• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.1
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• pp.28-38
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• 2010

The factors influencing the relapse and recurrence of skeletal deformity after the orthognathic surgery include various factors such as condylar deviation, the amount of mandibular set-back, stretching force by the soft tissues and muscles around the facial skeleton. The purpose of this report is to recognize and analyze the possible factors of reoperation after orthognathic surgery, due to early relapses. Six patients underwent reoperation after the orthognathic surgeries out of 110 patients from 2006 to 2009 were included in this study. In most cases, clincal signs of the insufficient occlusal stability, anterior open bite, and unilateral shifting of the mandible were founded within 2 weeks postoperatively. Although elastic traction was initiated in every case, inadequate correction made reoperation for these cases inevitable. The chief complaints of five cases were the protruded mandible combined with some degree of asymmetric face and in the other one case, it was asymmetric face only. Various factors were considered as a major cause of post-operative instability such as condylar sagging, counter-clockwise rotation of the mandibular segment, soft tissue tension related with asymmetrical mandibular set-back, preoperatively existing temporomandibular disorder (TMD), poor fabrication of the final wafer, and dual bite tendency of the patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.2
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• pp.172-178
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• 2000

When we establish treatment planning of facial asymmetry, we must predict each asymmetrical element that will be changed upon coronal, axial, sagittal plane. At the visual point, prediction of the change of coronal plane is most important. It is important difference between Rt. and Lt. mandibular angle belonging to posterior coronal plane, as well as anterior coronal plane, such as upper and lower incisor, or midline of chin point. Several methods for control bulk of mandibular angle are additional angle shaving after osteotomy, grinding contact area between proximal and distal segment for decrease the volume, or bone graft for increase the volume. But, at the point of bimaxillary surgery, transverse position of posterior maxilla is an important factor for control it. So, we would report transverse movement of posterior maxilla for decrease asymmetry on the posterior coronal plane of face, that is, asymmetry of mandibular angular portion.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.2
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• pp.143-148
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• 2009

Introduction: To correct abnormal occlusal plane by orthognathic surgery, we need to have clear criteria for therapeutic occlusal plane. Authors introduced the concept of individualized ideal occlusal plane(Y-plane), which is determined by the size and form of the mandible, and the ideal incisor tip considering upper and lower lip. Authors studied the following to verify if the actual occlusal plane of the patients with optimal jaw relationship corresponds with the individualized ideal occlusal plane. Patients: We reviewed 44 patients who have normal occlusion visitied in the Dept. of orthodontics, Pundang CHA hospital. Methods: We evaluated if there are agreement between individualized ideal occlusal plane(Y plane) and occlusal plane of actual patients. And we confirmed if tested group has a normal face by measuring FABA, FMA, AB-LOP. Results: There were no significant differences of FABA, FMA, AB-LOP, Mo-Y plane between male and female. FABA, FMA and AB-LOP were included in the normal value. Average distance of Mo-Y plane was $0.75{\pm}0.78mm$. Conclusion: Individualized ideal occlusal plane may be applied to orthognathic surgery.

• The korean journal of orthodontics
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• v.27 no.5 s.64
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• pp.733-741
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• 1997

As a result of surgical orthodontic treatment of mandibular prognathism, changes take place in the skeletal and soft orofacial components. Although some investigators had stated that permanent reduction of airway space was observed after mandibular setback surgery, it was not clear that this permanent reduction was sustained during long-term follow-up. The purpose of this study was to assess the changes in oropharyngeal airway space and soft tissue orofacial component following the mandibular setback surgery and during the follow-up period. The correlation between the changes of the oropharyngeal airway space and the changes of other soft tissue orofacial component was also assessed. The findings of this study were as follows ; 1. The oropharyngeal airway space area decreased following mandibular setback surgery for mandibular prognathism and continued to decrease during the follow-up period(p<0.05). 2. The pharyngeal depth at Xi point level and the 2nd cervical vertebra point level decreased after the surgery and remained during the follow-up period(p<0.05). The decrease of these pharyngeal depth was correlated with the decrease of oropharyngeal airway space area(p<0.01). 3. The decrease of pharyngeal depth at the 3rd and 4th cervical vertebra point level was not significant after the surgery and during the follow up period. 4. The hyoid bone moved downward after the surgery(p<0.05), but returned to its original position during the follow-up period. 5. The length & height of tongue and the Position of epiglottis base did not change significantly(p>0.05). 6. The soft palate was displaced posteriorly after the surgery and remained to its changed position during the follow-up period(p<0.05) due to posterior displacement of tongue. The changes of soft palate were significantly correlated with the decrease of oropharyngeal airway space area(p<0.01). 7. The narrowing of oropharyngeal airway space was due to the posterior displacement of tongue above the level of epiglottis tip. The posterior displacement of tongue following mandibular setback osteotomy remained during the follow-up period.

