Evaluation of Stability Following Two-Jaw Surgery

양악 수술 후 안정성 평가

  • Lee, Sung-Yong (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Kim, Su-Gwan (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Kim, Seo-Yoon (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Oh, Ji-Su (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Moon, Kyung-Nam (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Yoon, Dae-Woong (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Kim, Hoon (Department of Dentistry, Eulji University Hospital) ;
  • Kim, Jeong-Sun (Department of Dental Hygieve, Gwangju Health College University)
  • 이승용 (조선대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 김수관 (조선대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 김서윤 (조선대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 오지수 (조선대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 문경남 (조선대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 윤대웅 (조선대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 김훈 (을지대학병원 치과) ;
  • 김정선 (광주보건대학교 치위생과)
  • Received : 2010.10.20
  • Accepted : 2011.01.28
  • Published : 2011.03.31

Abstract

Purpose: Orthognathic surgery is required in patients with severe skeletal disharmony and facial asymmetry, which results in functional and esthetic improvement. Recently, bimaxillary surgery has become generalized. Establishment of the occlusal plane among several other factors included in the surgery plan is a major consideration for the diagnosis and treatment plan and it is also an important factor for postoperative stability. Methods: In this study, we assessed postoperative stability of occlusal plane, B-point, and pogonion point on 20 patients who underwent two-jaw surgery in the Chosun Dental Hospital from 2000 to 2007. Preoperative and postoperative states and at least a one year postoperative follow-up were compared. Results: The postsurgical relapse volume of the occlusal plane to the SN plane and the FH plane was $-0.26{\pm}2.8^{\circ}$ and $-0.44{\pm}3.29^{\circ}$, respectively and after two-jaw surgery, the stability of occlusal plane was maintained. The horizontal relapse degree was $0.85{\pm}0.46$ mm and $0.76{\pm}0.48$ mm, respectively, and the vertical relapse degree was $1.16{\pm}0.36$ mm and $1.13{\pm}0.71$ mm of the B point and the Pogonion point at the time after minimal 1 year. Conclusion: The vertical relapse amount was shown to be slightly larger than the horizontal relapse amount.

Keywords

References

  1. Bjork N, Eliasson S, Wictorin L. Changes in facial profile after surgical treatment of the mandibular protrusion. A cephalometric study, 1 and 11 years after treatment. Scand J Plast Reconst Surg 1971;5:41-6. https://doi.org/10.3109/02844317109042935
  2. Connor AM, Moshiri F. Orthognathic surgery norms for American black patients. Am J Orthod 1985;87:119-34. https://doi.org/10.1016/0002-9416(85)90021-1
  3. Kajikawa Y. Changes in soft tissue profile after surgical correction of skeletal class III malocclusion. J Oral Surg 1979; 37:167-74.
  4. Steinhauser EW. Historical development of orthognathic surgery. J Cranio Maxillofac Surg 1996;24:195-204. https://doi.org/10.1016/S1010-5182(96)80002-3
  5. Ive J, McNeil RW, West RA. Mandibular advancement: skeletal and dental changes during fixation. J Oral Surg 1977;35: 881-6.
  6. Schendel SA, Epker BN Results after mandibular advancement surgery: an analysis of 87 cases. J Oral Surg 1980;38: 265-82.
  7. Bothur S, Blomqvist JE, Isaksson S. Stability of Le Fort I osteotomy with advancement: a comparison of single maxillary surgery and a two-jaw procedure. J Oral Maxillofac Surg 1998;56:1029-33; discussion 1033-4. https://doi.org/10.1016/S0278-2391(98)90248-8
  8. Proffit WR, Philips C, Turvey TA. Stability after surgical- orthodontic corrective of skeletal Class III malocclusion. 3. Combined maxillary and mandibular procedures. Int J Adult Orthod Orthognath Surg 1991;6:211-25.
  9. Donatsky O, Bjorn-Jorgensen J, Holmqvist-Larsen M, Hillerup S. Computerized cephalometric evaluation of orthognathic surgical precision and stability in relation to maxillary superior repositioning combined mandibular advancement or set back. J Oral Maxillofac Surg 1997;55:1071-9; discussion 1079-80. https://doi.org/10.1016/S0278-2391(97)90282-2
  10. Franco JE, Van Sicles JE, Thrash WJ. Factors contributing to relapse on rigidly fixed mandibular setbacks. J Oral Maxillofac Surg 1989;47:451-6. https://doi.org/10.1016/0278-2391(89)90276-0
  11. Wolford LM, Chemello PD, Hilliard FW. Occlusal plane alteration in orthognathic surgery. J Oral Maxillfoac Surg 1993; 51:730-40; discussion 740-1. https://doi.org/10.1016/S0278-2391(10)80410-0
  12. Reyneke JP, Evans WG. Surgical manipulation of the occlusal plane. Int J Adult Orthod Orthogn Surg 1990;5:99-110.
  13. Pepersack WJ, Chausse JM. Long term follow up of the sagittal splitting technique for correction of mandibular prognatism. J Maxillofac Surg 1978;6:117-40. https://doi.org/10.1016/S0301-0503(78)80079-4
  14. MacIntosh RB. Experience with the sagittal osteotomy of the mandibular ramus: a 13-year review. J Maxillofac Surg 1981;9:151-65. https://doi.org/10.1016/S0301-0503(81)80036-7
  15. Perez MM, Sameshima GT, Sinclair PM. The long-term stability stability of LeFort I maxillary downgrafts with rigid fixation to correct vertical maxillary deficiency. Am J Orthod Dentofac Orthop 1997;112:104-8. https://doi.org/10.1016/S0889-5406(97)70280-4
  16. Martis CS. Complications after mandibular sagittal split osteotomy. J Oral Maxillofac Surg 1984;42:101-7. https://doi.org/10.1016/0278-2391(84)90320-3
  17. Enlow DH, Kuroda T, Lewis AB. Intrinsic cranioacial compensations. Angle Orthod 1971;41:271-85.
  18. Harvold EP, Hierici G, Vargervic K. Experiments on the development of dental malocclusions. Am J Orthod 1972;61: 38-44. https://doi.org/10.1016/0002-9416(72)90174-1
  19. Wolford LM, Chemello PD, Hilliard FW. Occlusal plane alteration in orthognathic surgery. J Oral Maxillofac Surg 1993; 51:730-40. https://doi.org/10.1016/S0278-2391(10)80410-0
  20. Moss JP. A cephalometris and electromyographic investigation of patients treated for the correction of mandibular prognathism by mandibular surgery only. Int J Orthod 1990;28:13-20