Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
권호 표지

CHANGES IN GONIAL ANGLE AND MANDIBULAR WIDTH AFTER ORTHOGNATHIC SURGERY IN MANDIBULAR PROGNATHIC PATIENTS

하악전돌증 환자에서 악교정수술 후 하악각 및 하악폭경의 변화

  • Kim, In-Ho (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University) ;
  • Han, Chang-Hun (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University) ;
  • Ryu, Sun-Youl (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University)
  • 김인호 (전남대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 한창훈 (전남대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 유선열 (전남대학교 치의학전문대학원 구강악안면외과학교실)
  • Published : 2006.04.30
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Abstract

The treatment plan for orthognathic surgery must be based on accurate predictions, and this can be produced the most esthetic, functional and stable results. The purpose of this study was aimed to evaluate the amount and interrelationship of the gonial angle and the mandibular width change after the mandibular setback surgery in the mandibular prognathic patients. Twenty patients were selected who received orthognathic surgery after presurgical orthodontic treatment. The patients with skeletal and dental Class III malocclusion were operated upon with bilateral sagittal split ramus osteotomy and mandibular setback. The lateral and posteroanterior cephalometric radiographs were taken preoperatively, postoperative 1 day and 12 months later after the orthognathic surgery, and then the gonial angle and mandibular width were measured. The computerized statistical analysis was carried out with SPSS/PC program. The gonial angle at postoperative 1 day was decreased about $5.3^{\circ}$ than preoperative value and the gonial angle at postoperative 12 months was increased about $1.4^{\circ}$ than postoperative 1 day. So the gonial angle at postoperative 12 months was decreased about $3.9^{\circ}$ than preoperative value. The mean preoperative gonial angle was $125.35^{\circ}{\pm}7.36$, showing significantly high value than normal and mean gonial angle at postoperative 12 months was $121.45^{\circ}{\pm}6.81$, showing value near to normal. The mandibular width at postoperative 1 day was decreased about 1.1 mm than preoperative value and the mandibular width at postoperative 12 months was more decreased about 1.7 mm than postoperative 1 day. So the mandibular width at postoperative 12 months was decreased about 2.8 mm than preoperative value. These results indicate that sagittal split ramus osteotomy in mandibular prognathic patients with high gonial angle is effective to improvement of gonial angle. It is considered to be helpful for maintenance of postoperative stable gonial angle area that detailed postoperative care and follow-up.

