• Title/Summary/Keyword: Genioplasty

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Effectiveness of hemocoagulase, tranexamic acid, and their combination for reducing blood loss in bimaxillary orthognathic surgery: a retrospective study

  • Min-Soo Kim;Se-Jin Han
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.4
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    • pp.208-213
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    • 2023
  • Objectives: Orthognathic surgery is a corrective intervention for maxillofacial deformities. Bleeding is a major concern for oral and maxillofacial surgeons. Various agents, such as hemocoagulase, tranexamic acid, and aprotinin have been developed to reduce intraoperative bleeding and transfusion requirements. Therefore, in this study we aimed to investigate the effects of hemocoagulase and tranexamic acid, as well as their simultaneous use, to reduce bleeding during orthognathic surgery. Patients and Methods: This retrospective study included patients who had undergone simultaneous orthognathic surgery of the maxilla and mandible between January 2013 and September 2022 and were classified into three groups based on drugs administered: hemocoagulase (Botropase), tranexamic acid, and a combination of both drugs. We recorded patient age, sex, weight, blood loss, and duration of surgery. Red blood cell (RBC), hemoglobin, hematocrit, and platelet levels were measured before, immediately after, and one day after surgery. Results: No statistically significant differences were found in blood loss, RBC, hemoglobin, hematocrit, or platelet levels between any of the groups. There were no differences in the drug effects between Le Fort I and bilateral mandibular sagittal split osteotomies, with or without double genioplasty. However, there were significant reductions in RBC, hemoglobin, hematocrit, and platelet levels during genioplasty. Conclusion: Tranexamic acid, hemocoagulase, and their combination had similar efficacy in patients who underwent Le Fort I and bilateral mandibular sagittal split osteotomies with and without genioplasty.

A comparative study of initial lateral cephalometric characteristics: mandibular setback surgery only versus mandibular setback surgery with advancement genioplasty (하악 후퇴술과 전진 이부성형술이 시행된 III급 부정교합자의 초진 시 측모 두부 방사선사진 특성에 관한 연구)

  • Kim, Jae-Sik;Kim, Jung-Il;Kang, Seung-Goo
    • The korean journal of orthodontics
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    • v.38 no.1
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    • pp.41-51
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    • 2008
  • Objective: The aim of this study was to compare the initial lateral cephalometric characteristics in two groups of patients: those that had mandibular setback surgery only and those that had mandibular setback surgery with advancement genioplasty. Methods: The lateral cephalograms of thirty-one patients were studied. Twenty-one Class III patients (group A) had only madibular setback surgery Twelve Class III patients (group B) had mandibular setback surgery with advancement genioplasty. Results: Differences between two groups were found in N-Me, ANS-Me, Occlusal Plane angle, Palatal Plane to U1, Mandibular Plane to L1, Mandibular Plane to L6, SN to U1, Sn-Stms, and Pog' projection. Compared to group A, group B showed more linguoversion and extrusion of upper incisors, more extrusion of lower incisors and lower first molar, and more steepness of the occlusal plane. N-Me, ANS-Me, and Sn-Stms were also longer in group B. But Pog' projection was shorter than group A. Conclusion: We conclude that certain initial lateral cephalometric characteristics may help indicate the inclusion of advancement genioplasty when mandibular setback surgery is planned in skeletal Class III patients.

Accuracy of artificial intelligence-assisted landmark identification in serial lateral cephalograms of Class III patients who underwent orthodontic treatment and two-jaw orthognathic surgery

  • Hong, Mihee;Kim, Inhwan;Cho, Jin-Hyoung;Kang, Kyung-Hwa;Kim, Minji;Kim, Su-Jung;Kim, Yoon-Ji;Sung, Sang-Jin;Kim, Young Ho;Lim, Sung-Hoon;Kim, Namkug;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.52 no.4
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    • pp.287-297
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    • 2022
  • Objective: To investigate the pattern of accuracy change in artificial intelligence-assisted landmark identification (LI) using a convolutional neural network (CNN) algorithm in serial lateral cephalograms (Lat-cephs) of Class III (C-III) patients who underwent two-jaw orthognathic surgery. Methods: A total of 3,188 Lat-cephs of C-III patients were allocated into the training and validation sets (3,004 Lat-cephs of 751 patients) and test set (184 Lat-cephs of 46 patients; subdivided into the genioplasty and non-genioplasty groups, n = 23 per group) for LI. Each C-III patient in the test set had four Lat-cephs: initial (T0), pre-surgery (T1, presence of orthodontic brackets [OBs]), post-surgery (T2, presence of OBs and surgical plates and screws [S-PS]), and debonding (T3, presence of S-PS and fixed retainers [FR]). After mean errors of 20 landmarks between human gold standard and the CNN model were calculated, statistical analysis was performed. Results: The total mean error was 1.17 mm without significant difference among the four time-points (T0, 1.20 mm; T1, 1.14 mm; T2, 1.18 mm; T3, 1.15 mm). In comparison of two time-points ([T0, T1] vs. [T2, T3]), ANS, A point, and B point showed an increase in error (p < 0.01, 0.05, 0.01, respectively), while Mx6D and Md6D showeda decrease in error (all p < 0.01). No difference in errors existed at B point, Pogonion, Menton, Md1C, and Md1R between the genioplasty and non-genioplasty groups. Conclusions: The CNN model can be used for LI in serial Lat-cephs despite the presence of OB, S-PS, FR, genioplasty, and bone remodeling.