• The korean journal of orthodontics
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• v.29 no.2 s.73
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• pp.239-249
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• 1999

In orthognathic surgery to obtain proper functional and esthetic form after skeletal discrepancy treatment, precise diagnosis and treatment plan are essential. Especially in two jaw surgeries that have serious upper and lower jaw problems, maxilla and mandible are arranged in three dimensions. Based on the maxillary rearrangement, mandibular sagittal and transverse positions are determined, and thus new occlusal plane is established. The object of this study is to evaluate the stability of the indiviual ideal occlusal plane based on the architectural and structural craniofacial analysis of Delaires. The subjects of this study were 48 patients who underwent two jaw surgeries, and they were equally divided into two groups, A and B. A group was operated with ideal occlusal plane and B group was not. Two groups were compared at the preoperative, immediate postoperative (average 4.3days), and long-term postoperative (average 1.3years) lateral cephalometric radiographs. The following results were obtained: 1. ANS was lower than that of PNS for both A and B after the surgery. That is, maxilla and mandible are rotated in posterior and superior direction. 2. Significances were found between $T_2$ and $T_3$ for both A and B are HRP-Me at vortical measurements, articular angle(p<0.01), gonial angle(p<0.01), and Mn. plane angle(p<0.05) at angular measurement. Mn. plane angle is increased at HRP-Me is decreased for both A and B. 3. There is no significance in skeletal stability aster the surgery between group A and B. 4. Horizontal movements of B and Pog by surgery have statistically significant inverse correlations with horizontal relapse of B and Pog, and vertical relapse of PNS, as well as Mn. Plane angle, and gonial angle after the surgery.

• The Journal of the Korean dental association
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• v.53 no.7
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• pp.468-475
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• 2015

In cleft lip and palate (CLP) patients, there are various degree of residual maxillofacial deformities in adolescent period. Usually, orthoganthic surgery for the cleft patients needs Le Fort I osteotomy and/or mandibular set-back surgery. Previous report from other institute had been shown that there is significant relapse after maxillary movement after Le Fort I osteotomy when the surgical advancement of the maxilla was over than 5 or 7mm in average. Recent comphrehensive report showed that most of the relapse was happened within 1 year and the total horizontal relapse of the maxilla was as high as 30% in average. Therefore, overcorrection is needed in maxillary surgery for cleft patients. Another concerns for cleft orthognathic surgery is the anatomical variation in pterygomaxillary region in cleft patients compared to control patients. Patients with CLP had larger and thicker pterygomaxillary dimensions, and the results imply that careful attention to pterygomaxillary anatomy is needed in patients with CLP undergoing Le Fort I surgery. This article reviews the pre and postoperative considering factors for orthognathic surgery for CLP patients.

• The korean journal of orthodontics
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• v.28 no.5 s.70
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• pp.751-761
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• 1998

The purpose of this study was to find the characteristics of lateral crphalogram of skeletal class III malocclusion patients to whom orthognathic surgery was essential. For this study 37 patients with skeletal class III and going to treat or be treated orthognathic surgery(age 7-17) were selected to experimental group and 56 people with normal occlusion (age 8-13) were selected to normal group and the two groups were evaluated and statistically analyzed and the results were as follows 1. In comparison of experimental group and normal group in prepubertal group, there were significant differences in ANS-U1/Me-L1, Mx. Length/Mn. Length, S-N/Go-Me, Wits, ANB, SN-Pog, IMPA, Facial Convexity, APDI (p<0.05) 2. In comparison of experimental group and normal group in pubertal group, there were significant differences in ANS-U1/Me-L1, S-Go/N-Me, Mx.Length/Mn.Length, S-N/Go-Me, Wits, Saddle Angle, SNB, ANB, SN-Pog, IMPA, Interincisal Angle, Facial Convexity, APDI (p<0.05) 3. Among items showing characteristics of skeletal class III malocclusion, there were no significant differences between prepubertal group and pubertal group in other items except Mx. Length/Mn. Length,APDI (p<0.05) 4. The significant correlationship was the highest between Saddle Angle and SNB, SN-Pog and SNB, ANB and Facial Convexity in experimental group

