• Title/Summary/Keyword: skeletal stability

Search Result 126, Processing Time 0.025 seconds

COMPARATIVE STUDY OF STABILITY AND RELAPSE ACCORDING TO FIXATION METHOD AFTER BILATERAL SAGITTAL SPLIT RAMUS OSTEOTOMIES IN MANDIBULAR PROGNATHIC PATIENTS (하악전돌증 환자의 하악지시상분할골절단술 후 고정방법에 따른 안정성과 회귀율에 대한 분석)

  • Choi, Hee-Won;Kim, Kyoung-Won;Lee, Eun-Young
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.27 no.4
    • /
    • pp.334-345
    • /
    • 2005
  • The purpose of this study was to compare the postoperative stability and relapse according to 2 different fixation methods after bilateral sagittal split ramus osteotomies in mandibular prognathic patients. Tweenty one patients with Class III dental and skeletal malocclusion who were treated with bilateral sagittal split ramus osteotomy were selected for this retrospective study. We classfied the patients into two groups according to the fixation methods of bony segments after osteotomies. Group W (n = 10) had the bone segments fixed with nonrigid wire and Group S (n = 11) had bicortical screws inserted in the gonial area through a transcutaneous approach. 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. Before surgery, both groups were balanced with respect to linear and angular measurements of craniofacial morphology. Mean posterior sagittal setback amounts of the mandibular symphysis was 8.6 mm in the wire group and 6.79 mm in the rigid group, Six months postoperatively, the wire group had 33.1% relapse of the mandibular symphysis and 22.8% in the rigid group relapse. Both groups experienced changes in the orientation and configuration of the mandible. It is thought that Rigid screw fixation is a more stable method than nonrigid wire fixation for maintaining mandibular setback after sagittal split ramus osteotomy.

THE CORRECTION OF CLASS III MANDIBULAR ASYMMETRY USING BILATERAL SAGITTAL SPLIT RAMUS OSTEOTOMY AND LATERAL ANGLE REDUCTION (외측 하악각 골절제술을 동반한 시상분할골절단술을 통한 골격성 3급 하악골 비대칭 환자의 치료)

  • Kang, Hee-Jea;Song, In-Woo;Kang, Yung-Ki;Kim, Jong-Ryoul
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.32 no.2
    • /
    • pp.132-140
    • /
    • 2010
  • Purpose: The aim of this study is to identify the usefulness of unilateral mandibular angle ostectomy, so-called "Lateral Angle Reduction", in asymmetric prognathism patients by the assessment of postoperative stability and esthetic results Patients and methods: For the retrospective study, 10 skeletal class III mandibular asymmetry patients who were performed SSRO and unilateral mandibular angle ostectomy, Lateral Angle Reduction, was selected. Lateral and posterioanterior cephalogram was taken before surgery (T0), 1day after surgery (T1) and 6month after surgery (T2). To know the esthetic results the facial width and lateral facial contour were examined on posterioanterior cephalogram and to know the postoperative stability B point and Incisor inferius was examined on lateral cephalogram. Statistical analysis was performed. Results: From T0 to T1, Intergonial width was significantly decreased, dominantly at shortened side but no significant changes at lengthened side. Those were well-maintained during 6 months. Lateral facial angle and Ramus angle was significantly decreased on only shortened side from T0 to T1. As a result, after surgery, there were no significant differences in all measurements between shortened side and lengthened side. Ramus deviation angle in shortened side and ramus angle in lengthened side which reflect the angulation of ramus on frontal plane didn't show significant changes after surgery and during postsurgical periods. Lower dental midline showed no statistical changes during postsurgical period. The relapse rate on B-point was 11.92%. Conclusion: Unilateral "Lateral angle reduction" in the asymmetric mandible is valuable to obtain the narrow lower face and symmetric facial contour with a good stability.

Upper and lower second premolar extraction treatment case - Treatment strategy for Class III borderline cases (상하악 제2소구치 발거 치료 증례 - III급 부정교합 경계증례의 치료전략)

  • Kim, Tae-Kyung;Kim, Jong-Tae;Yang, Won-Sik
    • The korean journal of orthodontics
    • /
    • v.32 no.3 s.92
    • /
    • pp.185-194
    • /
    • 2002
  • When treating borderline cases which have mild crowding, non-extraction treatment may be considered firstly. But crowding may be reappeared by relapse and it may have problems in esthetics and stability. Secondarily four first premolar extraction treatment may be considered. But this may cause dish-in face by overretracting anterior teeth. In this cases, extraction of four second premolar is preferred because this resolves crowding without aggravating profile and has good stability after treatment. So we review cases treated by four second premolar extraction which show good treatment results and stability. The patients had good profile, Class I molar relationship, mild crowding and skeletal discrepancy and their growth had almost completed.

