The relationship between fixation method and early central condylar sagging after bilateral sagittal split ramus osteotomy in orthognathic surgery

2020 ◽  
Vol 48 (10) ◽  
pp. 928-932 ◽  
Author(s):  
Ömer Berköz ◽  
Soner Karaali ◽  
Erol Kozanoğlu ◽  
Bora Edim Akalın ◽  
Atilla Çeri ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Fixation Method ◽  
Sagittal Split Ramus Osteotomy ◽  
The Relationship

Biomechanical Evaluation of a New Fixation Method for Stabilization of Sagittal Split Ramus Osteotomy After Mandibular Advancement

2021 ◽  
Vol 6 ◽  
pp. 247275122110192
Author(s):  
Karel Kuik ◽  
Jean Pierre T. F. Ho ◽  
Cornelis Klop ◽  
Maurits H. T. de Ruiter ◽  
Cornelis J. Kleverlaan ◽  
...  
Keyword(s):  
Hybrid Method ◽  
In Vitro Study ◽  
Mandibular Advancement ◽  
Fixation Method ◽  
Common Procedure ◽  
Sagittal Split Ramus Osteotomy ◽  
Fixation Methods ◽  
Biomechanical Evaluation ◽  
Monocortical Screws

Study Design: Biomechanical in vitro study. Mandibular advancement after sagittal split ramus osteotomy (SSRO) is a common procedure in orthognathic surgery. Several fixation methods are used for stabilization of SSRO. Objective: The aim of this study was to compare a new fixation method (gridplate) with more contemporary applied methods of fixation. Material and Methods: In this study, 50 polyurethane hemimandibles with a prefabricated SSRO were used as specimens. All hemimandibles were advanced by 8 mm and divided into 5 groups with different fixation methods: (A) one 4-hole miniplate with 4 monocortical screws; (B) two 4-hole miniplates with 8 monocortical screws; (C) one 4-hole miniplate with 4 monocortical screws and 1 bicortical screw in the retromolar area (hybrid method); (D) 3 bicortical screws in an inverted-L pattern; and (E) one 8-hole gridplate with 8 monocortical screws. Loads in newtons were recorded at displacements of the mandibular incisive edge at 1 mm, 3 mm and 5 mm. Results: Fixation with 3 bicortical screws and the gridplate presented the most stability, followed by two 4-hole miniplates. Fixation with the hybrid method or the single miniplate showed the least stability. Conclusion: According to the results of this study, the 8-hole gridplate design appears a sufficient fixation method regarding stabilization of SSRO with larger mandibular advancement.

scholarly journals Sagittal Split Ramus Osteotomy in the Shortest Buccal Bone Marrow Distances of the Mandible on the Coronal Plane

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Chun-Ming Chen ◽  
Han-Jen Hsu ◽  
Ping-Ho Chen ◽  
Shih-Wei Liang ◽  
I-Ling Lin ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Mandibular Canal ◽  
Class Ii ◽  
Coronal Plane ◽  
Class Iii ◽  
Sagittal Split Ramus Osteotomy ◽  
Mandibular Foramen ◽  
Skeletal Class ◽  
Skeletal Pattern ◽  
The Relationship

Purpose. This study investigated the relationship between the shortest buccal bone marrow of the ramus and skeletal patterns. Materials and Methods. Using cone-beam computed tomography data (specifically, the A point-nasion-B point (ANB) angle), we divided patients into three groups as follows: skeletal class I ( 0 ° < ANB < 4 ° ), class II (ANB: ≥4°), and class III (ANB: ≤0°). Sixteen vertical sections in the coronal plane were taken starting from slice 0 (original intact mandibular canal) anteriorly at 2 mm intervals to slice 15 (30 mm). The thickness of the mandible (M) and shortest buccal bone marrow (SBM) were measured. The data of SBM were divided into two groups ( SBM ≥ 1   mm and SBM < 1   mm ). For each skeletal pattern, an SBM   value < 1   mm was considered to indicate a high possibility of postoperative nerve paresthesia and bad split. Results. The three skeletal pattern groups also did not significantly differ in their M values for all sections. The mean SBM values of class III (0.91–2.11 mm) at 6–16 mm anterior to the mandibular foramen were significantly smaller than those of class II (1.53–3.17 mm). Comparing the occurrence ratio of SBM < 1   mm , the highest and lowest probabilities in class III (55% and 21.7%, respectively) were significantly larger at 6–20 mm anterior to the mandibular foramen than those in class II (28.3% and 5%, respectively). Conclusion. Class III had a significantly shorter SBM distance and higher SBM occurrence probability than class II at the mandibular ramus region, implying that class III participants are more likely than class II participants to have nerve paresthesia and bad split after sagittal split ramus osteotomy.

scholarly journals Orthognathic surgery: doubts from patients with orofacial fissures regarding the immediate postoperative period

2021 ◽  
Vol 74 (2) ◽  
Author(s):  
Tatiane Henrique ◽  
Fábio Luiz Banhara ◽  
Natiele Favarão da Silva ◽  
Francely Tineli Farinha ◽  
Maila Meryellen Ferreira Garcia Manso ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Sun Exposure ◽  
Functional Results ◽  
Tertiary Hospital ◽  
Speech Communication ◽  
Surgical Wound ◽  
Cross Sectional ◽  
Activity Restriction ◽  
The Subject ◽  
The Relationship

