• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권2호
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• pp.141-147
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• 2007

The purpose of this study was to evaluate the effects of maxillary occlusal plane angle to postoperative skeletal stability by comparative analysis after two-jaw surgery of patients with skeletal CIII malocclusion. This study was made with lateral cephalometric radiography of 52 patients with skeletal class III malocclusion that were performed to Le Fort I osteotomy and BSSRO. And 52 patients were divided to Group A(n=30) and B(n=22). Maxillary posterior impaction was not conducted in Group A, which the pre-operative maxillary occlusal plane angle was in a normal range, and for Group B, which the pre-operative maxillary occlusal plane was low, the maxillary posterior impaction was conducted. The results were obtained as follows : 1. The relapse rate of Group A, which the pre-operative maxillary occlusal plane angle was in a normal range, was relatively stable compared to Group B, which the pre-operative maxillary occlusal plane was low. 2. The relapse rate of each measurement of Group B, which had the maxillary occlusal plane altered during the operation, was somewhat high, and of those, the post-operative relapse rate of overjet, overbite, mandibular plane angle appeared to be significantly high in the statistics. The analyzed results above, was thought to be indicating that the pre-operative maxillary occlusal plane angle was closely related to the post-operative skeletal stability, and that obtaining post-operative skeletal stability only through operative normalization of occlusal plane angle may meet limitations.

• 대한치과교정학회지
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• 제29권4호
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• pp.457-466
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• 1999

하악 후퇴술 후의 골격성 재발과 치열 변화는 악간고정(intermaxillary fixation, IMF)제거 후 뿐만 아니라 악간고정기간 중에도 일어난다고 보고되고 있다. 악간고정기간 중에 일어나는 골격성 재발에 따른 골편간 견고한 융합의 방해, 보상성 치아이동, 전치부 개방교합 등과 같은 여러 가지 부작용은 술후 교정치료에 많은 영향을 미칠 수 있으므로 임상적으로 중요한 의미를 갖는다. 본 연구는 악간고정기간 중에 일어나는 골격성 재발과 치열의 변화를 알아보고자 시행하였으며, 하악전돌증의 치료를 위해서 양측성 하악지 시상분할골절단술(bilateral sagittal split ramus osteotomy, BSSRO)과 강선고정 (wire fixation), 악간고정을 시행한 28명을 대상으로 하였다. 본 연구에서는 측모 두부 방사선 사진을 통하여 수술에 의한 골편들의 이동량과 방향, 악간고정기간 중의 골격성 재발과 치열 변화의 양과 방향을 측정하였다. 또한 수술에 의한 골편들의 이동과 골격성 재발과의 상관관계, 골격성 재발과 치열 변화간의 상관관계를 평가하였다. 본 연구를 통하여 다음과 같은 결론을 얻었다. 1. 수술에 의한 골편의 이동방향은 원심골편은 후상방으로, 근심골편은 시계방향으로 회전하였다. 2. 악간고정기간 중에 원심골편의 전방부는 후방 변위, 후방부는 상방 변위하였으며 근심골편은 상방 변위와 함께 근심골편의 gonion(p-Go)부위는 전방 변위를 하였다. 악간고정기간중에 근심골편의 gonion(p-Go)의 전방 변위는 수술에 의한 근심골편의 gonion (p-Go)의 후방으로의 이동량과 유의한 상관관계를 보였다. 즉, 수술에 의한 근심골편의 gonion(p-Go)의 후방으로의 이동이 많을수록 악간고정기간 중의 근심골편의 gonion(p-Go)의 전방 변위는 증가하였다. 3. 악간고정기간 중에 수평피개, 수직피개는 변화가 없었다. 상악 전치부는 후방경사(retroclination), 하악 전치부는 후방경사, 정출이 일어났으며, 이러한 보상성 치아이동은 악간고정기간 중의 근심골편의 gonion(p-Go)의 상방 변위와 유의한 상관관계를 보였다. 즉, 악간고정기간 중의 근심골편의 gonion(p-Go)의 상방 변위가 클수록 보상성 치아 이동량도 증가하였다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권2호
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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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권2호
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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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• 제15권3호
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• pp.229-237
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• 1993

자자는 1991년 2월부터 1993년 2월까지 경북대학교병원 구강악안면외과에 하악전돌 및 개구교합을 주소로 내원하여 하악골 시상골절단술을 이용하여 악교정 수술을 받은 환자중 추적 조사가 가능했던 9명의 개구교합을 동반한 하악 전돌증 환자와 개구교합이 없는 하악 전돌증 환자 9명, 총 18명을 대상으로 두부 상사선 규격사진을 이용한 술후 재발에 관한 연구를 시행하여 다음과 같은 결과를 얻었다. 1. 비개구교합군에 비해 개구교합군에서 술전 전안면고경, 하악 하연 평면각 및 하악 우각부 값이 더 크게 나타났으나 유의성은 없었다.(p>0.05) 2. 개구교합군에서 수술시 SNB 값과 하악 하연 길이의 변화량이 하악의 재발과 통계적으로 유의한 상관 관계가 있었다.(p.<0.01) 3. 개구교합군에서 전안면고경은 술후 비교적 안정되어 있었다. 4. 개구교합군과 비개구교합군에서 수술에 의한 하악 하연 평면각의 변화와 하악의 수평 이동량은 재발과 상관 관계가 없었다.(p>0.01) 5.개구교합을 가진3급 부정교합 환자에서 하악골 시상골 절단술을 시행시 본 연구에서는 수직적 재발보다는 수평적 재발에 문제가 있었다.

