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Serin M, Altinel D, Toplu G, Rakici IT, Toplu SG. Lefort 1 Osteotomy Study of Maxillary Bone in Caprine Skull Model: Comparison of Different Osteotomy Techniques (Piezo Versus Lindemann Bur Versus Manual Chisel). J Craniofac Surg 2024; 35:1581-1584. [PMID: 38767364 DOI: 10.1097/scs.0000000000010309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/03/2024] [Indexed: 05/22/2024] Open
Abstract
OBJECTIVE In this study, we aimed to compare the efficiency of different osteotomy techniques for Lefort 1 osteotomy in an experimental caprine skull model. METHODS Twelve caprine skulls were used for the study. Skulls were divided into 3 groups: (1) manual chisel group, (2) Lindemann bur group, and (3) piezo osteotomy group. Bilateral osteotomies were performed on each skull. Results were evaluated with three-dimensional computerized tomography scans and macroscopic observations of the mucosal tears and soft tissue. RESULTS The mean length of the bone gap in the manual, Lindemann, and piezo groups was 4.8 (±0.7), 3.38 (±1.49), and 1.39 (±0.3) mm, respectively ( P < 0.05). The mean number of comminuted fractures in the manual, Lindemann, and piezo groups was 5.5 (±1.4), 1.6 (±0.3), and 0.6 (±0.5), respectively ( P < 0.05). Mucosal tearing and soft tissue damage based on subjective inspection observations were negligible in the piezo technique. Soft tissue and mucosal damage were observed significantly more in the manual chisel osteotomy method compared with the other 2 techniques. CONCLUSION We anticipate that piezo, which has started to be used in new application areas besides rhinoplasty, will continue to be used more widely, especially in reconstructive orthognathic surgery, due to the minimal damage it causes to tissues. With the long-term results, much healthier interpretations can be made.
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Affiliation(s)
- Merdan Serin
- Department of Plastic, Reconstructive and Esthetic Surgery, Goztepe Training and Research Hospital, Medeniyet University
| | - Dinçer Altinel
- Department of Plastic, Reconstructive and Esthetic Surgery, Istanbul Training and Research Hospital, Health Sciences University
| | - Gaye Toplu
- Private practice in Plastic, Reconstructive and Esthetic Surgery, Istanbul, Turkey
| | - Ibrahim Taşkın Rakici
- Department of Radiology, Istanbul Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Selçuk Göksel Toplu
- Department of Biostatistics and Medical IT, Health Sciences Institute, Duzce University, Duzce, Turkey
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Tzironi G, Zubizarreta-Macho Á, Brunsó-Casellas J, Cabriada-Nuño V, Lobo Galindo AB, Albaladejo Martínez A, De Carlos-Villafranca F. Nasal and maxillary sinus volume change in patients with obstructive sleep apnea after bimaxillary advancement surgery. BMC Oral Health 2023; 23:879. [PMID: 37978478 PMCID: PMC10656828 DOI: 10.1186/s12903-023-03657-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 11/11/2023] [Indexed: 11/19/2023] Open
Abstract
The airway complex is modified by bimaxillary advancement surgery performed in patients suffering from obstructive sleep apnea (OSA). The aim of the present study is to analyse the volume of nasal and maxillary sinus after bimaxillary advancement surgery in patients suffering from OSA. The maxillary sinus and nasal complex of eighteen patients with OSA was measured through cone-beam computed tomography (CBCT) before and after they were treated with bimaxillary advancement surgery. Digital planning software was used to effectively measure the upper volume changes, as well as, statistical analysis of the results was performed.Methods Eighteen patients were diagnosed with OSA the severity of which was measured by the apnea hypopnea index and were selected and submitted to preoperative and postoperative CBCT scans. Afterwards, datasets were uploaded into therapeutic digital planning software (Dolphin Imaging) to measure the volume of the right and left maxillary sinus and nasal and maxillary sinus complex. Statistically analysis between preoperative and postoperative measures was performed by Student t-test statistical analysis.Results The paired t-test showed statistically significant volumetric reductions in the left maxillary sinus (p = 0.0004), right maxillary sinus (p < 0.0001) and nasal and maxillary sinus complex (p = 0.0009) after bimaxillary advancement surgery performed in patients suffering from OSA.Conclusion The results showed that bimaxillary advancement surgery reduces the maxillary sinus volume as well as, the fossa nasal and sinus complex volume.
