Journal of the Korean Association of Oral and Maxillofacial Surgeons

  • 제29권1호
  • /
  • Pages.26-34
  • /
  • 2003
  • /
  • 2234-7550(pISSN)
  • /
  • 2234-5930(eISSN)
대한구강악안면외과학회 (The Korean Association of Oral and Maxillofacial Surgeons)
권호 표지

하악골 전돌증환자의 구내 하악골상행지 수직골절단술후 이하두정 계측방사선사진상에서의 근심골편의 형태 및 위치 변화

MORPHOLOGIC AND POSITIONAL CHANGE OF THE PROXIMAL SEGMENTS AFTER INTRAORALVERTICAL RAMUS OSTEOTOMY OF THE MANDIBULAR PROGNATHISM ON SUBMENTOVERTEX CEPHALOGRAM

  • 정재형 (국민건강보험공단 일산병원 치과) ;
  • 박형식 (연세대학교 치과대학 구강악안면외과학교실) ;
  • 황충주 (연세대학교 치과대학 교정학교실)
  • Chung, Jae-Hyung (Dept. of Dentistry, Ilsan Hospital, Hational Health Insurance Corp.) ;
  • Park, Hyung-Sik (Dept. of Oral & Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Hwang, Chung-Ju (Dept. of Orthodontics, College of Dentistry, Yonsei University)
  • 발행 : 2003.02.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Intraoral Vertical Ramus Osteotomy,along with Sagittal Split Ramus Osteotomy,is an popular surgical technique performed on mandibular prognathism. However Intraoral Vertical Ramus Osteotomy has been suspected for an initial mobilization at the healing phase of segment because it does not employ the rigid fixation between segments. To execute a study on the healing phase of segment after Intraoral Vertical Ramus Osteotomy on the horizontal plane, 102 patients (204 parts) who were diagnosed mandibular prognathism and took Intraoral Vertical Ramus Osteotomy at the Yonsei University dental hospital were observed during the period of before operation, immediately postoperation, 1 month, 3 months, 6 months, and 12 months. The change in the width of segment and horizontal angle of proximal segment and condylar head on the Submentovertex Cephalogram taken from those patients represented following results. 1. The width of proximal and distal segment decreased with the lapse of time. It decreased into 84.5% between immediate postoperative and 6M and even continued to decrease till 12M. 2. The horizontal angle of the proximal segment did medial rotation according as the lapse of time and rigorously continued till 3M. The rotation angle of condylar head indicated its tendency of recurrence to the original position but the entire recurrence was not allowed. The bigger an initial angle was, the higher was the tendency of recurrence after the operation while the rotation angle remained still bigger. 3. After grouping into group 1, group 2,and group 3 based on the extent of the variation of rotation angle of condylar head at immediate postoperative, the variation of rotation angle was measures in each group. The result presented that the initial rotation angle of condylar head had correlation with that of proximal segment but had no relation with the extent of setback of the mandible. However a quantitative analysis alone is not a sufficient method for analyzing the healing phase of segment on the horizontal plane.Therefore a multilateral analysis using 3 dimensional data such as CT is recommendable for the future study.

