• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.4
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• pp.208-213
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• 2023

Objectives: Orthognathic surgery is a corrective intervention for maxillofacial deformities. Bleeding is a major concern for oral and maxillofacial surgeons. Various agents, such as hemocoagulase, tranexamic acid, and aprotinin have been developed to reduce intraoperative bleeding and transfusion requirements. Therefore, in this study we aimed to investigate the effects of hemocoagulase and tranexamic acid, as well as their simultaneous use, to reduce bleeding during orthognathic surgery. Patients and Methods: This retrospective study included patients who had undergone simultaneous orthognathic surgery of the maxilla and mandible between January 2013 and September 2022 and were classified into three groups based on drugs administered: hemocoagulase (Botropase), tranexamic acid, and a combination of both drugs. We recorded patient age, sex, weight, blood loss, and duration of surgery. Red blood cell (RBC), hemoglobin, hematocrit, and platelet levels were measured before, immediately after, and one day after surgery. Results: No statistically significant differences were found in blood loss, RBC, hemoglobin, hematocrit, or platelet levels between any of the groups. There were no differences in the drug effects between Le Fort I and bilateral mandibular sagittal split osteotomies, with or without double genioplasty. However, there were significant reductions in RBC, hemoglobin, hematocrit, and platelet levels during genioplasty. Conclusion: Tranexamic acid, hemocoagulase, and their combination had similar efficacy in patients who underwent Le Fort I and bilateral mandibular sagittal split osteotomies with and without genioplasty.

• Journal of Yeungnam Medical Science
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• v.2 no.1
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• pp.271-279
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• 1985

The authors treated a case of bimaxillary dentoalveolar protrusion corrected by anterior segmental osteotomies: As presurgical treatment & process, closing of the upper anterior spacing with fixed appliances was worked out, cephalometric predicition & model surgery was done, and fabrication of intra-arch acrylic resin splints were made. It was not necessary to make an intermaxillary fixation with wire after surgery. Only intramaxillary fixation of anterior retracted mobile segment with resin plate was required for 8 weeks. After surgical treatment, leveling of the upper and lower arch with rectangular arch wire were accomplished as the Intrusion of anterior teeth proceeded. We will continue to improve the class II molar relationship by using class II elastics and have a good occlusiion through the orthodontic treatment.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.4
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• pp.319-324
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• 2009

Kole's Anterior segmental osteotomy of the mandible is commonly used to close an anterior open bite, to depress an elevated anterior dentoalveolar segment, or to retrude or advance a dentoalveolar segment. The procedure is often combined with an anterior maxillary segmental osteotomy to correct bimaxillary protrusion. We report 53-year-old woman who the extruded state of mandibular anterior alveolar segment was corrected using an mandibular anterior alveolar segmental osteotomy and dental implantation of the anterior maxilla. We planned to remove the old prosthesis, and then perform an anterior mandibular segmental osteotomy and implant restoration of the anterior maxilla. We suggest that anterior segmental osteotomy is very useful for rehabilitating edentulous patients with malaligned alveolar segment.

• 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.

• The korean journal of orthodontics
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• v.33 no.6 s.101
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• pp.475-483
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• 2003

The purpose of this study is to evaluate hard and soft tissue changes following the subapical osteotomy in bimaxillary dentoalveolar protrusion patients requiring maximal retraction adult female patients was selected. Surgical procedures were performed by the same surgeon, anterior subapical osteotomy techniques were employed on the maxilla and cephalometric radiograms were traced and superimposed using the best-fit method and two reference The results were as follows 1. The bodily movement of the maxillary anterior segment was achieved in a posterior moved posteriorly with a slight correction of the lower incisors. 2. The horizontal soft tissue measurements changed significantly after treatment, but Nt and Sn vertical soft tissue measurements indicated that Ls moved inferiorly and Li superiorly. 3. The correlation between hard and soft tissue changes indicated that ${\Delta}HId/{\Delta}HLi,\;{\Delta}HId/{\Delta}LL-Eline,\;{\Delta}Hpt.B/{\Delta}HILS,\;and\;{\Delta}UI-FH/{\Delta}NL$ were significant. 4. More lower lip relative to upper lip retraction was demonstrated in relation to Rickett's E-line. The ratio between upper lip displacement was $50\%$, and between the lower incisor and lower lip displacement was $60\%$. We conclude from the results that the anterior subapical osteotomy is an efficient treatment severe dentoalveolar protrusion and desire rapid results.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.1
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• pp.59-69
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• 2001