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Affiliation(s)
- Georgia Tzironi
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37008, Salamanca, Spain
| | - Álvaro Zubizarreta-Macho
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37008, Salamanca, Spain.
- Department of Endodontics, Faculty of Health Sciences, Alfonso X El Sabio University, 28691, Madrid, Spain.
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Avda. Universidad, 1. 28691. Villanueva de La Cañada, Madrid, Spain.
| | | | - Valentín Cabriada-Nuño
- Sleep and Ventilation Unit, Respiratory Division, Cruces University Hospital, Barakaldo, Spain
| | - Ana Belén Lobo Galindo
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37008, Salamanca, Spain
| | | | - Félix De Carlos-Villafranca
- Department of Surgery and Medical-Surgical Specialties, Area of Orthodontics, Faculty of Medicine, University of Oviedo, Oviedo, Spain
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Ravelo V, Olate G, Unibazo A, de Moraes M, Olate S. Retrospective Analysis of the Airway Space Changes in Dentofacial Deformity after Two-Jaw Orthognathic Surgery Using Cone Beam Computed Tomography. J Pers Med 2023; 13:1256. [PMID: 37623506 PMCID: PMC10455173 DOI: 10.3390/jpm13081256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023] Open
Abstract
Orthognathic surgery is used to modify anomalies in maxillomandibular position; this process can significantly affect the anatomy of the airway and cause functional changes. This study aims to define the impact of mandibular maxillary movement on the airway of subjects with dentofacial deformity. A retrospective study was conducted on subjects with Angle class II (CII group) and Angle class III (CIII group) dentofacial deformities. The subjects were treated via bimaxillary surgery; for all of them, planning was performed with software and 3D printing. Cone beam computed tomography (CBCT) was obtained 21 days before surgery and 6 months after surgery and was used for planning and follow-up with the same conditions and equipment. Was used the superimposition technique to obtain the maximum and minimum airway areas and total airway volume. The data were analyzed with the Shapiro-Wilk test and Student's t-test, while Spearman's test was used to correlate the variables, considering a value of p < 0.05. Thus, 76 subjects aged 18 to 55 years (32.38 ± 10.91) were included: 46 subjects were in CII group, treated with a maxillo-mandibular advancement, and 30 subjects were in the CIII group, treated with a maxillary advancement and a mandibular setback. In the CII group, a maxillary advancement of +2.45 mm (±0.88) and a mandibular advancement of +4.25 mm (±1.25) were observed, with a significant increase in all the airway records. In the CIII group, a maxillary advancement of +3.42 mm (±1.25) and a mandibular setback of -3.62 mm (±1.18) were noted, with no significant changes in the variables measured for the airway (p > 0.05). It may be concluded that maxillo-mandibular advancement is an effective procedure to augment the airway area and volume in the CII group. On the other hand, in subjects with mandibular prognathism and Angle class III operated with the maxillary advancement and mandibular setback lower than 4 mm, it is possible to not reduce the areas and volume in the airway.
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Affiliation(s)
- Víctor Ravelo
- Grupo de Investigación de Pregrado en Odontología (GIPO), Universidad Autónoma de Chile, Temuco 4810101, Chile
| | - Gabriela Olate
- Center for Morphological and Surgical Studies (CEMyQ), Universidad de La Frontera, Temuco 4811230, Chile
| | - Alejandro Unibazo
- Department of Oral and Maxillofacial Surgery, AGP Hospital, Lautaro 4860133, Chile
| | - Márcio de Moraes
- Division of Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas, Piracicaba 13414-903, SP, Brazil
| | - Sergio Olate
- Center for Morphological and Surgical Studies (CEMyQ), Universidad de La Frontera, Temuco 4811230, Chile
- Department of Oral and Maxillofacial Surgery, AGP Hospital, Lautaro 4860133, Chile
- Division of Oral, Facial and Maxillofacial Surgery, Universidad de La Frontera, Temuco 4811230, Chile
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Morphological Changes in Total and Inferior Part of Maxillary Sinus After Le Fort I Osteotomy, as Determined by Cone-Beam Computed Tomography. J Craniofac Surg 2023; 34:e153-e156. [PMID: 35973117 DOI: 10.1097/scs.0000000000008895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/07/2022] [Indexed: 11/26/2022] Open
Abstract
To investigate morphological changes of the total and inferior part of the maxillary sinus following Le Fort I osteotomy. 21 skeletal class II and 49 skeletal III patients who underwent orthognathic surgery were enrolled in this retrospective study. Cone-beam computed tomography taken before (T1) and 6 to 24 months after (T2) orthognathic surgery were imported into Mimics 20.0 software to analyze morphological changes of the total and inferior part of the maxillary sinus. Volume of the whole maxillary sinus was significantly reduced after surgery ( P ≤0.008), while the volume of the inferior part of the maxillary sinus was significantly greater than before surgery ( P ≤0.004). Maxillary sinus floor moved occlusally after Le Fort I osteotomy. Movement in the pitch direction of the posterior maxilla affected the state of the maxillary sinus mucosa after orthognathic surgery. Le Fort I osteotomy exerts a significant impact on the morphology of the total and inferior part of the maxillary sinus.
