Journal of the Korean Association of Oral and Maxillofacial Surgeons

  • 제29권6호
  • /
  • Pages.407-420
  • /
  • 2003
  • /
  • 2234-7550(pISSN)
  • /
  • 2234-5930(eISSN)
대한구강악안면외과학회 (The Korean Association of Oral and Maxillofacial Surgeons)
권호 표지

하악전돌증 환자의 하악지시상분할골절단술 후 단안모화 경향과 그 결정인자에 대한 분석

ANALYSIS OF SHORT FACE TENDENCY AND IT'S DETERMINANT FACTORS AFTER BILATERAL SAGITTAL SPLIT RAMUS OSTEOTOMY OF MANDIBULAR PROGNATHISM

  • 강지연 (충북대학교 의과대학 구강악안면외과학교실) ;
  • 최희원 (충북대학교 의과대학 구강악안면외과학교실) ;
  • 김경원 (충북대학교 의과대학 구강악안면외과학교실)
  • Kang, Ji-Yeon (Dept. of Oral & Maxillofacial Surgery, Medical College, Chungbuk National University) ;
  • Choi, Hee-Won (Dept. of Oral & Maxillofacial Surgery, Medical College, Chungbuk National University) ;
  • Kim, Kyoung-Won (Dept. of Oral & Maxillofacial Surgery, Medical College, Chungbuk National University)
  • 발행 : 2003.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose : The purpose of this study was to analyse the facial changes and factors contributing to then after bilateral sagittal split ramus osteotomy of mandibular prognathism. Materials and Methods : Forty patients with Class III dental and skeletal malocclusion who were treated with bilateral sagittal split ramus osteotomy were reviewed. Frontal and lateral cephalometric radiographs were taken preoperatively, immediate postoperatively and more than six months postoperatively in each patient. After tracing the cephalometric radiographs, various parameters were measured. Results : 1. Gonial angle at postoperative two days was decreased about $10.4^{\circ}$ than preoperatively and gonial angle at postoperative six months was increased about $6.8^{\circ}$ than postoperative two days. So, gonial angle at postoperative six months was decreased about $3.6^{\circ}$ than preoperative gonial angle. 2. Facial height postoperative two days was decreased about 0.8mm than preoperatively and facial height at postoperative six months was decreased about 0.7mm than postoperative two days. So, facial height at postoperative six months was decreased about 1.5mm than preoperative facial height. 3. Mandibular width postoperative two days was decreased about 1.0mm than preoperatively and mandibular width at postoperative six months was increased about 1.8mm than postoperative two days. So, mandibular width at postoperative six months was decreased about 2.8mm than preoperative mandibular width. 4. Amount of set back and mandibular plane angle were not influencing on relapse degree. Conclusion : It is thought that bilateral sagittal split ramus osteotomy in mandibular prognathic patients is effective to improve long face and steep gonial angle. More prudent operation and careful postoperative management is required to maintain stable face postoperatively. Further research for soft tissue changes and factors which are related with relapse is needed.

