• Journal of Oral Medicine and Pain
• /
• v.38 no.3
• /
• pp.255-260
• /
• 2013

Bilateral sagittal split ramus osteotomy(BSSRO) of the mandible is an essential and commonly used procedure to correct dentofacial deformities and malocclusion. The possible complications associated with BSSRO include inferior alveolar nerve injury, bleeding, temporomandibular disorder, unfavorable fractures, and clinical relapse. The incidence of facial nerve palsy after orthognathic surgery recently reported is 0.1%. The probable etiologies have included facial nerve compression, complete or incomplete nerve transection, nerve traction, and nerve ischemia from anesthetic injection. Postoperative facial palsy is one of the most serious complications because it reduces the quality of life and significantly reduces social interaction. The case of a 24-year-old patient who underwent bilateral sagittal split ramus osteotomy is described. The medical records and postoperative photographs were reviewed in detail to collect information on the clinical course, treatment, and outcomes.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.23 no.2
• /
• pp.169-173
• /
• 2001

Maxillary-malar deficiency is the most frequently occurring midface dentofacial deformity. Clinicaly patients with maxillary-malar deficiency exhibit malar and infraorbital rim deficiency and class III malocclusion. For treatment of these deformities, modified LeFort III osteotomy have been used. Modified LeFort III osteotomy advances maxilla with orbital rims and zygomatic bone anteroposteriorly. This is a case of patient who had severe mandibular prognthism with midface deformity. We performed modified LeFort III osteotomy for maxillary-malar advancement and simultaneous bilateral sagittal split ramus osteotomy for mandibular prognathism and autogenous iliac bone graft.

• The korean journal of orthodontics
• /
• v.29 no.3 s.74
• /
• pp.327-337
• /
• 1999

Patients with skeletal class III can be succesfully treated by either orthognathic surgery or orthodontic treatment owing to unavoidable circumstances. Systers were treated , elder syster by orthognathic surgery and younger one by compromised treatment. For the ideal treatment goal, orthognathic surgery will be inevitable in skeletal problem case, but by the patient's private situations orthodontist cannot help doing compromised treatment. It could be another option if correct biomechanical approach is used.

• Imaging Science in Dentistry
• /
• v.36 no.4
• /
• pp.183-188
• /
• 2006

Purpose: The purpose of this research was to study bone changes after bilateral sagittal split osteotomy through fractal analysis and measurement of mandibular cortical thickness. Materials and Methods: This study included twenty-two prognathic patients who underwent bilateral sagittal split osteotomy. Panoramic radiographs of these patients were taken immediately before operation and at 1 month, 6 months, and 12 months postoperatively. The fractal dimension was measured by the box-counting method in the region of interest centered on both the basal and interdental bones between the first and second mandibular molars. Measurements of mandibular cortical thickness were taken both in the area between the first and second mandibular molars and at the osteotomy site. Changes of fractal dimension and cortical thickness over four stages were statistically analyzed. Results: The fractal dimension of the mandibular basal bone before surgery and after 1 month, 6 months and 12 months were $1.4099{\pm}0.0657,\;1.382{\pm}0.0595,\;1.2995{\pm}0.0949,\;and\;1.4166{\pm}0.0676$, respectively (Repeated-measures ANOVA, P<0.001). However, no statistically significant differences were noted in interdental fractal dimensions among the four stages. Mandibular cortical thickness between the first and second mandibular molars before operation and after 1 month, 6 months and 12 months was $3.74{\pm}0.48mm,\;3.63{\pm}0.47mm,\;3.41{\pm}0.61mm\;and\;3.55{\pm}0.66mm$ (P<0.01), respectively. Mandibular cortical thickness at the osteotomy site at each of the four stages was $3.22{\pm}0.44mm,\;2.87{\pm}0.59mm,\;2.37{\pm}0.61mm\;and\;2.64{\pm}0.62mm$, respectively (P<0.001). Conclusion: This study suggests that the mandibular tissue continued decreasing for 6 months postoperatively and then increased over the subsequent 6 months.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.36 no.4
• /
• pp.255-261
• /
• 2010

Introduction: To evaluate the skeletal stability after a bilateral sagittal split osteotomy (BSSO) setback of the mandible fixed with a biodegradable internal fixation device or metal internal fixation device. Materials and Methods: Thirty consecutive patients underwent mandibular setback via BSSO. Fifteen patients were fixed with a biodegradable internal fixation device or metal internal fixation device respectively. Posteroanterior (PA) and lateral cephalograms were taken preoperatively and at two days, 5.5 months and 14.5 months postoperatively. The relevant skeletal points were traced and digitized to evaluate the skeletal changes postoperatively. The relapse rates were analyzed and compared statistically. Results: There was no statistically significant differences in postoperative stability between the two groups.(P<0.05) Conclusion: The biodegradable internal fixation device may make an effective device alternative to a metal internal fixation device for setback BSSO.

• The korean journal of orthodontics
• /
• v.29 no.4 s.75
• /
• pp.457-466
• /
• 1999

It has been reported that skeletal relapse and dental change after mandibular setback do occur not only after intermaxillary fixation(IMF) removal but also during IMF The side effects of skeletal relapse during IMF have clinical importance because they can cause many Postoperative orthodontic Problems. Generally, the Prevention of solid union between segments, compensatory tooth movement, anterior openbite, etc. have been cited as the side effects of jaw displacement. The purpose of this study was to evaluate the skeletal relapse and dental change during IMF. The material consisted of 28 patients who were treated by BSSRO(bilateral sagittal split ramus osteotomy), wire osteosynthesis, IMF for correction of mandibular prognathism. Through cephalometric analysis, the amount and direction of surgical movement, skeletal relapse and dental change during IMF were measured. The correlation between surgical movement and skeletal relapse, between skeletal relapse and dental changes were evaluated. The following conclusions were obtained; 1. Distal segment was repositioned backward and upward, proximal segment showed clockwise rotation during surgery. 2. During ]m, anterior portion of distal segment was displaced backward and posterior portion was displaced upward. Proximal segment was displaced upward with forward movement of p-Go(gonion of proximal segment). Backward surgical movement of p-GO was significantly correlated with forward displacement of p-Go. 3. Overjet and overbite were not changed during IMF. The compensatory tooth movements during IMF were characterized by retroclination of upper incisors md retroclination, extrusion of lower incisors. These compensatory tooth movements had statistically significant correlation with upward displacement of d-Go (gonion of distal segment).