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Jang TS, Lee SW, Lee BS, Shim G, Seon S, Ohe JY. Sinus mucosal healing pattern according to pterygomaxillary disjunction type after Le Fort I osteotomy. J Korean Assoc Oral Maxillofac Surg 2022; 48:292-296. [PMID: 36316187 PMCID: PMC9639255 DOI: 10.5125/jkaoms.2022.48.5.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/11/2022] [Accepted: 08/17/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES During Le Fort I osteotomy, the separation of the pterygomaxillary junction (PMJ) is a difficult procedure for most surgeons because it is invisible. In this process, damage to the posterior structures constituting the sinus or those adjacent to it, including the maxillary sinus posterior wall and pterygoid plate, may occur. We would like to investigate the effects of this on the inside of the maxillary sinus after surgery and whether there are complications. MATERIALS AND METHODS One-hundred patients who underwent Le Fort I osteotomy from 2013 to 2020 using cone-beam computed tomography images were classified into two groups (clean-cut type and fractured type) according to the PMJ cutting pattern. In addition, the mucosal thickness in the maxillary sinus was divided into preoperative, postoperative three months, one year, and the change over the course of surgery was evaluated retrospectively. RESULTS Of the total 100 cases, the clean-cut type numbered 28 cases and the fractured type totaled 72 cases. Among the fracture types, part of the sinus wall and the pterygoid plate were broken in 69 cases, and the maxillary sinus posterior wall was detached in three cases. There was no statistically significant difference in sinus mucosal thickening between the clean-cut type and fractured type of the PMJ, three months and one year after surgery between the two groups. However, there was a significant difference in sinus mucosal thickness at postoperative one year in the case where a partial detachment of the maxillary sinus posterior wall occurred compared to not. CONCLUSION Even if there is some damage to the structures behind the PMJ, it may not be reasonable to spend some time on the PMJ separation process considering the overall postoperative complications, if there is no significant difference inside the sinus, or increased probability of postoperative complications.
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Affiliation(s)
- Tae-Seok Jang
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital, Seoul, Korea
| | - Seung-Woo Lee
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital, Seoul, Korea
| | - Baek-Soo Lee
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital, Seoul, Korea,Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Gyujo Shim
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital, Seoul, Korea
| | - Suyun Seon
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital, Seoul, Korea
| | - Joo-Young Ohe
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital, Seoul, Korea,Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea,Joo-Young Ohe, Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea, TEL: +82-2-958-9360, E-mail: , ORCID: https://orcid.org/0000-0002-4411-7871
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Computed Tomography Assessment of Maxillary Sinus and Inferior Nasal Airway After Le Fort I Osteotomy. J Craniofac Surg 2022; 33:1835-1839. [PMID: 35761444 DOI: 10.1097/scs.0000000000008502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 01/12/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE This study aimed to evaluate and predict the factors that affect the postoperative maxillary sinus and inferior nasal cavity conditions after Le Fort I osteotomy. SUBJECTS AND METHODS The rate of aerated (healthy) sinus area and the inferior nasal airway area were calculated by preoperative computed tomography measurements and at 1 week and 1 year postoperatively. Factors predicting the rate of aerated sinus area and the ratio of the inferior nasal cavity area after 1-week were examined using these variables. RESULTS The subjects consisted of 112 patients (224 sides) who underwent Le Fort I osteotomy with sagittal split ramus osteotomy. The rate of aerated sinus area after 1 week was significantly correlated with sex, age, and amount of blood loss (P < 0.0001). The rate of the inferior nasal cavity area after 1 week was significantly correlated with the anterior impaction amount of the maxilla and the preoperative rate of the inferior nasal airway area (P= 0.0017). CONCLUSIONS This study suggests that attention should be paid to females, older patients, and the amount of blood loss to prevent sinusitis, and larger maxillary impaction at the anterior site should be carefully planned to prevent severe nasal obstruction immediately after Le Fort I osteotomy.