키워드

참고문헌

  1. Burstone CJ, James RB. Cephalometrics for orthognathic surgery. J Oral Surg 1978;36:269-77.
  2. Shira RB. Mandibular deficiency syndrome. Oral Surgery Oral Medicine Oral Pathology 1978; 45:329-48. https://doi.org/10.1016/0030-4220(78)90520-0
  3. Jacobson A, Evans WG. Mandibular prognathism. Am J Orthod 1974;66:140-171. https://doi.org/10.1016/0002-9416(74)90233-4
  4. 우순섭, 최용수, 박원희, 유임학, 이영수, 심광섭. 진성 골격성 Ⅲ급 부정교합에서 두개저, 상악, 하악의 위치 및 크기에 관한 연구. 대한악안면성형재건외과학회지 2000;28:24-30.
  5. Bjork A. Some biological aspects of prognathism and occlusion of the teeth. Angle Orthod 1951;21:3-27.
  6. Bjork A. The nature of the facial prognathism and its relation to normal occlusion of the teeth. Angle Orthod 1951;37:106-124.
  7. Brehm HL, Jackson DL. Investigation of the extent of the need for orthognatic services. Am J Orthod 1961;47:148-149.
  8. Ast DB, Carlos JP, Cons NC. The prevalance and caracteristics of malocclusion among senior high school students in upstate N.Y. Am J Orthod 1965;51:437-445.
  9. Huber RE, Reynolds JW. A dentofacial study of male students at the University of Michigan in the physical hardening program. AM J Orthod 1946;32:1-21.
  10. Chan GKH. Class Ⅲ malocclusion in Chinese ; Etiology and treatment. Am J Orthod 1974;65:152-156. https://doi.org/10.1016/0002-9416(74)90176-6
  11. 유영규. 연세대학교 2,378명을 대상으로 한 부정교합 빈도에 관한 연구. 대한치과교정학회지 1971;2:35-40.
  12. 이신재, 서정훈. 7-18세 청소년의 부정교합에 대한 인식과 교정치료 수요에 관한 연구. 대한치과교정학회지 1994;24:367-394.
  13. Proffit WR. editors. Contemporary orthodontics. 2nd ed. St Louis: Mosby;1993. p.233.
  14. Ricketts RM. Planing treatment on the basis of the facial pattern and an estimate of its growth . Angle Orthod 1957;27:14-37.
  15. Downs WB. Variations in facial relationship : their significance in treatment and prognosis. AM J Orthod 1948;34:812-840. https://doi.org/10.1016/0002-9416(48)90015-3
  16. Bjork A. The face in profile. Sevensk Tandlakare Tidskrift 40, Lund, 1947, Berlingska Bok Tryckeriet.
  17. Steiner CC. Cephalometrics for you and me. J Orthod 1953;39:729-755. https://doi.org/10.1016/0002-9416(53)90082-7
  18. Riedel Ra. The relation of maxillary structures to cranium in maocclusion and in normal occlusion. Angle Orthod 1952;22:142-145.
  19. Koski K. Analysis of profile roentgenograms by means of a new circle method. Dent Rec 1953;73:139-189.
  20. Wylie WL. The assesment of anteroposterior dysplasia . Angle Orthod 1947; 17:97-109.
  21. Moore JW. Variation of sella nasion plane its effect on SNA and SNB. J Oral Surg 1976; 34:24-26.
  22. Lundstom A. Head posture in relation to slope of the sella-nasion line. Angle Orthod 1982;52:79-82.
  23. Ellis EⅢ, Macnamara JA Jr. Cephalometric reference planes sella nasion vs Frankfort horizontal. Int J Adult Orthod Orthognath Surg 1988; 3:81-87.
  24. Marcotte MR. Head posture and dentofacial proportions. Angle Orthod 1981; 51:208-213.
  25. Burstone CJ. The integumental profile. Am J Orthod 1964;44:1-25.
  26. Reitzik M. Skeletal and dental changes after surgical correction of mandibular prognathism. J Oral Surg. 1980;38:109-16. https://doi.org/10.1016/0030-4220(74)90321-1
  27. 조병욱, 이용찬, 남종훈, 김태영. 하악의 후방이동을 위한 하악골시상골절단술후의 회귀성향에 관한 연구. 대한구강악안면외과학회지 1988;14:1-4.
  28. 이장열, 유형석, 유영규. 제Ⅲ급 부정교합자의 악교정수술후 골격적 재발양상에 관한 연구. 대한치과교정학회지 1998;28:461-77.
  29. Reychler H, Schilli W, Ewers R. The influence of prognathism surgery on the width and the length of the third of the face. J Maxillofac Surg 1980;8:95-8. https://doi.org/10.1016/S0301-0503(80)80080-4
  30. 손형민, 장현석, 임재석, 권종진, 이부규. 골격성 제3급 부정교합환자의 하악지시상분할골절단술후 하안면 폭경 및 고경의 변화에 대한두부계측방사선학적 연구. 대한악안면성형재건외과학회지 2000; 22:337-342.
  31. Stella JP, Astrand P, Epker BN. Patterns and etiology of relapse after correction of class Ⅲ open bite via subcondylar ramus osteotomy. Int J Adult Orthod Orthognath Surg 1986;1:91-95.
  32. 김종철, 유영규. Gonial angle에 따른 두부 및 안면부 골격의 변화에 관한 연구. 대한치과교정학회지 1978;8:27-37.
  33. Will LA, Joondeph DR, West RA. Condylar position following mandibular advancement : Its relationship to relapse. J Oral Maxillofac Surg 1984;42:578-85. https://doi.org/10.1016/0278-2391(84)90088-0
  34. Jager A, Kubein-Messenberg D, Luhr HG. A longitudinal study of combined orthodontic and surgical treatment of class malocclusion with deep overbite. Int J Adult Orthod Orthognath Surg 1991;6:29-38.
  35. Riedel RA. Relation of maxillary structure to the cranium in malocclusion and in normal occlusion . Angle Orthod 1952; 22:142-.
  36. Bell WH, Proffit WR, White RP. Surgical correction of dentofacial deformities. Saunders 1980;1:149.
  37. 노준, 유영규. 한국 젊은 여성의 심미적 안모형태에 관한 두부방사선계측학적 연구. 대한치과교정학회지 1988;18:127-39.
  38. 백일수, 유영규. 청소년기 정상교합자에 대한 두부방사선계측학적 연구. 대한치과교정학회지 1982;12:177-91.
  39. Vries KD, Devriese PP, Hovinga J. Facial palsy after sagittal split osteotomy. J Oral Maxillofac Surg 1993;21:50-53.
  40. Christos SM. Complication after sagittal split osteotomy. J Oral Maxillofac Surg 1984;42:101-7. https://doi.org/10.1016/0278-2391(84)90320-3
  41. Obwegeser H. Der offene biss in chirurgischer sicht. Schweigz Maschr Zahnhk 1975;33:412-26.
  42. 이근호, 권대근, 장도근, 이상한. 심한 하악골전돌증 환자의 외과적치험례. 대한악안면성형재건외과학회지 1994;16:33-39.
  43. Wuerpel EH. On facial balance and harmony. Angle Orthod 1937;7:81-89.
  44. 신민철, 이상철. 하악전돌증 환자의 악교정 수술후 시간경과에 따른 안모 연조직 변화에 관한 연구. 대한악안면성형재건외과학회지 1997;19:351-361.
  45. McNeil RW, Holly JR, Sunderberg RJ. Skeletal relapse during IMF. J Oral Surg 1973;31:212-218.
  46. Gassmann CJ, Van Sickels JE, Tharash WJ. Causes, location, and timing of relapse following rigid fixation after mandibular advancement. J Oral Maxillofac Surg 1986;48:450-454. https://doi.org/10.1016/0278-2391(90)90229-U
  47. Michiwaki Y, Yoshida H, Ohno K, Michi K. Factors contribution to skeletal relapse after surgical correction of mandibular prognathism. J Craniomaxillofac Surg 1990;18:195-201. https://doi.org/10.1016/S1010-5182(05)80410-X
  48. Quast DC, Biggerstaff RH, Haley JV. The short term and long term soft tissue profile changes accompanying mandibular advancement surgery Am J Orthod 1983;84:29-6.