• Journal of International Society for Simulation Surgery
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• v.1 no.1
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• pp.23-26
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• 2014

The aim of this report is to evaluate accuracy using3D surgical simulationand digitally printedwafer in orthognathic surgery. 22-year-old female was diagnosed with mandibular prognathism and apertognathia based on 3D diagnosis using CT. Digital dentition images were taken by laser scanning from dental cast, and each STL images were integrated into one virtual skull using simulation software. Digitalized intermediate wafer was manufactured using CAD/CAM software and 3D printer, and used to move maxillary segment in real patient. Constructed virtual skull from 1 month postoperative CT scan was superimposedinto simulated virtual model to reveal accuracy. Almost maxillo-mandibular landmarks were placed in simulated position within 1 mm differences except right coronoid process. Thus 3D diagnosis, surgical simulation, and digitalized wafer could be useful method to orthognathic surgery in terms of accuracy.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.18.1-18.9
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• 2016

Background: The aim of this study was to examine the relationship between improvements in lip asymmetry at rest and while smiling after orthognathic surgery in patients with skeletal class III malocclusion. Methods: This study included 21 patients with skeletal class III malocclusion and facial asymmetry. We used preoperative and postoperative CT data and photographs to measure the vertical distance of the lips when smiling. The photographs were calibrated based on these distances and the CT image. We compared preoperative and postoperative results with the t test and correlations between measurements at rest and when smiling by regression analyses. Results: There were significant correlations between the postoperative changes in canting of the mouth corners at rest, canting of the canines, canting of the first molars, the slope of the line connecting the canines, and the slope of the line connecting first molars. The magnitude of the postoperative lip line improvement while smiling was not significantly correlated with changes in the canting and slopes of the canines, molars, and lip lines at rest. Conclusions: It remains difficult to predict lip line changes while smiling compared with at rest after orthognathic surgery in patients with mandibular prognathism, accompanied by facial asymmetry.

• Journal of Dental Rehabilitation and Applied Science
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• v.22 no.4
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• pp.271-281
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• 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.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.2
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• pp.190-197
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• 2011

The management of mandibular prognathism was revolutionized by the advent of the of sagittal split ramus osteotomy (SSRO) technique as described by Obwegesser and Trauner in 1957. Facial nerve palsy following SSRO is a rare but serious problem. In the event of post-operative facial palsy, careful clinical and neurophysiological investigations such as a nerve condunction test for facial function is mandatory. The authors examined patients with facial palsy following SSRO. Patients recovered after 3~4 months and we had performed clinical examinations with electromyography and nerve conduction tests during follow-up period.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.4
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• pp.383-390
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• 2000

The purpose of this study was to compare the soft tissue movements in facial profile predicted by a computer package with those that had actually accured following a sagittal split ramal osteotomy. The reliability of predicting the results of orthodontic surgical treatment was analysed. The study was based on the serial records of 30 consecutive patients who had been treated by means of a sagittal split ramal osteotomy. The serial lateral cephalometric radiographs used for the study were taken at the following stages: immediate preoperative : immediate postoperative : 6 months postoperative. A superimposition T1, T2-3 was generated to allow visual comparision. The results can be considered in relation to four important parts of the facial profile :the nose, upper lip, lower lip, and chin. The nose & Upper lip:The amount of movement of the upper lipwas not badly predicted for the average case. The lower lip: There was a significant trend over the whole sample for vertical positionof the lower lip to be less well predicted. The chin: The soft tissue movements of the chin were well predicted.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.2
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• pp.95-101
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• 2003

The purpose of this study was to evaluate the patterns of skeletal changes of proximal and distal segments after one jaw surgery and two jaw surgery with posterior impaction using SSRO on mandible in order to determine the skeletal origin of relapse and compare the stability of surgical methods in anterior open bite. The points and lines from lateral cephalometrics were measured before, after surgery, and at least 6-month follow up period. And then, the positional change of the proximal and distal segment were evaluated respectively. The results obtained were as follows; In cases of two jaw surgery, the results were stabler because they had less relapse factors. In cases of one jaw surgery, the value of APD were increased but it didn't relapse to the original value. Both of proximal and distal segments were responsible for the relapse tendency. But in one jaw surgery, the rotation of proximal segment was more responsible, and in two jaw surgery, the rotation of distal segment was.

