• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권2호
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• pp.82-87
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• 2013

Purpose: This study evaluated postoperative maxillary stabilities in patients with skeletal Class III malocclusion who were taken both maxillary advancement surgery and mandibular retrusive surgery, using Le Fort I osteotomy, through three-dimensional computed tomography. Methods: We selected 14 patients who were taken postoperative three-dimensional computerized tomography at the time before surgery, immediately after surgery, six months after surgery among the patients undergone both maxillary advancement surgery using Le Fort I osteotomy and mandibular retrusive surgery using bilateral sagittal split ramus osteotomy. We measured and compared the vertical distance of A-point and posterior nasal spine (PNS), the horizontal distance of A-point and PNS in transverse plane and coronal plane of the three-dimensional reconstructed images, respectively. Results: In transverse plane, the distance difference between immediately after surgery ($S_1$) and immediately before surgery ($S_0$) of A-point was $-0.04{\pm}1.80$ mm, $S_2$ and $S_0$ was $-0.15{\pm}1.69$ mm, and between $S_1$ and $S_2$ was $0.11{\pm}0.58$ mm. There were no significant differences between these data (P>0.05). In transverse plane, the distance between $S_1-S_0$ of PNS was $-3.87{\pm}2.37$ mm, $S_2-S_0$ of PNS was $-3.79{\pm}2.39$ mm, and $S_1-S_2$ of PNS was $-0.08{\pm}0.18$ mm. There were significant differences between these data (P<0.05). In coronal plane, the distance between $S_1-S_0$ of A-point was $3.99{\pm}0.86$ mm, $S_2-S_0$ was $3.57{\pm}1.09$ mm, and $S_1-S_2$ was $0.42{\pm}0.42$ mm. There were significant differences between these data (P<0.05). In coronal plane, the distance between $S_1-S_0$ of PNS was $3.82{\pm}0.96$ mm, $S_2-S_0$ was $3.43{\pm}0.91$ mm, and $S_1S_2$ was $0.39{\pm}0.49$ mm. There were significant differences between these data (P<0.05). In transverse plane, it was estimated that PNS has no statistical postoperative stability in the same direction. In coronal plane, it was estimated that both A-point and PNS had no statistical postoperative stability (P<0.05). Conclusion: Clinically, the operation plan needs to take into account of the maxillary relapse.

• Journal of Dental Rehabilitation and Applied Science
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• 제22권4호
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• pp.289-300
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• 2006

This study was performed to investigate the influence of orthognathic surgery on the temporomandibular dysfunction in skeletal class III malocclusion. The temporomandibular joint status in 22 patients(mean age: 23.7 years) who received orthognathic surgery such as mandibular BSSRO(14 patients), maxillary Le Fort I osteotomy with mandibular BSSRO(8 patients) was evaluated by craniomandibular index. All these patients received orthognathic surgery at least 6 months ago. The mean score and standard deviation was obtained and compared with that of 22 normal individuals(mean age: 24.8years) by Student's t-test. In mandibular movement, the score of orthognathic surgery group was higher than that of the normal group. All the items except mandibular movement did not show any differences between the two groups.

• The korean journal of orthodontics
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• 제36권1호
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• pp.63-73
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• 2006

Numbers of postulations lie on the difference of integumental changes with two major surgical remedies of one jaw vs. two jaw surgery in skeletal Class III malocclusion. Accordingly it was the aim of the study to elucidate the skeletal profile changes with an accompanying disposition of soft tissues, consequently to yield the correlation and ratio of soft tissue changes with two types of surgical procedures, which in turn make it possible to predict the soft tissue outcomes by means of assembled regression equations. Cephalometric headfilms of fifty two adult skeletal Class III comprised of 26 maxillary advancement by Le Fort I osteotomy and mandibular setback by sagittal split ramus osteotomy simultaneously (double jaw surgery, group A), 26 mandibular setback alone (one jaw surgery, group B) were statistically analyzed. Group A manifested 72.4% soft tissue advancement to skeletal changes in the upper lip area, while group B appeared to have no statistically significant changes. The nasolabial angle showed more increment in group A than in group B, whereas the mentolabial angle illustrated more reduction in group B. The backward movement of soft tissue pogonion to skeletal change revealed 98% in group A, and 109% in group B. The double jaw surgery group characteristically revealed remarkable integ umental change in the upper lip area, while the one jaw surgery had major effects in the lower lip and soft tissue pogonion areas.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권1호
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• pp.117-127
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• 1991

When open reduction of maxilla fractures is postponed due to concurrent life-threatening injuries, delayed union may result with malunion or nonunion. If delayed malunion is occurred, significant facial deformity may result, including a dished-out face, irregular retromaxillism with Angle's class III malocclusion, open anterior bite, nasal collapse, telecanthus and malar flattening. The treatment planning for this problem includes cephalometric evaluation anterior and lateral tomograms, dental casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue attachment at the fracture site. In this paper, one case presented a 58-year-old female patient with maxilla retrusion after comminuted fracture, who was treated with orthodontic methods of maxillary protraction headgear and Plaster headcap, whereas the other two cases were about male patients who were treated principally with surgically open reduction or Le Fort I-controlled transverse osteotomy with iliac bone graft.

• Journal of Korean Dental Science
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• 제16권1호
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• pp.87-98
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• 2023

This report presents a case of successful treatment of skeletal Class III malocclusion with transverse discrepancy in adult by surgery-first approach. Traditionally dental decompensation is necessary prior to surgery in 2-jaw surgery to correct transverse and rotational discrepancy. However, the hyrax-type palatal expansion appliance was used to improve maxillary expansion accuracy and postoperative stability in this surgery-first approach (segmental Le Fort I osteotomy and mandibular setback surgery). It was established to be an effective means of precisely predicting postoperative occlusion and achieving stable retention after surgery of skeletal Class III malocclusion with maxillary transverse discrepancy.