Application of Hinged Transarticular External Skeletal Fixator (HTAESF) for Proximal Tibial Physeal Fracture in a Dog (개의 근위 경골 성장판 골절에서 경첩 관절경유 외고정의 적용)

  • Kim, Kwan;Heo, Su-Young;Lee, Hae-Beom
    • Journal of Veterinary Clinics
    • /
    • v.29 no.6
    • /
    • pp.502-505
    • /
    • 2012
  • An 8-month-old, 3.5 kg intact female Toy Poodle was presented for non-weight-bearing lameness on left hindlimb. In radiological testing, left proximal tibal type II Salter-Harris physeal fracture and fibular fracture were seen. Following open reduction, the fracture was stabilized with cross-pins, tension band wires, and a hinged transarticular external skeletal fixator (HTAESF). The range of the HTAESF was increased to $25^{\circ}$ at 7 days postsurgery and to $70^{\circ}$ at 14 days post-surgery. The HTAESF was removed 3 weeks after surgery. At 6 weeks post-surgery, the fracture was successfully healed with no complications and the patient recovered a normal gait. Seven months post-surgery, the patient had a normal gait and a normal stifle joint range of motion compared to the contralateral normal limb. This is a case in which the combined use of cross-pins, tension band wires, and HTAESF was successful for treatment of a proximal tibial physeal fracture in a dog. It is thought that these methods are beneficial for stability of fracture site and recover of joint's normal range of motion through early joint movement.

MAXILLARY MOLAR DISTALIZATION WITH THE BONE-SUPPORTED PENDULUM (Bone-supported pendulum을 이용한 상악대구치 원심이동)

  • Jang, Yong-Gul;Park, Ho-Won;Lee, Ju-Hyun;Seo, Hyun-Woo
    • Journal of the korean academy of Pediatric Dentistry
    • /
    • v.36 no.3
    • /
    • pp.464-474
    • /
    • 2009
  • To distalize the maxillary molars, the traditional techniques such as extra-oral traction, Wilson distalizing arches, removable spring appliances and Schwarz plate-type appliances have been used. But, these need considerable patient cooperation. For minimal patient compliance, many practitioners use the pendulum appliances. Several clinical studies demonstrated pendulum is effective molar distalization appliance in the growing patient(using the premolars and the palate as anchorage). But unfortunately, maxillary anterior teeth also shift mesially as the molar moves distally. As a result anchorage loss is occurred. To overcome these disadvantages, we used bone-supported pendulum, combined the conventional pendulum with Skeletal Anchorage System(SAS). The miniscrew was implanted in the anterior paramedian region of the median palatal suture, which has comparatively sufficient bone thickness and is low risk to damage on the dental follicles. We report three cases, using bone-supported pendulum for the maxillary molar distalization in children. After treatment, we find out anchorage stability, minimal unfavorable anterior tooth movement and sufficient molar distalization.

  • PDF

ORTHODONTIC TREATMENT WITH MINISCREWS IN MIXED DENTITION (혼합치열기의 miniscrew를 이용한 교정치료)

  • Lim, Su-Min;Yang, Yeon-Mi;Kim, Jae-Gon;Baik, Byeong-Ju;Lee, Yong-Hun;Shin, Jeong-Geun
    • Journal of the korean academy of Pediatric Dentistry
    • /
    • v.35 no.2
    • /
    • pp.367-375
    • /
    • 2008
  • Anchorage plays an important role in orthodontic treatment. Skeletal anchorage like the miniscrew is considered a more effective method in anchorage control than conventional anchorage which needs much patient's cooperation. The miniscrew offers many advantages. 1) It is easy to insert and to remove. 2) It can endure the force needed for moving teeth. 3) It can be immediately loaded and 4) Patient cooperation is not needed. 5) It is economic compared to other skeletal anchorage systems. In comparison to adult's bones, children's bones have comparatively poor bone quality and quantity. Therefore, it is hard to obtain primary stability in younger patients. However, if the miniscrew can be retained successfully, it will be effective in many orthodontic treatments. In these cases, we used the miniscrew in correcting of diastema, in aligning dental midline, and in rendering a forced eruption of impacted tooth in mixed dentition patient. We obtained satisfactory results.

