Purpose: Although there have been several studies of reduced airway space after mandibular setback surgery using the sagittal split ramus osteotomy technique, research on the risk factors for changes of the airway space is lacking. Therefore, this study was performed to examine airway changes and the position of the hyoid bone after orthognathic surgery, and to assess possible risk factors. Methods: In this retrospective study, 50 patients who underwent posterior displacement of the mandible by the bilateral sagittal split ramus osteotomy technique were included. Changes of the position of the hyoid bone and the airway space were analyzed over various follow-up periods, using cephalometric radiography taken preoperatively, immediately after surgery, eight weeks after surgery, six months after surgery, and one year after surgery. To identify risk factors, multiple regression analysis of age, gender, body mass index (BMI), posterior mandibular movement, and the presence of genioplasty was performed. Results: Inferor and posterior movement of the hyoid bone was observed postoperatively, but subsequent observations showed regression towards the anterosuperior aspect. The airway space also significantly decreased after surgery (P<0.05), and increased slightly up until six months after surgery. The airway space significantly decreased (${\beta}=0.47$, P<0.01) as the amount of mandibular setback increased. However, age, sex, BMI, and presence of genioplasty were not associated with airway reduction. Conclusion: The amount of mandibular set back was significantly associated with postoperative reduction of airway space. It is necessary to establish a treatment plan considering this factor.
Objective: To compare postoperative positional changes in the mandibular proximal segment between the conventional orthognathic surgery (CS) and the surgery-first approach (SF) using intraoral vertical ramus osteotomy (IVRO) in patients with Class III malocclusion. Methods: Thirty-eight patients with skeletal Class III malocclusion who underwent bimaxillary surgery were divided into two groups according to the use of preoperative orthodontic treatment: CS group (n = 18) and SF group (n = 20). Skeletal changes in both groups were measured using computed tomography before (T0), 2 days after (T1), and 1 year after (T2) the surgery. Three-dimensional (3D) angular changes in the mandibular proximal segment, condylar position, and maxillomandibular landmarks were assessed. Results: The mean amounts of mandibular setback and maxillary posterior impaction were similar in both groups. At T2, the posterior portion of the mandible moved upward in both groups. In the SF group, the anterior portion of the mandible moved upward by a mean distance of 0.9 ± 1.0 mm, which was statistically significant (p < 0.001). There were significant between-group differences in occlusal changes (p < 0.001) as well as in overjet and overbite. However, there were no significant between-group differences in proximal segment variables. Conclusions: Despite postoperative occlusal changes, positional changes in the mandibular proximal segment and the position of the condyles were similar between CS and SF, which suggested that SF using IVRO achieved satisfactory postoperative stability. If active physiotherapy is conducted, the proximal segment can be adapted in the physiological position regardless of the occlusal changes.
Purpose : To evaluate the effect of deviation of mandibular positioning, by changing the mandibular plane inclination, on the measured height and width of mandible in spiral conventional tomography. Materials and Methods : By means of the Scanora multifunctional unit, cross-sectional tomograms were taken from two human dried mandibles at the mandibular angulations: -15 degree, -10 degree, -5 degree, and 0 degree. Twenty-eight sites in two dried mandibles were imaged. One examiner measured the bone heights and widths at selected sites on the images and the actual bone heights were recorded. Results : The bone heights at the four mandibular inclinations overestimated real bone heights and the mean difference between actual heights and image heights on 0 degrees was the smallest (P<0.01). The bone widths on -15 degrees were narrowest and there were significant differences between bone widths measured at the four mandibular inclinations (P<0.001). We found statistically significant differences between both bone heights and widths as measured according to the mandibular plane angle for the posterior region (P<0.01). Conclusion : The use of different mandibular positioning may result in discrepancies in heights and widths when measured from the cross-sectional tomographic images. It is suggested that the mandibular positioning may play a significant role in the measurement of mandibular heights and widths.
