Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
권호 표지

An Evaluation of Initial Stability after Maxillary Posterior Impaction

상악의 후상방 회전이동을 시행한 환자에서의 초기 안정성 평가

  • Ahn, Sang-Wook (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Kwon, Taek-Kyun (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Lee, Sung-Tak (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Song, Jae-Min (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Kim, Tae-Hoon (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Hwang, Dae-Seok (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Shin, Sang-Hoon (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University) ;
  • Chung, In-Kyo (Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University)
  • 안상욱 (부산대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 권택균 (부산대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 이성탁 (부산대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 송재민 (부산대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 김태훈 (부산대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 황대석 (부산대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 신상훈 (부산대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 정인교 (부산대학교 치의학전문대학원 구강악안면외과학교실)
  • Received : 2011.04.08
  • Accepted : 2011.05.09
  • Published : 2011.05.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study was designed to retrospectively evaluate the postsurgical initial stability of the Le Fort I osteotomy with posterior impaction and rigid internal fixation for the correction of mandibular prognathism with midface deficiency. Particular attention was paid to the magnitude and direction of the initial postsurgical change. Methods: 20 healthy patients with mandibular prognathism and midface deficiency participated in this study. All patients underwent Le Fort I osteotomy with posterior impaction and mandibular setback BSSO by one surgeon. Preoperative (T0), immediate postoperative (T1) and follow-up period (T2) cephalograms were taken and analyzed. Change between T0~T1 and T1~T2 was measured and analyzed. Results: Between T0~T1, significant differences were observed in all measurements except the ANS point and mandibular plane angle. Between T1~T2, only the occlusal plane angle was significantly changed. No significant changes were found in all other measurements. Conclusion: This study indicates that Le Fort I osteotomy with posterior impaction is stable at initial stages. Although changes in the occlusal plane angle were observed, it was caused by tooth movement after post-operative orthodontic treatment. However, more studies with larger samples are required to form definitive conclusions. Conclusion: This study indicates that Le Fort I osteotomy with posterior impaction is stable at initial stages. Although changes in the occlusal plane angle were observed, it was caused by tooth movement after post-operative orthodontic treatment. However, more studies with larger samples are required to form definitive conclusions.

