, intraoperative, and postoperative periods to increase the safety of orthognathic surgery procedures. This review was registered on http://www.crd.york.ac.uk/PROSPERO as CRD42013004711. Electronic supplementary material The online version of this article (doi:10.1007/s00784-015-1452-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M Jędrzejewski
- Department of Dental Surgery, Pomeranian Medical Uniwersity, ul. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland,
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17
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Ettinger KS, Wyles CC, Bezak BJ, Yildirim Y, Arce K, Viozzi CF. Impact of Perioperative Fluid Administration on Postoperative Morbidity and Length of Hospital Stay Following Maxillomandibular Advancement for Obstructive Sleep Apnea. J Oral Maxillofac Surg 2015; 73:1372-83. [PMID: 25843820 DOI: 10.1016/j.joms.2014.12.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 12/15/2014] [Accepted: 12/23/2014] [Indexed: 11/18/2022]
Abstract
PURPOSE The purpose of this study was to evaluate whether the volume of perioperative fluids administered to patients undergoing maxillomandibular advancement (MMA) for treatment of obstructive sleep apnea (OSA) is associated with an increased incidence of postoperative complications and prolonged length of hospital stay. MATERIALS AND METHODS A retrospective cohort study design was implemented and patients undergoing MMA for OSA at the Mayo Clinic were identified from 2001 through 2014. The primary predictor variable was the total volume of intravenous fluids administered during MMA. The primary outcome variable was length of hospital stay in hours. Secondary outcome variables included the presence of complications incurred during postoperative hospitalization. Additional covariates abstracted included basic demographic data, preoperative body mass index, preoperative apnea-hypopnea index, preoperative Charlson comorbidity index, preoperative American Society of Anesthesiologists score, type of intravenous fluid administered, surgical complexity score, duration of anesthesia, duration of surgery, and the use of planned intensive care unit admission. Univariate and multivariable models were developed to assess associations between the primary predictor variable and covariates relative to the primary and secondary outcome variables. RESULTS Eighty-eight patients undergoing MMA for OSA were identified. Total fluid volume was significantly associated with increased length of stay (odds ratio [OR] = 1.34, 95% confidence interval [CI], 1.05-1.71; P = .020) in univariate analysis. Total fluid volume did not remain significantly associated with increased length of hospital stay in stepwise multivariable modeling. Total fluid volume was significantly associated with the presence of postoperative complications (OR = 1.69; 95% CI, 1.08-2.63; P = .021) in univariate logistic regression. CONCLUSION Fluid administration was not found to be significantly associated with increased length of hospital stay after MMA for OSA. Increased fluid administration might be associated with the presence of postoperative complications after MMA; however, future large multicenter studies will be required to more comprehensively assess this association.
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Affiliation(s)
- Kyle S Ettinger
- Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic and Mayo College of Medicine, Rochester, MN.
| | - Cody C Wyles
- Medical Student, Mayo Clinic and Mayo College of Medicine, Rochester, MN
| | - Brett J Bezak
- Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic and Mayo College of Medicine, Rochester, MN
| | - Yavuz Yildirim
- Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic and Mayo College of Medicine, Rochester, MN
| | - Kevin Arce
- Assistant Professor of Surgery and Program Director, Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic and Mayo College of Medicine, Rochester, MN
| | - Christopher F Viozzi
- Assistant Professor of Surgery and Program Chair, Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic and Mayo College of Medicine, Rochester, MN
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18
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Robl MT, Farrell BB, Tucker MR. Complications in Orthognathic Surgery. Oral Maxillofac Surg Clin North Am 2014; 26:599-609. [DOI: 10.1016/j.coms.2014.08.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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19
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Chhibber A, Upadhyay M, Uribe F, Nanda R. Long-term surgical versus functional Class II correction: a comparison of identical twins. Angle Orthod 2014; 85:142-56. [PMID: 25075777 DOI: 10.2319/011314-46.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The purpose of this twin case comparison was to assess the short- and long-term effects of nonsurgical treatment vs orthognathic surgical treatment for Class II correction. Two identical twins (age 13 years 3 months) were treated for Class II correction where one patient was treated nonsurgically using a fixed functional appliance, while the other was treated using orthognathic mandibular advancement surgery. The patients were recalled and evaluated 5 years in retention. Comparing changes in the short and long term, surgical treatment led to superior skeletal results compared to the nonsurgical twin. However, the soft tissue profile was remarkably similar for both patients suggesting that soft tissue profile changes may not necessarily follow similar changes in the bony skeletal structures.