ABSTRACT Objectives: to identify the main doubts regarding the immediate postoperative care of patients with orofacial clefts undergoing orthognathic surgery. Methods: cross-sectional, quantitative study, developed in a public and tertiary hospital, between November 2017 and May 2018. Data collection occurred through interviews during the preoperative nursing consultation. An instrument was used to describe doubts, which later were grouped according to the subject. Results: 48 patients participated. The doubts referred to sun exposure (56%), food/mastication (48%), the relationship between intermaxillary block-breathing-vomiting (48%), oral hygiene (31%), physical activity restriction (27%), nasopharyngeal cannula, removal of surgical stitches, hospitalization time and speech/communication (23%), bleeding, cryotherapy, facial massage, aesthetic and functional results, healing, edema/ecchymosis, postoperative pain, and changes in facial sensitivity (21%). Conclusions: the doubts were related to food, the period of convalescence, care for the surgical wound, postoperative complications, and medications.

Assessment of the relationship between size, shape and volume of the sella turcica in class II and III patients prior to orthognathic surgery

2020 ◽  
Vol 42 (5) ◽  
pp. 577-582 ◽  
Author(s):  
Bruna T. Silveira ◽  
Karin S. Fernandes ◽  
Tarcila Trivino ◽  
Larissa Y. F. dos Santos ◽  
Claudio F. de Freitas
Keyword(s):  
Orthognathic Surgery ◽  
Sella Turcica ◽  
Class Ii ◽  
The Relationship

scholarly journals Analysis of Mandibular Test Specimens Used to Assess a Bone Fixation System

2015 ◽  
Vol 8 (3) ◽  
pp. 171-178 ◽  
Author(s):  
LeandroStocco Baccarin ◽  
Renato Correa Viana Casarin ◽  
JorgeVicente Lopes-da-Silva ◽  
LuisAugusto Passeri
Keyword(s):  
Biomechanical Testing ◽  
Load Resistance ◽  
Fixation Method ◽  
Sagittal Split Ramus Osteotomy ◽  
Biomechanical Behavior ◽  
Synthetic Materials ◽  
Group A ◽  
Materials Used ◽  
Group B

The aim of this study was to assess through biomechanical testing if different synthetic materials used to fabricate test specimens have a different biomechanical behavior in comparison with other materials when simulating in vitro load resistance of a fixation method established for sagittal split ramus osteotomy (SSRO). Thirty synthetic and standardized human hemimandible replicas with SSRO were divided into three groups of 10 samples each. Group A—ABS plastic; Group B—polyamide; and Group C—polyurethane. These were fixated with three bicortical position screws (16 mm in length, 2.0-mm system) in an inverted L pattern using perforation guide and 5-mm advancement. Each sample was submitted to linear vertical load, and load strength values were recorded at 1, 3, 5, 7, and 10 mm of displacement. The means and standard deviation were compared using the analysis of variance ( p < 0.05) and the Tukey test. A tendency for lower values was observed in Group B in comparison with Groups A and C. At 3 and 5 mm of displacement, a difference between Groups A and C was found in comparison with Group B ( p < 0.05). At 7 and 10 mm of displacement, a difference was found among the three groups, in which Group C showed the highest values and Group B the lowest ( p < 0.05). Taking into consideration the results obtained and the behavior of each material used as a substrate, significant differences occurred among the materials when compared among them.

scholarly journals Dimensional changes of maxillary sinuses and pharyngeal airway in Class III patients undergoing bimaxillary orthognathic surgery

2013 ◽  
Vol 83 (5) ◽  
pp. 824-831 ◽  
Author(s):  
Eleni Panou ◽  
Melih Motro ◽  
Mustafa Ateş ◽  
Ahu Acar ◽  
Nejat Erverdi
Keyword(s):  
Orthognathic Surgery ◽  
Class Iii ◽  
Cross Sectional ◽  
Dimensional Changes ◽  
Pharyngeal Airway ◽  
Mandibular Setback ◽  
Bimaxillary Orthognathic Surgery ◽  
Significant Change ◽  
The Relationship ◽  
Maxillary Sinuses

ABSTRACT Objective: To evaluate the pharyngeal airway and maxillary sinus volume changes after mandibular setback surgery combined with maxillary advancement and/or impaction surgery. Materials and Methods: Seventeen Class III skeletal patients (11 females, 6 males) who required bimaxillary orthognathic surgery were selected. Volumetric measurements were performed using cone beam computed tomography (CBCT) scans preoperatively and 3.9 ± 0.87 months postoperatively. All the CBCT scans were assessed and analyzed using MIMICS 14.0 software. Preoperative and postoperative volumes of pharyngeal airway and maxillary sinuses and the relationship between the amounts of surgical movement of the jaws and the above volumes were statistically evaluated. Results: The pharyngeal airway area presented no significant change except for the lower and total pharyngeal airway volumes in males, in whom a significant decrease was observed (4196.27 ± 2061.11 mm3 and 3375.53 ± 3624.67 mm3, respectively). No significant change was observed in the minimal cross-sectional area of the pharyngeal airway. There was a significant decrease in the volume of the maxillary sinuses after the surgery by 3448.09 ± 3315.56 mm3. No correlation was found between the amount of skeletal movement and the change in the volume of pharyngeal airway or maxillary sinuses. Conclusion: There was a significant decrease only for lower and total pharyngeal airway volumes in males and a significant decrease in the volume of the maxillary sinuses.

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