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Khaghaninejad MS, Khojastehpour L, Danesteh H, Changizi M, Ahrari F. Changes in the pharyngeal airway after different orthognathic procedures for correction of class III dysplasia. Maxillofac Plast Reconstr Surg 2022; 44:23. [PMID: 35678935 PMCID: PMC9184694 DOI: 10.1186/s40902-022-00352-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/24/2022] [Indexed: 12/02/2022] Open
Abstract
Objective This study was conducted to compare changes in pharyngeal airway after different orthognathic procedures in subjects with class III deformity. Methods The study included CBCT scans of 48 skeletal class III patients (29 females and 19 males, mean age 23.50 years) who underwent orthognathic surgery in conjunction with orthodontic treatment. The participants were divided into three groups of 16, as follows: Group 1, mandibular setback surgery; group 2, combined mandibular setback and maxillary advancement surgery; and group 3, maxillary advancement surgery. CBCT images were taken 1 day before surgery (T0), 1 day (T1), and 6 months (T2) later. The dimensions of the velopharynx, oropharynx, and hypopharynx were measured in CBCT images. Results In all groups, there was a significant decrease in airway variables immediately after surgery, with a significant reversal 6 months later (P < 0.05). In subjects who underwent maxillary advancement, the airway dimensions were significantly greater at T2 than the T0 time point (P < 0.05), whereas in the mandibular setback and bimaxillary surgery groups, the T2 values were lower than the baseline examination (P < 0.05). The alterations in airway variables were significantly different between the study groups (P < 0.05). Conclusions The mandibular setback procedure caused the greatest reduction in the pharyngeal airway, followed by the bimaxillary surgery and maxillary advancement groups, with the latter exhibiting an actual increase in the pharyngeal airway dimensions. It is recommended to prefer a two-jaw operation instead of a mandibular setback alone for correction of the prognathic mandible in subjects with predisposing factors to the development of sleep-disordered breathing.
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Affiliation(s)
- Mohammad Saleh Khaghaninejad
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Khojastehpour
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Danesteh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Changizi
- Oral and Maxillofacial Surgery Resident, Department of Oral and Maxillofacial Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farzaneh Ahrari
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
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Simakova AA, Gorbatova LN, Grjibovski AM, Arutyunyan KS, Ryzhkov IA. [Dimensions of the upper airways and its impact on the dentoalveolar system development]. STOMATOLOGIIA 2022; 101:93-99. [PMID: 35362710 DOI: 10.17116/stomat202210102193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Due to the high mobility and variability of bone structures and soft tissues surrounding the upper respiratory tract, the exact boundaries for measuring and normalizing the size of the respiratory tract have not yet been determined. Studies have determined the relationship between the narrowing of the upper jaw and a decrease in the transverse dimensions of the airways, as well as a positive effect in changing the size of the airways after orthodontic treatment and/or orthognathic surgery. Nevertheless, the results of research in this area may differ greatly from different specialists, which indicates that the topic is poorly studied and it is necessary to continue and expand the range of scientific works to assess the state of the upper respiratory tract and their relationship with the orthodontic status.
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Affiliation(s)
- A A Simakova
- Northern State Medical University, Arkhangelsk, Russia
| | - L N Gorbatova
- Northern State Medical University, Arkhangelsk, Russia
| | - A M Grjibovski
- Northern State Medical University, Arkhangelsk, Russia
- West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
- Al Farabi Kazakh National University, Almaty, Kazakhstan
- North-Eastern Federal University, Yakutsk, Russia
| | | | - I A Ryzhkov
- Northern State Medical University, Arkhangelsk, Russia
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Lobo F, Filho LI, Sigua-Rodriguez EA, da Silva BG, Tolentino EDS, Borges YM, da Silva MC, Tonin RH, Iwaki LCV. Evaluation of ortogonblender software bone movement tools in bimaxillary orthognatic surgeries performed in dolphin software. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:417-421. [PMID: 34628097 DOI: 10.1016/j.jormas.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 09/23/2021] [Accepted: 10/04/2021] [Indexed: 11/15/2022]
Abstract
The aim of this observational, longitudinal and retrospective study was to evaluate the fidelity of virtual surgical planning (VSP) performed on Dolphin Imaging & Management Solutions® 11.95 software on hard tissues, using the tools of the open-source software OrtogOnBlender - Blender3D. For this, linear, angular and 7-point anatomical measurements of the skeletal profile were used, and the discrepancies between the VSP and the result after bimaxillary orthognathic surgery were calculated. Pre- and postoperative cone beam CT (CBCT) scans of 43 consecutive patients with class II and III skeletal deformities were evaluated and the results of the VSP were compared to the 1-month postoperative results. All overlapping points presented values within the range considered clinically irrelevant (< 2 mm and < 4°) and differences were not significant (p > 0.05). The comparison of anatomical points showed lower values (≤ 2.11 mm) in point A of class II. For hard tissues, the comparison between VSP and 1-month postoperative tomography demonstrated the faithful results of virtual planning using this software.