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Affiliation(s)
- Aditya Chhibber
- a Assistant Professor, Division of Orthodontics, Section of Growth & Development, Columbia University College of Dental Medicine, New York, NY
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20
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Impact of intraoperative fluid administration on length of postoperative hospital stay following orthognathic surgery. J Oral Maxillofac Surg 2014; 73:22-9. [PMID: 25443382 DOI: 10.1016/j.joms.2014.07.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 06/30/2014] [Accepted: 07/23/2014] [Indexed: 11/21/2022]
Abstract
PURPOSE The purpose of this study was to evaluate whether the volume of intraoperative fluids administered to patients during routine orthognathic surgery is associated with increased length of hospital stay for postoperative convalescence. MATERIALS AND METHODS A retrospective cohort study design was used to identify 168 patients undergoing routine orthognathic surgery at Mayo Clinic from 2010 through 2014. The primary predictor variable was total volume of intravenous fluids administered during orthognathic surgery. The primary outcome variable was the length of hospital stay in hours as measured from the completion of the procedure to patient dismissal from the hospital. Additional covariates were collected including patient demographic data, preoperative American Society of Anesthesiologists (ASA) score, type of intravenous fluid administered, complexity of surgical procedure, and duration of anesthesia. RESULTS On univariate analysis, total fluid was significantly associated with increased length of stay (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.42 to 2.33; P < .001). After adjustment for surgical complexity and duration of anesthesia on multivariable regression analysis, the association of fluid level with length of hospital stay was no longer statistically significant (OR, 0.86; 95% CI, 0.61 to 1.22; P = .39). Duration of anesthesia remained the only covariate that was significantly associated with increased length of hospital stay in the multivariable regression model (OR, 2.21; 95% CI, 1.56 to 3.13; P < .001). CONCLUSIONS Among surgical complexity, duration of anesthesia, and total volume of intraoperative intravenous fluids administered for routine orthognathic surgery, the duration of anesthesia has the strongest predictive value for patients requiring prolonged hospital stay for postoperative convalescence.
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21
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Wong L, Currie A, Abu-Serriah M. Unusual cause of iatrogenic anterior open bite after bilateral sagittal split mandibular advancement osteotomy. Br J Oral Maxillofac Surg 2014; 52:767-8. [PMID: 24930056 DOI: 10.1016/j.bjoms.2014.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 05/20/2014] [Indexed: 11/30/2022]
Abstract
We describe a case of anterior open bite after bilateral sagittal split mandibular advancement osteotomy. The discrepancy in height between the proximal and distal segments at the osteotomy sites damaged the soft tissue and caused bony interferences. Removal of the maxillary third molars and bilateral removal of bony interferences of the distal segments using a bur led to full resolution and a good orthognathic outcome on follow-up.