• Archives of Craniofacial Surgery
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• v.18 no.1
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• pp.65-70
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• 2017

A 25-years-old woman with mandibular prognathism underwent a mandibular setback by way of mandibular sagittal split ramus osteotomy (MSSRO). After 2 days of operation, she developed difficulty of closing her right eye. The blink reflex test and motor nerve conduction study of the right orbicularis oris muscle were revealed right facial neuropathy of unknown origin and House-Brackmann facial nerve grading system (HBFNGS) grade V. For treatment, we initially prescribed oral prednisolone and nimodipine including physical therapy. The samples consisted of 11 facial nerve palsy patients caused by MSSRO and were analysed about onset of facial nerve palsy, postoperative HBFNGS, final HBFNGS, treatment method and recovery time. At 10 weeks of treatment of nimodipine, she had completely regained normal function (HBFNGS grade I) of the right facial nerve. The clinical results lead to assume a fast recovery of facial nerve function by the nimodipine medication, whereas average time of recovery is 16.32 weeks in references. Despite of the limited one patient treated, the result was very promising with respect to a faster recovery of the facial nerve function. Considering the use of nimodipine treatment for peripheral facial nerve palsy following a surgical approach with an anatomically preserved nerve can be recommended.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.2
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• pp.191-198
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• 1991

This is a case report and review of literature of the facial asymmetry corrected by various surgical methods. In case 1, facial asymmetry resulted from osteochondroma of condyle and corrected via condylectomy only. In case 2, unilateral condylar hyperplasia with compensatory maxillary growth resulted in severe facial asymmetry. Procedures used in case 2 are vertical ramus osteotomy, condylectomy, genioplasty, mandibular inferior border ostectomy and Le Fort I osteotomy.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.2
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• pp.184-190
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• 2000

Objective : To compare two different methods of rigid fixation in postoperative stability after mandibular setback. Material and Methods : 28 patients with Class III malocclusion were treated by bilateral sagittal split ramus osteotomy(BSSRO) and mandibular setback were selected for this study. Group A(n=14) had the bone segments fixed with monocortical miniplate on the lateral side of the mandibular body and Group B(n=14) had three noncompressive bicortical screw inserted at the genial area through a transcutaneous approach. Cephalograms were taken preoperatively, postoperatively within 1 weeks and at a follow-up period (mean 8.9 months after surgery) and the amount of setback and postoperative change were measured. Results : Postoperative relapse between two groups was minimal in setback of the mandible. Statistical analysis showed no significant difference in postoperative relapse. Conclusion : This study suggests that both methods of skeletal fixation investigated give comparable postoperative stability and their use in mandibular setback appears to be a fairly stable clinical procedure .

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.4
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• pp.563-569
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• 1996

Skeletal and dental changes were examined in 38 patients of mandibular prognathism who been treated by a bilateral sagittal split osteotomy(SSRO) and internal fixation using titanium mini-screws. All patients were followed up for over 8 months after the surgeries, and postoperative cephalometric measurements were compared at 2 months and at 8 months. Linear measurements of the "Pog-most posterior screws" and angular measurementsts of "SN-Pog'were compared to figure out the change of bony fragments. The significancy of data were tested by unpaired T-test. The results were as follows : 1. The fixation screws were changed in cephalometric position as little as $0.32{\pm}2.51mm$ in SSRO and $0.15{\pm}1.00mm$ in SSRO & Le Fort I Osteotomy.(P<0.05) 2. Mandibular set-back over 5mm resulted in less stability of the fixation screws and higher relapse tendency. 3. The internal fixation using two screws along the inferior border and one on the superior ridge is considered to be very resistant to postoperative relapse of the repositioned bony segments.