• Archives of Plastic Surgery
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• 제44권1호
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• pp.19-25
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• 2017

Background Numerous condylar repositioning methods have been reported. However, most of them are 2-dimensional or are complex procedures that require a longer operation time and a highly trained surgeon. This study aims to introduce a new technique using a condylar repositioning plate and a centric relation splint to achieve a centric relationship. Methods We evaluated 387 patients who had undergone surgery for skeletal jaw deformities. During the operation, a centric relation splint, intermediate splint, final centric occlusion splint, and condylar repositioning plate along with an L-type mini-plate for LeFort I osteotomy or a bicortical screw for bilateral sagittal split ramus osteotomy were utilized for rigid fixation. The evaluation included: a physical examination to detect preoperative and postoperative temporomandibular joint dysfunction, 3-dimensional computed tomography and oblique transcranial temporomandibular joint radiography to measure 3-dimensional condylar head movement, and posteroanterior and lateral cephalometric radiography to measure the preoperative and postoperative movement of the bony segment and relapse rate. Results A 0.3% relapse rate was observed in the coronal plane, and a 2.8% relapse rate in the sagittal plane, which is indistinguishable from the dental relapse rate in orthodontic treatment. The condylar repositioning plate could not fully prevent movement of the condylar head, but the relapse rate was minimal, implying that the movement of the condylar head was within tolerable limits. Conclusions Our condylar repositioning method using a centric relation splint and miniplate in orthognathic surgery was found to be simple and effective for patients suffering from skeletal jaw deformities.

• 대한치과교정학회:학술대회논문집
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• 대한치과교정학회 1999년도 제32회 학술대회
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• pp.45.2-46
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• 1999

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권4호
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• pp.407-413
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• 2000

To evaluate the stability after orthognathic surgery in cleft lip and palate patients using rigid fixation, 20 patients underwent primary repair in childhood and later developed a jaw deformity and malocclusion that required orthognathic surgery were reviewed. Two groups, one of 10 patients performed Le Fort I osteotomy with sagittal split ramus osteotomy and one of 10 patients with sagittal split ramus osteotomy of the mandible, were evaluated. Each group had unilateral cleft only and all alveolar cleft sites had been grafted with autogeneous bone before the orthognathic surgery. The amount of surgical movement and relapse were compared in both horizontal and vertical dimensions. Two-jaw surgery group was more stable than mandibular surgery only group in mandibular position (p< 0.05). Statistically significant relapse was observed in mandibular skeletal point in mandibular surgery group (p<0.05). There was no statistically significant relapse in the skeletal point of two-jaw surgery group. However, the correlation between the horizontal surgical movement and relapse was detected (r = 0.88). This correlation indicates the need of overcorrection. The presence of scar tissues and relatively deficient maxillary bone could be attributed to this close relation between the surgical change and relapse.

• 대한치과교정학회지
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• 제34권4호
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• pp.313-324
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• 2004

본 연구에서는 성장기 골격성 III급 부정 교합 한자의 치료 전 측모 두부방사선 계측사진에서 얻을 수 있는 골격성, 치성 분석을 통하여 안정군과 재발군을 구별하여 주는 요소를 찾아보아 III급 부절 교합의 치료시 안정성을 고려한 치료 선택에 도움을 주고자 하였다 고정식 교정 장치를 통한 전치부 반대 교합 혹은 절단 교합의 골격성 III급 부정 교합 치료 후 최소 1년 동안 안정된 결과를 보인 안정군 33명과 관찰 기간 동안 절단 교합 이하의 수평 피개를 보인 재발군 22명을 연구 대상으로 하여 비교하였으며 t-test를 시행하여 다음과 같은 결론을 얻었다. 1. 건후방적 골격 형태보다는 수직적 형태, 특히 AB-maxillo-mandibular triangle내의 수직적 형태가 III급 부정 교합치료의 예후에 주요한 결정 인자로 나타났다. 수직 각도 계측 항목에 의한 안정군과 재발군간의 비교에서 유의성 있는 차이를 보인 항목은 AB-MP, ODI로 나타났다(P<0.01). 수직 비율 계측 항목에서도 MP-P/AL, PP-P/AL항목이 유의성 있는 차이를 보였다(P<0.05). 2. 재발의 경향은 교합 평면 특히. 하악 교합 평면이 전하방으로 급경사를 이룰수록 증가했다. 친합 평면 경사도와 관련된 계측 항목에 의한 안정군과 재발군간의 비교에서 OP(L)-PP, OP-PP, AB-OP(L), Wits appraisal항목이 유의성 있는 차이를 보였다(P<0.05). 본 연구는 전후방 부조화가 아닌 골격성, 치성 수직 부조화가 재발을 예측하는 적절한 기준이 됨을 시사하였다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권1호
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• pp.29-34
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• 1999

Special attention should be directed toward the preservation of preoperative condylar position during orthognathic surgery because their positional change may leads to postoperative skeletal relapse as well as TM joint problem. Various condylar positioning devices, therefore, have been introduced and utilized in orthognathic surgery. Even though most of them provided us with improvement of surgical results, we also found some problems including limited indication, etc. For more accurately repositioning the maxilla and the mandible and its wide versatility, a newly designed maxilla and condylar positioning device based on the fixed part of cranium is introduced.