  • PDF

Application and effects of condylectomy in asymmetric patients with condylar hyperplasia (과두과증식을 동반한 안면비대칭 환자에서 과두절제술의 적용과 효과)

  • Lim, Kyoung-Sub;Cha, Jung-Yul;Hwang, Chung-Ju
    • The korean journal of orthodontics
    • /
    • v.38 no.6
    • /
    • pp.437-455
    • /
    • 2008
  • Condylar hyperplasia is a pathologic condition showing 3-dimensional skeletal hyperplasia of the mandible. The reason for condylar hyperplasia is not yet known, but the effects of hormone, trauma, infection, genetics, fetal condition, and hypervascularity are known as possible reasons. When we diagnose a patient as having condylar hyperplasia, it is important to decide if it is in progress or not. Treatment for facial asymmetry due to condylar hyperplasia are decided accordingly, including condylectomy, that is removal of growth site of the affected condyle, and conventional orthognathic surgery only or condylectomy with orthognathic surgery after the completion of growth. Therefore, it is important to determine the growth state of condylar hyperplasia in treatment stability. This is verified through bone scan and regular check-ups with 3D CT or PA cephalogram. This case report introduces an improved case of facial asymmetry with condylectomy together with orthognathic surgery.

Investigating the effect of age on skeletal stability after sagittal split ramus osteotomy for mandibular setback

  • Lee, Chung-O;Hwang, Hee-Don;Choi, Jin-Wook;Kim, Jin-Wook;Lee, Sang-Han;Kwon, Tae-Geon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.38 no.6
    • /
    • pp.354-359
    • /
    • 2012
  • Objectives: The purpose of this study was to investigate whether the age factor would be related with stability of mandibular setback surgery for patients with mandibular prognathism. Materials and Methods: We compared the relapse patterns of 47 patients divided into three age groups (termed younger, adult, and older). The younger group consisted of patients between 15 and 17 years old; the adult group was made up of patients between 21 and 23 years old, and the older group was made up of patients more than 40 years old. The positional change of B point was evaluated at preoperative, postoperative, and follow-up states. Results: The horizontal relapse ratio was 21.7% in the younger group, 15.3% in the adult group, and 15.7% in the older group. Although relatively higher degrees of relapse were found in the younger group, this increase was not statistically significant. Spearman's correlation analysis was performed to explore other factors contributing to relapse. We subsequently found that the amount of relapse was related to horizontal setback. Conclusion: Although the degree of relapse in younger patients is not significant;y higher compared to other groups. The major contributing factor to relapse after sagittal split ramus osteotomy is amount of setback rather than age when the surgery was performed to patients over than 15 years of age.

STABILITY AFTER SURGICAL CORRECTION OF MANDIBULAR PROGNATHISM USING BILATERAL SAGGITAL SPLIT RAMUS OSTEOTOMY AND FIXATION WITH POLY-L/DL-LACTIDE COPOLYMER SCREWS ($BIOSORB^{TM}FX$) (하악지 시상 골절단술 이후 흡수성 나사를 사용하여 고정한 환자에서 술 후 안정성에 대한 연구)

  • Kwon, Taek-Kyun;Kim, Yong-Deok;Shin, Sang-Hun;Kim, Uk-Kyu;Kim, Jong-Ryoul;Chung, In-Kyo
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.27 no.2
    • /
    • pp.160-163
    • /
    • 2005
  • This study was designed to assess skeletal stabilily after surgical correction of mandibular prognathism by bilateral saggital split ramus osteotomy(BSSRO) and fixation with absorbable screws. From July 2001 to September 2003, 30 patients with Class III malocclusion were treated with BSSRO and mandibular setback. They underwent fixation with Biosorb$^{TM}$ FX screws. Cephalograms were obtained preoperatibely, 2 or 3 days postoperatively, and about 12 months after the operation. Changes in the position of lower incisor tip, B point, and pogonion were examined on lateral cephalograms. The mean mandibular setback just after surgery was 10.6mm. 12 months after surgery, mean relapse at pogonion represented 17.9% and 15.1% at B point. Our results suggest that fixation of the bony segments with absorbable screws after BSSO may be used effectively in properly selected cases.

A Study on the Postoperative Stability of Hard Tissue in Orthognathic Surgery Patients Depending on the Difference of Occlusal Plane (악교정 수술시 교합평면의 차이에 따른 술후 경조직의 안정성에 관한 연구)

  • Hwang, Chung-Ju;Lim, Seon-A;Moon, Jeong-Lyon
    • The korean journal of orthodontics
    • /
    • v.29 no.2 s.73
    • /
    • pp.239-249
    • /
    • 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.

  • PDF