Soft tissue changes associated with advancement genioplasty in skeletal class III individuals receiving mandibular set-back surgery (골격성 III급 부정교합자에서 전진이부성헝술을 동반한 하악 후퇴술 후 연조직 외형의 변화)

  • Kim, Keun-Ryoung;Kim, Seong-Sik;Son, Woo-Sung;Park, Soo-Byung
    • The korean journal of orthodontics
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    • v.38 no.2
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    • pp.104-120
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    • 2008
  • Purpose: The purpose of this study was to assess the hard and soft tissue changes associated with mandibular bilateral sagittal split osteotomy and genioplasty. Methods: This is a retrospective study of 40 patients who underwent either bilateral sagittal split osteotomy for mandibular setback (BSSO group, n = 20) or in combination with advancement genioplasty (Genio group, n = 20). Lateral radiographs, were taken before and immediately after surgery, and at least 6 months after surgery. Results: Comparing hard and soft tissue changes between the BSSO group and Genio group, there were significant differences in the lower incisor, soft tissue B point (B'), and soft tissue Pogonion (Pg') (p < 0.5). The mean ratio of hard and soft tissue changes for B/B', Pg/Pg', and Menton/soft tissue Menton after surgery in the BSSO group was 0.997, 0.965, and 1.022 respectively, and 0.824, 0.602, and 0.887 respectively in the genio group. Significant differences were found between the two groups. There were significant differences in lip thickness (B-B', Pg-Pg') in the Genioplasty group between pre and postsurgery, but not in the BSSO group. Pogonion to Labrale inferior and B' had a correlation coefficient of 0.833, 0.922, respectively for the BSSO group, and 0.775, 0.799 for the Genio group. Conclusions: The results indicate that there is a significant difference between bilateral sagittal split osteotomy with or without genioplasty in the lower facial esthetics values. The combination of mandibular setback and genioplasty had a smaller change in soft tissue thickness of the symphysis area after surgery than that of mandibular setback only.

Esthetic Consideration on Genioplasty (하악골 정중부 수평 골절단술 시행시 심미적 고찰)

  • Cho, Byong-Ouck;Nam, Jong-Hoon;Lee, Young-Ho
    • The Journal of the Korean dental association
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    • v.25 no.9 s.220
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    • pp.847-854
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    • 1987
  • Genioplasty may considerably change a person's face which needs surgical correction of deformed chin. Comprehensive treatment planning is therefore decisive for the treatment to be successful. A three-dimensional analysis of chin relative to cranial base, upper and lower jaws using the frontal and lateral facial photographs and cephalographs permits classification of the defective chin position and provides a basis for operation planning and deciding upon the operation method. A chin miniplate system has been developed for intraoperative registration securing the sagittal, vertical and horizontal position of the osteotomized chin and ould reduce the relapse rate.

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TREATMENT OF ANTERIOR OPEN BITE WITH BIMAXILLARY ANTERIOR SEGMENTAL OSTEOTOMY AND GENIOPLASTY (양악 전방분절골절단술과 이부 성형술을 통한 개방교합의 치험례)

  • Hwang, Yong-In;Hong, Sun-Min;Park, Jun-Woo;Rhee, Gun-Joo;Cho, Hyung-Jun;Cheon, Se-Hwan;Park, Yang-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.3
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    • pp.355-364
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    • 2008
  • Skeletal anterior open bite is a difficult problem to correct in orthodontic treatment. To treat adult patients who have skeletal anterior open bite, we considered two methods. Combination treatment of orthodontics & surgery and camouflage orthodontic treatment. In adults, treatment of severe skeletal anterior open bite consists mainly of surgically repositioning the maxilla or the mandible. However, camouflage therapy is often the treatment of choice for skeletal open bite patients who have mild to moderate skeletal discrepancies when growth modification is no longer possible. But excellent results generally require careful coordination of the orthodontic and surgical phases of treatment. This is a case report of a skeletal anterior open bite patients who were treated with orthodontic treatment and orthognathic surgery. First case was diagnosed as skeletal class I malocclusion & bimaxillary protrusion with anterior open bite, and finally treatment ended for removal of open bite with orthodontic procedure and bimaxillary anterior segmental osteotomy surgery. Second case was diagnosed as skeletal class II malocclusion with open bite & mandibular retrusion, and was treated with only camouflage orthodontics because she feared to have a surgery. In a regular follow up visit after debonding we proposed to the patient advanced genioplasty, and in her agreement her facial esthetics was improved through the surgery.