MANDIBULAR ADVANCEMENT WITH DISTRACTION OSTEOGENESIS FOR ADULT CLASS II MALOCCLUSION PATIENT WITH CONDYLAR RESORPTION

악관절 흡수양상을 보이는 성인 하악 후퇴증 환자에서 양측 하악골 골신장술을 이용한 하악 전진술

  • Paeng, Jun-Young (Department of Oral and Maxillofacial Surgery, College of Dentistry, Wonkwang University) ;
  • Lee, Sang-Woo (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ;
  • Lee, Jin-Yong (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ;
  • Myoung, Hoon (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ;
  • Hwang, Soon-Jung (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ;
  • Seo, Byoung-Moo (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ;
  • Choi, Jin-Young (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ;
  • Lee, Jong-Ho (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ;
  • Choung, Pill-Hoon (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ;
  • Kim, Myung-Jin (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University)
  • 팽준영 (원광대학교 치과대학 구강악안면외과학교실) ;
  • 이상우 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 이진용 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 명훈 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 황순정 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 서병무 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 최진영 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 이종호 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 정필훈 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 김명진 (서울대학교 치과대학 구강악안면외과학교실)
  • Published : 2007.05.31

Abstract

Purpose: Distraction osteogenesis is considered to take favorable effect on the TMJ and be beneficial to prevent the relapse after the mandibular advancement of Class II malocclusion patient. This is the report with literature review on the mandibular advancement in the patients showing preoperative condylar resorption and who need larger amount of advancement. Patients and method: Distraction osteogenesis using intraoral device was performed for three mandibular hypoplasia patients (one male and two females). All patients were adult over 18 years old. The patients showed condylar bony resorption preoperatively. The distraction was performed intraorally with modified SSRO. After 7 days of latency period, activation was performed at the rate of 1.0 mm/day with twice turn. The devices were removed after 4-8 month consolidation period. Results: Total advancement of mandible was average 13 mm. One patient showed openbite immediately after removal of distraction device. It took long time to guide the openbite with elastics. The comparison between cephalometries immediately after device removal and postoperative six month revealed average 3.4 mm relapse. This means that mandibular advancement with distraction osteogenesis needs overcorrection and elastic rehabilitation even after enough consolidation periods. Conclusion: Larger amount of mandibular advancement could be achieved with distraction osteogenesis in severe mandibular hypoplasia with condylar resorption. However, some relapse was found during the follow-up period and the over correction is considered to be needed. The effect of distraction osteogenesis seems to be investigated with long-term follow-up.

Keywords

References

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