• The korean journal of orthodontics
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• v.40 no.3
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• pp.145-155
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• 2010

Objective: Lateral cephalometric radiographs have been the main form of resource for assessing two dimensional anteroposterior airway changes. The purpose of this study was to evaluate the three dimensional volumetric change in the upper airway space in Class III malocclusion patients who underwent mandibular setback surgery. Methods: Three dimensional cone-beam computed tomographs (CBCT) and their three dimensional reconstruction images were analyzed. The samples consisted of 20 adult patients (12 males and 8 females) who were diagnosed as skeletal Class III and underwent mandibular setback surgery. CBCTs were taken at 3 stages - Baseline (1.8 weeks before surgery), T1 (2.3 months after surgery), and T2 (1 year after surgery). Pharyngeal airway was separated according to the reference planes and reconstructed into the nasopharynx, the oropharynx and the hypopharynx. Measurements at Baseline, T1, and T2 were compared between groups. Results: The result showed the volume of the pharyngeal airway decreased significantly 2.3 months after surgery (p < 0.001) and the diminished airway did not recover after 1 year post-surgery. The oropharynx was the most decreased area. Conclusions: These findings suggest that mandibular setback surgery causes both short-term and long-term decrease in the upper airway space.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.1
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• pp.79-84
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• 2007

Acute respiratory distress syndrome(ARDS) is severe acute hypoxic respiratory failure state with dynamic impairment in oxygen and carbon dioxide transfer with the need for high levels of supplementary oxygen and a high minute ventilation. This syndrome is caused by pulmonary edema due to increased permeability of the alveolar capillary barrier by various factors. ARDS is an uncommon, but a potentially life-threatening complication. Therefore, immediate diagnosis and appropriate therapy must be performed. The present case is post-extubation ARDS immediately occurred in an orthognathic surgery patient who are healthy 19-year-old man. He rapidly recovered from ARDS without complication by early diagnosis and proper treatment. This case report was aimed to describe the process of the development, possible causes and the management of ARDS occurred in an orthognathic surgery patient

• The korean journal of orthodontics
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• v.28 no.2 s.67
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• pp.237-253
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• 1998

Surgical-orthodontic treatment is performed for the skeletal Class III patients with no remaining growth and too big a skeletal discrepancy (or camouflage treatment, and two jaw surgery is needed in order to have maximum effect in such patients. In two jaw surgery cases, surgical alteration of the occlusal plane is necessary to establish optimal function, esthetics and postoperative sability, therefore the establishment of the occlusal plane is essential in diagnosis and treatment. The object of this study is to evaluate the stability of the indiviual ideal occlusal plane bsaed on the architectural and structural craniofacial analysis of Delaires. Thus, the subjects of this study were 48 patients who underwent two jaw surgery, and divided in two groups. Each group were composed of 24patients, A group were operated with ideal occlusal plane and B group were not. Two groups were compared at the preoperative, immediate postoperative (average 4.3days), and long-term postoperative (average 1.3years) lateral cephalometric radiographs. The following results were obtained: 1. There was no significance in occlusal plane angulation between $T_2\;and\;T_3$. Average long term follow-up changes of occlusal Plane angle were $0.24^{\circ}{\pm}2.43$, with FH plane and $0.15{\circ}{\pm}2.16{\circ}$ with SN plane in all 48 patients. These results demonstrated that the occlusal plane after two jaw surgery in skeletal Class III malocclusion was stable. 2. There was no significance in postoperative stability of occlusal plane between A and B group. 3. There was no significance in postoperative stability of occlusal plane depending on surgeon and operative method within each group. 4. The postoperative changes of occlusal plane were correlated to the postoperative changes of jaw rather than tooth position. 5. There was no correlation between the postoperative changes of occlusal plane and maxillary impaction and mandibular setback with surgery.