Komal Sheth;Kulvinder Singh Banga;Ajinkya M. Pawar;James L. Gutmann;Hyeon-Cheol Kim
Restorative Dentistry and Endodontics
/
v.47
no.1
/
pp.1.1-1.13
/
2022
Objectives: This study assessed the shape and anatomical relationship of the mental foramen (MF) to mandibular posterior teeth in an Indian sub-population. Materials and Methods: In total, 475 existing cone-beam computed tomography records exhibiting 950 MFs and including the bilateral presence of mandibular premolars and first molars were assessed. Images were evaluated 3-dimensionally to ascertain the position, shape, and anatomical proximity of MFs to mandibular teeth. The position and shape of MFs were measured and calculated. The Pythagorean theorem was used to calculate the distance between the root apex of the mandibular teeth and the MF. Results: MFs exhibited a predominantly round shape (left: 67% and right: 65%) followed by oval (left: 30% and right: 31%) in both males and females and in different age groups. The root apices of mandibular second premolars (left: 71% and right: 62%) were closest to the MF, followed by distal to the first premolars and mesial to the second premolars. The mean vertical distance between the MF and the nearest tooth apex calculated on sagittal sections was 2.20 mm on the right side and 2.32 mm on the left side; no significant difference was found according to sex or age. The distance between the apices of the teeth and the MF was ≥ 4 mm (left; 4.09 ± 1.27 mm and right; 4.01 ± 1.15 mm). Conclusions: These findings highlight the need for clinicians to be aware of the location of the MF in treatment planning and while performing non-surgical and surgical endodontic procedures.
This study was designed to compare extreme variations in facial growth in order to examine the relationships between the glenoid fossa position and skeletal malocclusions. It was hypothesized that patients with large mandibular plane-sella nasion angles would have a more superior fossa position than patients with small mandibular plane-sella nasion angles. It was also hypothesized that patients with large ANB angles would have a more posterior fossa position than patients with small ANB angle. For this study, the data from lateral roentgenocephaloprams of 72 Females and 72 males aged from 10 to 18 years were used. The results were as follows 1. In the case of large ANB angle, glenoid fossa position was relatively posterior than that of small ANB angle in Female, but it was not significant in male. 2. In the case of large APDI, glenoid fossa position was relatively anterior in female, but it was not significant in male. 3. In the case of large SN-Go Gn angle, glenoid fossa position was relatively superior in both male and female. 4. In the case of large ODI, glenoid fossa position was relatively inferior in both male and female.
This study was performed to investigate the effect of change of body posture on the rest position and the rotational torque movement of the mandible. Thirty dental students without any signs and symptoms of temporomandibular disorders and with natural dentition were selected for this study. Cervical inclination and the amount of the mandibular movement on protrusion, on left and right excursion, and on tapping in three body postures such as sitting position, supine position without pillow, and supine position with pillow were measured by goniometer, Cervical-Range-of-$Motion^{(R)}$, and mandibular tracking device, $BioEGN^{(R)}$ with $Rotate!^{(R)}$ program. The data obtained were classified and processed according to body posture and type of lateral guidance with SPSS windows program and the results were as follows: 1. There was significant difference among the three cervical inclinations by body postures. 2. Comparison of mandibular rest positions among body postures showed significant difference only for lateral distance in frontal plane, but comparison between before and after swallowing showed significant difference except for the lateral distance, vice versa. 3. Distance and amount of the rotational torque movement on protrusion and/or lateral excursions didn't show any difference by body posture. But by both body posture and lateral guidance type, there were slightly significant difference for some items. 4. A significant difference was shown for the rotational torque movement in frontal plane on tapping by body postures, for the lateral distance in frontal plane on sitting position by lateral guidance type, and for the rotational torque movement in frontal plane by both body posture and lateral guidance type.