Purpose : The purpose of the present study was to evaluate postoperative stability and soft-tissue osseous relations of the long face syndrome patients. Methods : Twenty-five patients who had undergone bimaxillary surgery to correct long face syndrome at the Pusan National University Hospital were evaluated. The lateral cephalograms of preoperative, 1 week postoperative and at least 1 year postoperative were examined. Results : 1. The facial height of the long face syndrome patients were longer than normal Korean adults. 2. The most common malocclusion type of the long face syndrome patients in Korea was class III. 3. Horizontal postoperative skeletal relapses were $-0.64{\sim}0.80mm$ in the maxilla, and $-0.56{\sim}0.48mm$ in the mandible. 4. Vertical postoperative skeletal relapses were $0.20{\sim}0.56mm$ in the maxilla, and $-0.80{\sim}0.20mm$ in the mandible. 5. Postoperative soft tissue changes in long face syndrome patients were correlated with postoperative skeletal changes. So prediction schemes for postoperative soft-tissue changes were obtainable. Conclusion : It is hard to predict the exact direction and quantity of the postoperative skeletal relapse in long face syndrome patient's orthognathic surgery because of large standard deviation. But soft tissue change is predictable via prediction scheme.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.2
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• pp.137-143
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• 2011

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.

• Archives of Plastic Surgery
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• v.50 no.3
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• pp.254-263
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• 2023

Background The three-dimensional (3D) evaluation of skeletal stability after orthognathic surgery is a time-consuming and complex procedure. The complexity increases further when evaluating the surgery-first orthognathic approach (SFOA). Herein, we propose and validate a simple time-saving method of 3D analysis using a single software, demonstrating high accuracy and repeatability. Methods This retrospective cohort study included 12 patients with skeletal class 3 malocclusion who underwent bimaxillary surgery without any presurgical orthodontics. Computed tomography (CT)/cone-beam CT images of each patient were obtained at three different time points (preoperation [T0], immediately postoperation [T1], and 1 year after surgery [T2]) and reconstructed into 3D images. After automatic surface-based alignment of the three models based on the anterior cranial base, five easily located anatomical landmarks were defined to each model. A set of angular and linear measurements were automatically calculated and used to define the amount of movement (T1-T0) and the amount of relapse (T2-T1). To evaluate the reproducibility, two independent observers processed all the cases, One of them repeated the steps after 2 weeks to assess intraobserver variability. Intraclass correlation coefficients (ICCs) were calculated at a 95% confidence interval. Time required for evaluating each case was recorded. Results Both the intra- and interobserver variability showed high ICC values (more than 0.95) with low measurement variations (mean linear variations: 0.18 mm; mean angular variations: 0.25 degree). Time needed for the evaluation process ranged from 3 to 5 minutes. Conclusion This approach is time-saving, semiautomatic, and easy to learn and can be used to effectively evaluate stability after SFOA.

• The korean journal of orthodontics
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• v.46 no.5
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• pp.301-309
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• 2016

Objective: The aim of this study was to evaluate the skeletal and dental changes after intraoral vertical ramus osteotomy (IVRO) with and without presurgical orthodontics by using cone-beam computed tomography (CBCT). Methods: This retrospective cohort study included 24 patients (mean age, 22.1 years) with skeletal Class III malocclusion who underwent bimaxillary surgery with IVRO. The patients were divided into the preorthodontic orthognathic surgery (POGS) group (n = 12) and conventional surgery (CS) group (n = 12). CBCT images acquired preoperatively, 1 month after surgery, and 1 year after surgery were analyzed to compare the intergroup differences in postoperative three-dimensional movements of the maxillary and mandibular landmarks and the changes in lateral cephalometric variables. Results: Baseline demographics (sex and age) were similar between the two groups (6 men and 6 women in each group). During the postsurgical period, the POGS group showed more significant upward movement of the mandible (p < 0.05) than did the CS group. Neither group showed significant transverse movement of any of the skeletal landmarks. Moreover, none of the dental and skeletal variables showed significant intergroup differences 1 year after surgery. Conclusions: Compared with CS, POGS with IVRO resulted in significantly different postsurgical skeletal movement in the mandible. Although both groups showed similar skeletal and dental outcomes at 1 year after surgery, upward movement of the mandible during the postsurgical period should be considered to ensure a more reliable outcome after POGS.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.4
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• pp.235-239
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• 2015

The Combitube is an emergency airway-maintaining device, which can supply oxygen to dyspneic patients in emergency situations following two-jaw surgery. These patients experience difficulty in opening the mouth or have a partially obstructed airway caused by edema or hematoma in the oral cavity. As such, they cannot maintain the normal airway. The use of a Combitube may be favorable compared to the laryngeal mask airway because it is a thin and relatively resilient tube. A healthy 24-year-old man was dyspneic after extubation. Oxygen saturation fell below 90% despite untying the bimaxillary fixation and ambubagging. The opening of the mouth was narrow; thus, emergency airway maintenance was gained by insertion of a Combitube. The following day, a facial computer tomography revealed that the airway space narrowing was severe compared to its pre-operational state. After the swelling subsided, the patient was successfully extubated without complications.