Keywords

References

  1. Reyneke JP, Evans WG. Surgical manipulation of the occlusal plane. Int J Adult Orthodon Orthognath Surg 1990;5:99-110.
  2. Turvey TA. Simultaneous mobilization of the maxiRa and mandible: Surgical technique and results. J Oral Maxillofac Surg 1982;40:96-9. https://doi.org/10.1016/S0278-2391(82)80033-5
  3. Ryu KW, Shin WC, Kim JG. Skeletal relapse rattern after sagittal split ramus osteotomy of mandibular prognathic patient. J Korean Assoc Maxillofac Plastic Reconstr Surg 2001;23:21-30.
  4. McNeil RW, Holly JR, Sunderberg RJ. Skeletal relapse during IMF. J Oral Surg 1973;31:212-27.
  5. 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;1:91-9.
  6. Gassmann CJ, Van Sickels JE, Thrash WJ. Causes, location and timing of relapse following rigid fixation after mandibular advancement. J Oral Maxillofac Surg 1990;48:450-4. https://doi.org/10.1016/0278-2391(90)90229-U
  7. Araujo A, Schendel SA, Wolford LM, Epker BN. Total maxillary advancement with and without bone grafting. J Oral Surg 1978;36:849-58.
  8. Michiwaki Y, Yoshida H, Ohno K, Michi K. Factors contributing to skeletal relapse after surgical correlation of mandibular prognathism. J Craniomaxillofac Surg 1990;18:195-200. https://doi.org/10.1016/S1010-5182(05)80410-X
  9. Carlotti AE, Schendel SA. An anlaysis of factors influencing stability of surgical advancement of the maxilla by the Le Fort I osteotomy. J Oral Maxillofac Surg 1987;45:924-8. https://doi.org/10.1016/0278-2391(87)90442-3
  10. Brehm HL, Jackson DL. An investigation of the extent of the need for orthognatic services. Am J Orthod 1961;47:148-9.
  11. Ast DB, Carlos JP, Cons NC. The prevalance and caracteristics of malocclusion among senior high school students in upstate New York. Am J Orthod 1965;51:437-45. https://doi.org/10.1016/0002-9416(65)90241-1
  12. Yoo YK, Kim NI, Lee HK. A study on the prevalence of malocclusion in 2,378 Yonsei University students. J Korean Orthod 1971;2:35-40.
  13. Lee SJ, Suhr CH. Recognition of malocclusion and orthodontic treatment need of 7-18 year-old Korean adolescent. J Korean Orthod 1994;24:367-94.
  14. Epker BN, Turvey T, Fish LC. Indication for simultaneous mobilization of the maxilla and mandible for the correction of dentofacial deformities. Oral Surg Oral Med Oral Pathol 1982;54:369-81. https://doi.org/10.1016/0030-4220(82)90381-4
  15. Epker BN, Fish LC. Surgical-orthodontic correction of Class III skeletal open-bite. Am J Orthod 1978;73:601-18. https://doi.org/10.1016/0002-9416(78)90222-1
  16. Bet NJ, Edwards SP. Soft tissue changes associated with orthognatic surgery-in Principles of oral and maxillofacial surgery. 2nd ed. Canada BC Decker; p.1233.
  17. Hedemark A, Freihofer HP Jr. The behaviour of the maxilla in vertical movements after Le Fort I osteotomy. J Maxillofac Surg 1978;6:244-9.
  18. Skoczylas LJ, Ellis E 3rd, Fonseca RJ, Gallo WJ. Stability of simultaneous maxillary intrusion and mandibular advancement: a comparison of rigid and nonrigid fixation techniques. J Oral Maxillofac Surg 1988;46:1056-64. https://doi.org/10.1016/0278-2391(88)90451-X
  19. Proffit WR, Phillips C, Turvey TA. Stability following superior repositioning of the maxilla by Le Fort osteotomy. Am J Orthod Dentofac Orthop 1987;92:151-61. https://doi.org/10.1016/0889-5406(87)90370-2
  20. Egbert M, Hepworth B, Myall R, West R. Stability of Le Fort I osteotomy with maxillary advancement: a comparison of combined wire fixation and rigid fixation. J Oral Maxillofac Surg 1995;53:243-8; discussion 248-9. https://doi.org/10.1016/0278-2391(95)90217-1
  21. Satrom KD, Sinclair PM, Wolford LM. The stability of double jaw surgery: a comparison of rigid versus wire fixation. Am J Orthod Dentofac Orthop 1991;99:550-63. https://doi.org/10.1016/S0889-5406(05)81632-4
  22. Yoon HJ, Rebellato J, Keller EE. Stability of the Le Fort I osteotomy with anterior internal fixation alone: a case series. J Oral Maxillofac Surg 2005;63:629-34. https://doi.org/10.1016/j.joms.2004.12.013
  23. Downs WB. Variations in facial relationship; their significance intreatment and prognosis. Am J Orthod 1948;34:812-40. https://doi.org/10.1016/0002-9416(48)90015-3
  24. Moore JW. Variation of sella nasion plane its effect on SNA and SNB. J Oral Surg 1976;34:24-6.
  25. Lundstrom A. Head posture in relation to slope of the sella-nasion line. Angle Orthod 1982;52:79-82.
  26. Ellis E 3rd, McNamara J Jr. Cephalometric reference planes--sella nasion vs Frankfort horizontal. Int J Adult Orthodon Orthognath Surg 1988;3:81-7.
  27. Burstone CJ, James RB, Legan H, Murphy GA, Norton LA. Cephalometrics for orthognathic surgery. J Oral Surg 1978;36:269-77.
  28. Burstone CJ. The integumental profile. Am J Orthod 1958;44:1-25. https://doi.org/10.1016/S0002-9416(58)90178-7
  29. Proffit WR, Turvey TA, Philips C. Orthognathic surgery: a hierarch of stability. Int J Adult Orthodon Orthognath Surg 1996;11:191-204.
  30. Proffit WR, Turvey TA, Phillips C. The hierarchy of stability and predictability in orthognathic surgery with rigid fixation: an update and extension. Head Face Med 2007;30:21.
  31. Van Sickel JE, Larsen AJ, Thrash WJ. Relapse after rigid fixation of mandibular advancement. J Oral Maxillofac Surg 1986;44:698-702. https://doi.org/10.1016/0278-2391(86)90037-6
  32. Kobayashi T, Watanabe I, Ueda K, Nakajima T. Stability of the mandible after sagittal ramus osteotomy for correction of prognathism. J Oral Maxillofac Surg 1986;44:693-7. https://doi.org/10.1016/0278-2391(86)90036-4
  33. Joss CU, Thuer UW. Stability of the hard tissue profile after mandibular setback in sagittal split osteotomies: a longitudinal and long-term follow-up study. Eur J Orthod 2008;30:352-8. https://doi.org/10.1093/ejo/cjn008
  34. Kaminishi RM, Davis WH, Hochwald DA, Nelson N. Improved maxillary stability with modified Le Fort I technique. J Oral Maxillofac Surg. 1983;4:203-5.