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Affiliation(s)
- L Wong
- Department of Oral and Maxillofacial Surgery, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | - A Currie
- Department of Oral and Maxillofacial Surgery, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | - M Abu-Serriah
- Department of Oral and Maxillofacial Surgery, John Radcliffe Hospital, Oxford, OX3 9DU, UK
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22
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Alolayan AB, Leung YY. Risk factors of neurosensory disturbance following orthognathic surgery. PLoS One 2014; 9:e91055. [PMID: 24599321 PMCID: PMC3945003 DOI: 10.1371/journal.pone.0091055] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 02/08/2014] [Indexed: 11/25/2022] Open
Abstract
Objectives To report the incidence of objective and subjective neurosensory disturbance (NSD) after orthognathic surgery in a major orthognathic centre in Hong Kong, and to investigate the risk factors that contributed to the incidence of NSD after orthognathic surgery. Materials and Methods A retrospective cross-sectional study on NSD after orthognathic surgery in a local major orthognathic centre. Patients who had bimaxillary orthognathic surgery reviewed at post-operative 6 months, 12 months or 24 months were recruited to undergo neurosensory tests with subjective and 3 objective assessments. Possible risk factors of NSD including subjects’ age and gender, surgical procedures and surgeons’ experience were analyzed. Results 238 patients with 476 sides were recruited. The incidences of subjective NSD after maxillary procedures were 16.2%, 13% and 9.8% at post-operative 6 months, 12 months and 24 months, respectively; the incidences of subjective NSD after mandibular procedures were 35.4%, 36.6% and 34.6% at post-operative 6 months, 12 months and 24 months, respectively. Increased age was found to be a significant risk factor of NSD after orthognathic surgery at short term (at 6 months and 12 months) but not at 24 months. SSO has a significantly higher risk of NSD when compared to VSSO. SSO in combination with anterior mandibular surgery has a higher risk of NSD when compared to VSSO in combination with anterior mandibular surgery or anterior mandibular surgery alone. Gender of patients and surgeons’ experience were not found to be risk factors of NSD after orthognathic surgery. Conclusion The incidence of NSD after maxillary and mandibular orthognathic procedures at post-operative 6 months, 12 months and 24 months was reported. Increased age was identified as a risk factor of short term post-operative NSD but not in long term (24 months or more). Specific mandibular procedures were related to higher incidence of NSD after orthognathic surgery.
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Affiliation(s)
- Albraa Badr Alolayan
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong
| | - Yiu Yan Leung
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong
- * E-mail:
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Pandyan DA, Siroraj P, Narayanan CD. Pseudoaneurysm of internal maxillary artery--an untold complication following distraction osteogenesis--a case report. J Oral Maxillofac Surg 2014; 72:605.e1-7. [PMID: 24528567 DOI: 10.1016/j.joms.2013.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 11/06/2013] [Accepted: 11/11/2013] [Indexed: 11/19/2022]
Abstract
Pseudoaneurysm of the internal maxillary artery is very rare and only a handful of cases have been reported in the literature thus far and none after placement of a prosthetic condyle and a distraction device. This case report highlights the need for early diagnosis, appropriate steps in management, and a multidisciplinary approach in a tertiary care center in treating this life-threatening condition and proper treatment planning to prevent this condition.
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Affiliation(s)
- Deepak Abraham Pandyan
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Sri Ramachandra Medical Center, Chennai, India
| | - Pearlcid Siroraj
- Resident, Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Sri Ramachandra Medical Center, Chennai, India.
| | - C D Narayanan
- Professor, Department of General Surgery, Sri Ramachandra Medical Center, Chennai, India
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Lee SY, Yang HJ, Han JJ, Hwang SJ. Effect of perioperative buccal fracture of the proximal segment on postoperative stability after sagittal split ramus osteotomy. J Korean Assoc Oral Maxillofac Surg 2014; 39:217-23. [PMID: 24471048 PMCID: PMC3858141 DOI: 10.5125/jkaoms.2013.39.5.217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 08/14/2013] [Accepted: 08/28/2013] [Indexed: 01/08/2023] Open
Abstract
Objectives Buccal fracture of the mandibular proximal bone segment during bilateral sagittal split ramus osteotomy (SSRO) reduces the postoperative stability. The primary aim of this study is to evaluate the effect of this type of fracture on bone healing and postoperative stability after mandibular setback surgery. Materials and Methods Ten patients who experienced buccal fracture during SSRO for mandibular setback movement were evaluated. We measured the amount of bone generation on a computed tomography scan, using an image analysis program, and compared the buccal fracture side to the opposite side in each patient. To investigate the effect on postoperative stability, we measured the postoperative relapse in lateral cephalograms, immediately following and six months after the surgery. The control group consisted of ten randomly-selected patients having a similar amount of set-back without buccal fracture. Results Less bone generation was observed on the buccal fracture side compared with the opposite side (P<0.05). However, there was no significant difference in anterior-posterior postoperative relapse between the group with buccal fracture and the control group. The increased mandibular plane angle and anterior facial height after the surgery in the group with buccal fracture manifested as a postoperative clockwise rotation of the mandible. Conclusion Bone generation was delayed compared to the opposite side. However, postoperative stability in the anterior-posterior direction could be maintained with rigid fixation.