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Affiliation(s)
- Fernanda Lobo
- Department of Dentistry, State University of Maringá (UEM), Maringá PR, Brazil.
| | - Liogi Iwaki Filho
- Department of Dentistry, State University of Maringá (UEM), Maringá PR, Brazil
| | | | - Breno Gabriel da Silva
- Department of Exact Sciences, "Luiz de Queiroz" College of Agriculture, University of São Paulo (ESALQ/USP), Piracicaba, Brazil
| | | | - Yana Miranda Borges
- Science and Technology of Amazonas (IFAM), Federal Institute of Education, Manaus, Brazil
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Yamashita AL, Iwaki Filho L, Ferraz FWDS, Ramos AL, Previdelli ITDS, Pereira OCN, Tolentino EDS, Chicarelli M, Iwaki LCV. Accuracy of three-dimensional soft tissue profile prediction in orthognathic surgery. Oral Maxillofac Surg 2021; 26:271-279. [PMID: 34302576 DOI: 10.1007/s10006-021-00988-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 07/11/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the accuracy of three-dimensional (3D) soft tissue prediction in bimaxillary orthognathic surgery. METHODS Cone-beam computed tomographs of 88 patients with class II (n = 46) and class III (n = 42) malocclusions, who underwent bimaxillary orthognathic surgery, were included in this retrospective study. 3D soft tissue prediction and postoperative outcome were compared by using ten landmarks of facial soft tissues. Patients' sex and age were also assessed. Results were analyzed using a mixed model methodology (p < 0.05). RESULTS The success criterion adopted was a mean discrepancy of < 2 mm. Most mandibular landmarks indicated a tendency for underprediction with a downward direction in class II patients, with some values > 2 mm. In class III, there was overprediction with a downward direction for the mandibular landmarks, with values < 2 mm. More accurate results were found in female and older patients. CONCLUSIONS 3D surgical planning showed clinically acceptable results for predicting soft tissues in patients undergoing bimaxillary orthognathic surgery, with more accurate results for class III patients. Although some differences were found when age and sex were interacted, a consistent association between these variables could not be stated. These results support the clinician, as accuracy can provide a strong guide to the surgeon when planning surgical orthodontic treatment.
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Affiliation(s)
- Amanda Lury Yamashita
- Department of Dentistry, State University of Maringá, Avenida Mandacaru n° 1550, bloco S-08, Maringá, Paraná, CEP: 87080-000, Brazil.
| | - Liogi Iwaki Filho
- Department of Dentistry, State University of Maringá, Avenida Mandacaru n° 1550, bloco S-08, Maringá, Paraná, CEP: 87080-000, Brazil
| | - Flávio Wellington da Silva Ferraz
- Department of Oral and Maxillofacial Surgery, Clinics Hospital of Medicine School and University Hospital of University of São Paulo, São Paulo, São Paulo, Brazil
| | - Adilson Luiz Ramos
- Department of Dentistry, State University of Maringá, Avenida Mandacaru n° 1550, bloco S-08, Maringá, Paraná, CEP: 87080-000, Brazil
| | | | | | - Elen de Souza Tolentino
- Department of Dentistry, State University of Maringá, Avenida Mandacaru n° 1550, bloco S-08, Maringá, Paraná, CEP: 87080-000, Brazil
| | - Mariliani Chicarelli
- Department of Dentistry, State University of Maringá, Avenida Mandacaru n° 1550, bloco S-08, Maringá, Paraná, CEP: 87080-000, Brazil
| | - Lilian Cristina Vessoni Iwaki
- Department of Dentistry, State University of Maringá, Avenida Mandacaru n° 1550, bloco S-08, Maringá, Paraná, CEP: 87080-000, Brazil
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Position of the mandibular canal before and after bilateral sagittal split ramus osteotomy: a cone beam computed tomographic study. Br J Oral Maxillofac Surg 2021; 60:279-285. [PMID: 34311998 DOI: 10.1016/j.bjoms.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 05/03/2021] [Indexed: 11/21/2022]
Abstract
The aim of this study was to evaluate the position of the mandibular canal (MC) before and after bilateral sagittal split ramus osteotomy (BSSRO) using cone-beam computed tomography (CT), and to compare the position of the MC in Class II and Class III patients in the preoperative period. Patients were divided into two groups: Class II (n = 38) and Class III (n = 41). Measurements of the superior, inferior, buccal, and lingual distances of the MC in relation to the cortical bone were taken at three levels in the proximal segment of the mandible. Results were analysed using the Kruskal-Wallis test (p < 0.05). In the Class II group the superior distance of the MC at levels 2 and 3, and the inferior distance at level 3 significantly decreased after BSSRO. In the Class III group, no significant differences were found at any level, and the inferior distances at all levels were smaller preoperatively than those in the Class II group. In the Class II group the position of the MC altered in relation to superior and inferior cortical bone after BSSRO. However, the position of the MC remained stable in the Class III group. Our results also suggest a deeper cut in inferior cortical bone in Class III patients.