Keywords

References

  1. Wackens G: The psychological implications of orthognathic surgery. Rev Belge Med Dent 2002;57:32-36
  2. Trauner D, Richard S, Obwegeser A, Hugo L: Surgical correction of mandibular prognathism and retrognathism with consideration of genioplasty. J Oral Surg 1957;10:787-792 https://doi.org/10.1016/0030-4220(57)90105-6
  3. Dal pont G: Retromolar osteotomy for correction of prognathism. J Oral Surg 1961;19:42-47 https://doi.org/10.1016/0030-4220(65)90214-8
  4. Lundberg M, Fromm B: The soft-tissue facial profile before and after surgical correction of mandibular protrusion. Acta Odontal Scand 1970;28:157-177 https://doi.org/10.3109/00016357009032025
  5. Robinson SW, Speidel TM, Isaacson RJ, Worms FW: Soft tissue profile change produced by reduction of mandibular prognathism. Angle orthod 1972;42:227-235
  6. Hershey HG, Smith LH: Soft tissue profile change associated with surgical correction of the prognathic mandible. Am J Ortho 1974;65:483-502 https://doi.org/10.1016/0002-9416(74)90031-1
  7. Pepersack WJ, Chausse JM: Long-term follow-up of sagittal splitting technique for correction of mandibular prognathism. J Maxillofac Surg 1978;6:117-140 https://doi.org/10.1016/S0301-0503(78)80079-4
  8. Hovell J: Muscle patterning factors in the surgical correction of mandibular prognathism. J Oral Surg 1964;22:122-126
  9. Reitzik M: Skeletal and dental changes after surgical correction of mandibular prognathism. J Oral Surg 1980;38:109-116 https://doi.org/10.1016/0030-4220(74)90321-1
  10. 팽준영, 박영욱, 김명진: 하악전돌증 환자에 있어 하악지 시상분 할골절단술시 원심골편의 후방부 변연절제술 후 하악우각부 경 조직 변화와 회귀경향에 관한 연구. 대한악안면성형재건외과학회지 1998;20:180-185
  11. Abe M, Ohashi Y, Igarashi K: Evaluation of Obwegeser-Dal ponts' method in 9 patients. Jpn J Oral Maxillofac Surg 1980;26:1528-1535 https://doi.org/10.5794/jjoms.26.1528
  12. 이상철, 김여갑, 류동목, 이완기: 하악전돌증의 악교정수술 후 연 조직 변화에 관한 연구. 대한악안면성형재건외과학회지 1992;14:217-227
  13. 박희대, 권대근, 이상한: 하악전돌증 환자의 하악지 시상골절단 술 후 경조직 변화에 따른 안모 연조직의 변화 분석. 대한악안면성형외과학회지 1996;18:87-108
  14. 강석훈, 김태준, 신효근: 하악전돌증 환자에 있어서 악교정수술 전후의 하악각 변화에 관한 임상적 연구. 대한구강악안면외과학회지 1998;24:193-197
  15. 권영호, 장현중, 이상한: 하악전돌증환자의 악교정수술 후 하악 각 변화에 관한 임상적 분석. 대한악안면성형재건외과학회지 2000;22:206-216
  16. 양동규, 양원식, 김종원: 악교정수술 후 두부경조직의 계측학적 변화. 대한구강악안면외과학회지 1982;8:47-55
  17. 조병욱, 이용찬, 고백진, 조원표: 악교정수술을 받은 악안면기형 환자의 skeletal pattern의 변화에 관한 연구. 대한악안면성형재건외과학회지 1990;12:1-6
  18. Ridel RA: Relation of maxillary structure to the cranium in malocclusion and in normal occlusion. Angle Orthod 1952;22:142-148
  19. Bell WH, Proffit WR, White RP: Surgical correction of dentofacial deformities. Saunders 1980;1:49-52
  20. 노준, 유영규: 한국 젊은 여성의 심미적 안모형태에 관한 두부방 사선계측학적 연구. 대한치과교정학회지 1988;12:127-139
  21. 백일수, 유영규: 청소년기 정상 교합자에 대한 두부방사선계측학 적 연구. 대한치과교정학회지 1982;12:177-191
  22. 김은희, 황현식: 정모두부방사선 촬영시 Head Posture Aligner의 유용성에 관한 연구. 대한치과교정학회지 2000;30:543-552
  23. 손형민, 장현석, 임재석, 권종진, 이부규: 제 III급 부정교합자의 악교정술 후 골격적 재발양상에 관한 연구. 대한악안면성형재건외과학회지 2000;22:37-342
  24. Ive J, McNeil RW, West RA: Mandibular advancement: skeletal and dental changes during fixation. J Oral Surg 1977;35:881-886
  25. Kohn MW: Analysis of relapse after mandibular advancement surgery. J Oral Surg 1978;36:676-684
  26. Lake SL, McNeil RW, Little RW, West RA: Surgical mandibular advancement: a cephalometric analysis of treatment response. Am J Orthod 1981;80:376-394 https://doi.org/10.1016/0002-9416(81)90173-1
  27. Franco JE, Van Sickels JE, Tharash WJ: Factors contributing to relapse in rigidly fixed mandibular setbacks. J Oral Maxillofac Surg 1989;47:451-456 https://doi.org/10.1016/0278-2391(89)90276-0
  28. Stella JP, Astrand P, Epker BN: Patterns and etiology of relapse after correction of class III open bite via subcondylar ramus osteotomy. Int J Adult Orthod Orthognath Surg 1986;1:91-95
  29. Gassmann CJ, Van Sickels JE, Tharash WJ: Causes, location and timing of relapse following rigid fixation after mandibular advancement. J Oral Maxillofac Surg 1990;48:450-454 https://doi.org/10.1016/0278-2391(90)90229-U
  30. Greebe RB, Tuinzing DB: Mandibular advancement procedures: Predictable stability and relapse. J Oral Maxillofac Surg 1984;57:13-16