• The korean journal of orthodontics
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• 제44권6호
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• pp.330-341
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• 2014

A 19-year-old woman presented to our dental clinic with anterior crossbite and mandibular prognathism. She had a concave profile, long face, and Angle Class III molar relationship. She showed disharmony in the crowding of the maxillomandibular dentition and midline deviation. The diagnosis and treatment plan were established by a three-dimensional (3D) virtual setup and 3D surgical simulation, and a surgical wafer was produced using the stereolithography technique. No presurgical orthodontic treatment was performed. Using the surgery-first approach, Le Fort I maxillary osteotomy and mandibular bilateral intraoral vertical ramus osteotomy setback were carried out. Treatment was completed with postorthodontic treatment. Thus, symmetrical and balanced facial soft tissue and facial form as well as stabilized and well-balanced occlusion were achieved.

• The korean journal of orthodontics
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• 제26권1호
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• pp.1-16
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• 1996

The purpose of this study was to evaluate the amount and interrelationship of the soft and hard tissue changes after simultaneous maxillary advancement and mandibular setback surgery in skeletal Class III malocclusion. The sample consisted of 25 adult patients(13 males and 12 females) who had severe anteroposterior skeletal discrepancy. These patients had received presurgical orthodontic treatment and surgical treatment which consisted of simultaneous Le Fort I or Le Fort II osteotomy and bilateral sagittal split ramus osteotomy. The presurgical and postsurgical lateral cephalograms were evaluated. The computerized statistical analysis was carried out with SPSS/$PC^+$ program. The results were as follows. 1. The correlation of maxillary hard and soft tissue horizontal changes were high and the ratios for soft tissue to A point were $71\%$ at Sn, $67\%$ at SLS and $37\%$ at LS. 2. The correlation of mandibular hard and soft tissue horizontal changes were very high and the ratios were $84\%$ at LI, $107\%$ at ILS, $96\%$ at Pog' and $97\%$ at Gn'. 3. The correlation of mandibular hard tissue horizontal changes and soft tissue vertical changes were moderate. 4. The upper to lower lip length were increased(P<0.001). 5. The soft tissue thickness were decreased in upper lip and increased in lower lip(P<0.001). The postsurgical changes were reversely correlated with initial thickness in upper lip.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권4호
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• pp.348-356
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• 2001

The factors related to relapse in 20 skeletal class III patients who performed two-jaw surgery with Le Fort I maxillary osteotomy and bilateral sagittal split ramus osteotomy was investigated. All patients were fixed with miniplate on the maxilla and three screws at each mandible. Cephalograms taken at preoperative, immediate postoperative and 8 months postoperative after surgery were traced and digitized. 1.The horizontal and vertical relapse of maxilla and mandibular chin points was within 1mm postoperatively. Compare to the preceding report concerning the mandibular set-back surgery only group, this reveals two-jaw surgery for mandibular prognathism using rigid fixation is more stable. 2.Although there was no significant relapse tendancy was observed at chin points, the screw tip land-marks moves anterio-superiorly and each side of the screws moved as a one unit. The screw tip points moved similar direction to the masticatory force and this movements might be influenced by the muscular tension to the distal segment of the mandible. 3.According to the regression analysis, the amount of horizontal and vertical movement of mandibular set-back influenced the mandibular relapse. However, direction and amount of maxillary surgical movement did not inf1uenced the maxillary and mandibular relapse.

• Korean Journal of Cleft Lip And Palate
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• 제10권1호
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• pp.57-65
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• 2007

It is well known that the main factor which contributes to the relapse of orthognathic surgery for Cleft Lip and Palate (CLP) patients is post-operative scar on hard and soft palate of maxilla. Therefore, to compensate the amount of relapse, though it cannot be the perfect way to prevent orthodontic, orthopedic relapse, the Le-fort I osteotomy of maxilla and set-back osteotomy of mandible are generally carried-out simultaneously. We are to review the factors contribute to the relapse of CLP patients after orthognathic surgery through this clinical case : The relapse of Skeletal Class III tendency immediately after orthognathic surgery for grown up CLP patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권5호
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• pp.407-412
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• 2011

Purpose: The purpose of the present study was to evaluate the postoperative skeletal stability of two-jaw surgery (Le Fort I osteotomy and bilateral sagittal split ramus osteotomy) via surgery first orthodontic treatment (SFOT) in class III malocclusion. Methods: Thirty-two patients who had two-jaw surgery via SFOT were included in this study. Serial lateral cephalograms were obtained before (T0), immediately after (T1), and six months after (T2) surgery. Twelve variables were measured for horizontal and vertical skeletal stability as well as for dental change. All measurements were evaluated statistically by a paired t-test ($P$ <0.05). Results: The mean skeletal changes were $0.1{\pm}2.5$ mm at point A and $-12.0{\pm}7.4$ mm at the pogonion. The mean horizontal relapse was 11.6% at the pogonion, and the mean vertical surgical changes included an upward displacement of $2.1{\pm}7.1$ mm and a forward displacement of $1.4{\pm}4.6$ mm at the pogonion. Upper incisor inclination decreased after surgery and was maintained at T2, and lower incisors were proclined from T1 to T2 by postsurgical orthodontic treatment. Conclusion: Postoperative skeletal stability of two-jaw surgery via surgery first orthodontic treatment in class III malocclusion was clinically acceptable.