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Ferraz FWDS, Iwaki-Filho L, Souza-Pinto GND, Iwaki LCV, Li AT, Cardoso MDA. A comparative study of the accuracy between two computer-aided surgical simulation methods in virtual surgical planning. J Craniomaxillofac Surg 2020; 49:84-92. [PMID: 33376041 DOI: 10.1016/j.jcms.2020.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/22/2020] [Accepted: 12/08/2020] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE The aim of this retrospective and observational study was to compare the accuracy of two different virtual surgical planning (VSP) protocols, namely, the CASS method and the modified CASS method. MATERIALS AND METHODS The patients underwent bimaxillary orthognathic surgery, planned using either the CASS method or the modified CASS method. Linear and angular discrepancies between the VSP outcome and postoperative outcome for both groups were compared for maxilla, mandible, and chin segments. Aside from the comparison between both groups, additional criteria were used to determine the accuracy of the protocol based on a linear and angular difference between planned and actual outcomes of less than 2 mm and 4°, respectively. The intergroup comparisons were performed by one-way ANOVA, with the level of significance set at 5%. RESULTS A total of 21 patients, of both genders, were assigned into group I (n = 11), planned with the CASS method, and group II (n = 10), planned with the modified CASS method. Both the CASS and modified CASS methods presented similar accuracy with regard to linear differences for the maxilla, mandible, and chin segments, except for ΔX for the mandibular segment, where the modified CASS method showed slightly better accuracy. However, there was a statistically significant difference with regard to angular differences in the chin segment, with the CASS method shown to be the more accurate. Aside from Δpitch for the chin segment, no linear or angular differences exceeded 2 mm or 4°. CONCLUSION Although statistically significant differences were found with regard to angular measurements in the chin segment, the accuracy of the modified CASS method for virtual planning can be considered as clinically equivalent, with a performance comparable to that of the CASS method.
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Affiliation(s)
- Flavio Wellington da Silva Ferraz
- Oral and Maxillofacial Surgery, Hospital Das Clínicas, University of São Paulo (USP), Rua Dr Eneas de Carvalho, 255, 05403-010, São Paulo, São Paulo, Brazil.
| | - Liogi Iwaki-Filho
- Oral and Maxillofacial Surgery, State University of Maringá (UEM), Avenida Mandacaru, 1550, 87080-000, Maringá, Paraná, Brazil.
| | - Gustavo Nascimento de Souza-Pinto
- Oral Radiology and Stomatology, Department of Dentistry, State University of Maringá (UEM), Avenida Mandacaru, 1550, 87080-000, Maringá, Paraná, Brazil.
| | - Lilian Cristina Vessoni Iwaki
- Oral Radiology and Stomatology, Department of Dentistry, State University of Maringá (UEM), Avenida Mandacaru, 1550, 87080-000, Maringá, Paraná, Brazil.
| | - An Tien Li
- Department of Dentistry, School of Health Sciences, University of Brasilia (UNB), Campus Universitário Darcy Ribeiro, Brasília, 70910-900, Distrito Federal, Brazil.
| | - Mauricio de Almeida Cardoso
- Department of Dentistry, São Leopoldo Mandic, Rua Dr José Rocha Junqueira, 13, 13045-755, Campinas, São Paulo, Brazil.
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