This study was carried out to investigate the relationship between tensed mandibular positions, muscle tenderness and EMG activity, respectively, and between range of motion of the neck and sternocleidomastoid muscle tenderness. Under stressful conditions, most of people take several types of behavioral patterns. Two of them observed frequently are clenching of teeth and grasping of fist. Prolonged clenching or grasping should increase electromyographic activity of associated muscle, especially muscles of mastication and neck muscles and will cause hyperfunction, dysfunction and muscle pain. So it is necessary to relate EMG activity with muscle pain. The author performed routine clinical examination in 47 patients with Temporomandibular Disorders, especially for presence or absence of muscle tenderness. Mandibular rest position was used as a baseline reference position and two more position in which EMG activity was taken were rest postion with grasping of fist and teeth clenching position. BioEMG of Biopak system (Bioresearch Inc, USA) was used for measuring of integrated EMG in masseter, anterior temporalis, anterior belly of digastic muscle and sternocleidomastoid muscle. To measure of the range of neck motion. CROM(Cervical-Range-of Motion, USA) was used. The obtained results were as follows : 1. EMG activity of all muscles except in masseter was higher in grasping of fist than those in rest position and there were significant correlation in EMG activity between the two position except in anterior belly of digastric muscle. 2. When comparing EMG activity between tender and non-tender muscle, all examined muscles did not show any significant difference. From this data, we could conclude that EMG activity was generally not changed with tenderness, of couse, it might be dependent with degree of muscle tenderness. 3. Number of tender points in examined muscles was also not significantly different between in patients with masticatory muscle disorders and in patients with internal derangement. 4. Cervical posture and range of motion of the neck was not differed significantly between in patients with and in patients without tenderness of sternocleidomastoid muscle.
Journal of Dental Rehabilitation and Applied Science
/
v.22
no.4
/
pp.271-281
/
2006
Long term prediction of surgical result of skeletal class III has not been evaluated adequately because the stability of orthognathic surgery would be affected by not only set back amount of mandible but also many other factors like skeletal pattern, hyoid position, and airway size. The aimof this study is to discriminate the factors which affect the stability of post-treatment result of surgical outcome of sagittal split ramus osteotomy. We have collected 37 patients (male: 17, female: 20) from patients who have been treated at Orthodontic Department in Dankook University. The patients underwent 3 times Cephalometric X-ray taking at pre-, post-orthognathic surgery and after 12 months retention. The subjects were divided into 2 groups (Stable group: 21, Relapse group: 16) according to their relapse amount. We have taken following results from Students t-test and discriminant analysis. The discriminant factors which discern relapse and stable groupe among treatment change variables were BX and Ba-HY. Hyoid bone moved to posterior and inferior position due to surgery and repositioned superiorly and posteriorly during retention period. Skeletal patterns of the relapse group are smaller mandibular plane angle, anterior mandibular position, and greater distance from hyoid bone to cervical bone and mandible respectively.
If the centric prematurity occurs after orthodontic treatment, it creates centric slide regarded as a possible factor in the cause of temporomandibular disorder and/or postorthodontic relapse. The purpose of this study was to investigate the manner of centric prematurity and centric slide in postorthodantic patients. The 36 orthodontic patients who had been treated with edgewise appliance at least 3 mouths previously were used in this study. After recording centric relation by the leaf gauge technique, the centric prematurity and centric slide were studied using SAM2 articulator and mandibular position indicator. The results were as follows : 1. The highest percentage of centric prematurities were found on the second molars. 2. The buccal incline of the palatal cusp was the most frequent area of centric prematurities in the maxilla, while the lingual incline of the buccal cusp was the most frequent area in the mandible. 3. There were no trends in the direction of centric slide on the mandibular position indicator. 4. There were no significant differences in centric discrepancies between the premolar extraction and nonextraction group.
The purpose of this study was to investigate the growth changes of maxilla and mandible and position changes of first permanent molars of growing children The author analyzed the data using cephalometric roentgenogram of 43 boys and 39 girls age of 6 to 11 with normal occlusion The obtained results were as follows 1 The eruption path of maxillary and mandibular first permanent molar superimposed on TM-ANS and mandibular plane shows individual variation 2 There was no correlation between horizontal and vertical changes of maxillary first permanent molar, but positive correlation in mandibular first permanent molar 3 As the eruption, the forward changes of mandibular first permanent molar was significantly greater than that of maxillary first permanent molar 4 As the ages were increased, there were irregular growth changes of maxilla and mandible 5 Growth changes of lower anterior facial height was relatively stable 6 N-S-${\bar{6}}$ was stable after age 7.
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