키워드

참고문헌

  1. Akin, R. K., Walters, P. J. : Experience with the intraoral vertical subcondylar osteotomy. J. Oral Surg. 33:342-345, 1975.
  2. Akiyuki Nishimura, Shigeyo Sakurada, Masayasu Iwase. : Posit- ional changes in the mandibular condyle and amount of mouth opening after sagittal split ramus osteotomy with rigid or nonrigid osteosynthesis.J. Oral Maxillofac Surg. 55:672-676, 1997.
  3. Alling, C. : Correction of mandibular prognathism by open oblique sliding osteotomies of the rami. J. Oral Surg. 23: 199-211, 1965.
  4. Astrand, P., Bergljung, L., and Nord, P.G. : Oblique sliding osteotomy of the rami in 55 patients with mandibular prognathism. Int. J. Oral Surg. 2: 89, 1973.
  5. Bell, W.H.:Surgical correction of dentofacial deformities, Vol.II, Chap.11 mandibular excess, pp.844. W.B. Saunders co., 1980.
  6. Bell, W.H. : Modern Practice in orthognathic and reconstructive surgery, Vol III, Chap. 61 mandibular prognathism, pp.2110. W. B. Saunders co., 1992.
  7. Bell, W.H. and Kennedy, J.W. : Biological vasis for vertical ramus osteotomy - a study of bone healing and revascularization in adult rhesus monkeys. J. Oral Surg. 29:313, 1971.
  8. Berhman, P.J. : Complications of sagittal osteotomy of the mandibular ramus. J. Oral Surg, 30:554, 1972.
  9. Boyne, P.J. : Osseous healing after oblique osteotomy of the mandibular ramus. J. Oral Surg. 25: 125, 1966.
  10. Caldwell, J.B., Letterman, G.S. : Vertical osteotomy in the mandibular rami for correction of prognathism. J. Oral Surg. 12;185, 1954.
  11. Egyedi., P., Houwing,M., and Jutten, E. : The oblique subcondylar osteotomy : report of results of 100 cases. J. Oral Surg. 39: 871, 1981.
  12. Forsberg, C. T., Et al. : Diagnosis and treatment planning of skeletal asymmetry with the submento-vertical radiograph. Am. J. Orthod. 85(3): 224�237, 1984.
  13. Gilbert K., Woo TL. : Further investigation of morphologic characters of the individual bones of the human skull. Biometrika 2:423-465, 1935.
  14. Hall, H.D., Chase, D.C., and Paylor, L.G. : Evalua-tion & Refinement of the intraoral vertical subcondylar osteotomy. J. Oral Surg. 33: 333, 1975.
  15. Hall, H.D., Mckenna, S.J. : Further refinement and evaluation of intraoral vertical ramus osteotomy. J. Oral Maxillofac Surg. 45 : 684-688, 1987.
  16. Hinds, E. C. : Surgical correction of acquired mandi-bular deformities. Am.J. Orthod. 43 : 160, March 1957.
  17. Isaacson, R., Kopytov, D., Bevis, R., and Waite, D. : Movement of the proximal and distal segments after mandibular ramus osteotomies. J. Oral Surg. 36 : 263, 1978.
  18. Jonsson, E., Svartz, K., Welander, U., and Astrand, P.: Mandibular rami osteotomies and their effect on the gonial angle. Int. J. Oral Surg.10: 168.
  19. Kraut, R.A. : Stabilization of the intraoral vertical osteotomy using small bone plates. J. Oral Maxillofac Surg. 46:908�910, 1988.
  20. McKibbin, B. : The biology of fracture healing in long bones. The journal of bone and joint surgery. 60-B : 150-162, 1978.
  21. Niebergall, C.F., Mercuri, L.G.: Intraoral vertical sub-condylar osteotomy: A national survey. J. Oral Maxillofac Surg. 43:450-452, 1985.
  22. Nordenram, A., and Waller, A.: Oral-Surgical Correc-tion of mandibular protrusion. Br.J.Oral Surg. 6:64, 1968.
  23. Paulus, G. W., Steinhauser, E. W. : A comparative study of wire osteosynthesis versus bone screws in the treatment of mandibular prognathism. J Oral Surg 54; 2-6, 1982. https://doi.org/10.1016/0030-4220(82)90408-X
  24. Phillips, C.: Skeletal alterations following TOVRO or BSSO procedures. Int.J. Adult Orthod. Orhog. Surg. 1;203-212, 1986.
  25. Rosenquist, M., and Shoort, W. :Bone repair in the mandible. A historical and biometric comparison between rigid and semi-rigid fixation. J. Oral Maxillofac. Surg. 41: 215, 1983.
  26. Sherpherd, J.P. : Changes in the mandibular ramus following osteotomy - A long-term review. Br. J. Oral Surg. 18:189-201, 1980.
  27. Timothy, G., Stroster., Valmy, Pangrazio-Kulbersh.: Assessment of condylar position following bilateral sagittal split ramus osteotomy with wire fixation or rigid fixation. Int. J. Adult Orthod. Orthog. Surg. Vol 9, No. 1, 55-63, 1994.
  28. Tornes, K., Gilhuus-Moe, O.T.:The surgical technique of vertical subcondylar osteotomy for correction of mandibular prognathism. a 10 year survey. Acta. Odont. Scand. 45;203, 1987. https://doi.org/10.3109/00016358709098860
  29. Westersson, P. L., Dahlberg, G., Hansson, L. G., Eriksson, L., and Ketonen, L.:Osseous and muscular change after vertical ramus osteotomy : A magnetic resonance imaging study. Oral Surg. Oral Med. Oral Pathol.72:139-145, 1991.
  30. Williamson, E.H., Charles, W. : Use of a submental-Vertex analysis for producing quality temporo-mandibular joint laminagraphs. Am. J. Orthod. 70:200, 1976.
  31. 이병인, 박형식. : 하악전돌증환자의 구내 하악골 상행지수직골절단술 후 골절편들의 장기 형태개조에 대한 임상적 연구. 대한구강악안면외과학회지22(1) : 70-85, 1996.
  32. 이상휘, 박형식 : 성견 하악골 상행지 수직 골절단술후조기 기능시의 골치유에 관한 연구. 대한구강악안면외과학회지23(3) : 434-457, 1997.
  33. 이충국, 장현호, 김희경 : 안모비대칭의 진단 및 처치. 대한구강악안면외과학회지. 17(3) : 1-10, 1991.