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Affiliation(s)
- Sang-Yoon Lee
- Department of Oral and Maxillofacial Surgery, Seoul National Unversity Dental Hospital, School of Dentistry, Brain Korea Plus, Seoul National Unversity, Seoul, Korea
| | - Hoon Joo Yang
- Department of Oral and Maxillofacial Surgery, Seoul National Unversity Dental Hospital, School of Dentistry, Brain Korea Plus, Seoul National Unversity, Seoul, Korea. ; Dental Research Institute, Seoul National University, Seoul, Korea
| | - Jeong-Joon Han
- Department of Oral and Maxillofacial Surgery, Seoul National Unversity Dental Hospital, School of Dentistry, Brain Korea Plus, Seoul National Unversity, Seoul, Korea
| | - Soon Jung Hwang
- Department of Oral and Maxillofacial Surgery, Seoul National Unversity Dental Hospital, School of Dentistry, Brain Korea Plus, Seoul National Unversity, Seoul, Korea. ; Dental Research Institute, Seoul National University, Seoul, Korea
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Al-Belasy FA, Tozoglu S, Dolwick MF. Mandibular Hypomobility After Orthognathic Surgery: A Review Article. J Oral Maxillofac Surg 2013; 71:1967.e1-1967.e11. [DOI: 10.1016/j.joms.2013.06.217] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 06/19/2013] [Indexed: 11/17/2022]
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Wahab P, Narayanan V, Nathan S, Madhulaxmi. Antibiotic prophylaxis for bilateral sagittal split osteotomies: a randomized, double-blind clinical study. Int J Oral Maxillofac Surg 2013; 42:352-5. [DOI: 10.1016/j.ijom.2012.10.036] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 08/22/2012] [Accepted: 10/11/2012] [Indexed: 11/27/2022]
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27
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Kang WS, Ahn M. A Case of Nasolacrimal Duct Obstruction after Two-Jaw Surgery. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.5.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Wan Seok Kang
- Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, Korea
| | - Min Ahn
- Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, Korea
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Survey on Complications of Orthognathic Surgery Among Oral and Maxillofacial Surgeons. J Craniofac Surg 2012; 23:e423-30. [DOI: 10.1097/scs.0b013e31825e49c1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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30
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Boyd SB. Management of Obstructive Sleep Apnea by Maxillomandibular Advancement. Oral Maxillofac Surg Clin North Am 2009; 21:447-57. [DOI: 10.1016/j.coms.2009.09.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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31
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Perciaccante VJ, Timmis DP. S113: Bad Splits of the Mandible–Prevention and Management. J Oral Maxillofac Surg 2009. [DOI: 10.1016/j.joms.2009.05.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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32
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Serafin B, Perciaccante VJ, Cunningham LL. Stability of orthognathic surgery and distraction osteogenesis: options and alternatives. Oral Maxillofac Surg Clin North Am 2008; 19:311-20, v. [PMID: 18088887 DOI: 10.1016/j.coms.2007.05.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Relapse in orthognathic surgery is multifactorial and can be attributed to posttreatment growth, condylar changes, lack of rigid fixation, and muscle pull and function. Consideration of these factors can aide the surgeon in the decision-making process with regards to treatment options and alternatives. This article reviews the stability of various orthognathic movements using traditional osteotomies and fixation, and compares them to what is currently in the literature regarding distraction osteogenesis.
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Affiliation(s)
- Bethany Serafin
- Oral and Maxillofacial Surgery, University of Kentucky, Lexington, KY 40536-0297, USA.
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