• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.2
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• pp.126-131
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• 2010

Objectives: This study is aimed to determine any differences in the postoperative stability between absorbable and titanium plate systems for fixation in orthognathic surgery with simultaneous maxillomandibular procedures especially including maxillary posterior impaction and advancement. Study Design: Forty patients with dentofacial deformities were randomly assigned into titanium (4 males and 6 females) and absorbable (17 males and 13 females) fixation group. All patients had undergone surgical alterations of maxilla with posterior impaction and advancement. A comparison study of the change in the maxillary position after the simultaneous surgery was performed with 1-day, 6-months postoperative lateral cephalograms compared to preoperative lateral cephalogram by tracing. Wilcoxon rank sum test was used for statistical analysis. Result: The position of the maxilla was stable after surgery and was not changed significantly from 1 day to 6 month after the simultaneous maxillomandibular surgery both in the experimental (absorbable plates) and control (titanium plates). Conclusion: This study suggests that application of absorable plating system in the fixation of maxillary segment in the simultaneous maxillomandibular procedures, leads to a predictable short-term postoperative skeletal stability comparable to the titanium plating system. Long term follow-up and further studies will be needed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.2
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• pp.148-156
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• 2007

Purpose: The aim of this study is the changes of upper respiratory airway space in patients with mandibular prognathism after 2-jaw orthognathic surgery in patients with skeletal classs III malocclusion. Method: We measured the lines between selected upper airway landmarks on lateral cephalometric x-ray films of skeletal class III 64 persons who had not been operated yet, were 6 months after operation. The test subjects were divided into 3 groups according to maxillary movement, as follows; maxillary advancement (MA) group, maxillary posterior impaction (MPI) group, maxillary posterior impaction and superior repositioning (MPI+MSR) group. Result: In this study, nasopharyngeal airway space in MPI+MSR group was significantly increased after operation (p<0.05). Oropharygeal and hypopharyngeal airway space in MA group and MPI group were significantly decreased after operation (p<0.05). From hyoid bone to anterior mandible point distance in MA group and MPI group were significantly decreased after operation (p<0.05). Conclusion: Oropharygeal and hypopharyngeal airway space were influenced more by mandibular set-back than maxillary movement. Maxillary movement surgery as well as mandibular setback surgery should be taken into consideration in order to minimize symptoms related to obstructive sleep apnea syndrome after operation.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.1
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• pp.21-26
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• 2006

Considering the skeletal class III malocclusion that complains of mandibular prognathism, there have been some studies of the mandibular change for comparing the changes of pre operative with post operative state. Nowadays it is common to do the orthognathic 2-jaw surgery for the correction of the maxillary deficiency, the post operative stability and the esthetics. We compare and analyze the changes of soft tissue around the nose and the lip with the changes in the direction and the amount of maxilla. Patients who were diagnosed as maxillofacial deformity and received orthognathic surgery of both jaws at Yongdong Severance hospital from 2001 through 2003 were included in this study. Their lateral cephalograms were analyzed, and the post operative change of hard tissue and soft tissue were studied. Upon analyzing the preoperative cephalograms and 6 month post operative cephalograms, there were significant in the vertical change of Labialis superius(Ls) and Stomion(Stm) in soft tissue in relation to the vertical change of skeletal landmarks (Anterior Nasal Spine, Subspinale, Prosthion, Incision Superious). In addition, there were no significance in horizontal movement of the skeletal landmarks among groups. In terms of hard tissue landmarks, group 3(maxillary posterior impaction and advancement surgery group) showed significantly greater change in the vertical movement of Anterior Nasal Spine(ANS), Subspinale(A), Prosthion(Pr), and Incision Superious(Is) compared with other groups. In terms of soft tissue change, group 3 showed more significant change in the vertical movement of Ls and Stm. This study calculated the changes of the skeletal and soft tissue landmarks in order to act as a guide in planning and performing the surgery and as a reference in predicting the postoperative change of facial appearance.

• The Journal of the Korean dental association
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• v.47 no.11
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• pp.750-757
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• 2009

Purpose : The purpose of this study is to evaluate the clinical availability of submentoplasty for esthethic improvement of the cervico-facial region of patients with obtuse chin-neck angle. Materials and methods : Case 1. We evaluate the changes of submental line length and chin-neck angle of 35-year-old woman with skeletal Class III and mandibular excess with excessive submental fat before and after surgery: Bilateral sagittal split ramus osteotomy(BSSRO) setback(5mm), Mandibular Angle Reduction, Reduction Malarplasty and Submentoplasty. In this case, It was done simultaneously with orthognathic surgery. Case 2. The changes of submental line length and chin-neck angle of 20-year-old man with skeletal class III and maxillary defiency were evaluated before surgery, at first surgery : Lefort I osteotomy(6mm posterior Impaction), BSSRO setback(9mm), Paranasal Augmentation and at second surgery: genioplasty(6mm advanced) with submentoplasty. In this case, submentoplasty and advancement genioplasty were done after 2 months post-operative periods. Results : Case 1. In case of the Skeletal Class III mandibular excess with submental fat deposit, It showed the improvement of submental angle and length of submental line after simultaneous submentoplasty. Submental angle is changed from $177^{\circ}$ (pre-op) to $151^{\circ}$ (post-op) and submental line length is changed from 8mm(pre-op) to 36mm(post-op). Case 2. The improvement of submental angle and length of submental line after delayed submentoplasty was aquired in case of the skeletal class III maxillary defiency. Submental angle is changed from $154^{\circ}$ (pre-op) to $161^{\circ}$ (first surgery) and to $153^{\circ}$ (second surgery) and submental line length is changed from 25mm(pre-op) to 19mm(first surgery) and to 23mm(second surgery). Conclusion : The results suggest that Submentoplasty is useful surgical procedure for esthethic improvement of the cervicofacial region of patients with obtuse chin-neck angle.