• Title/Summary/Keyword: setback

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Change of the upper airway after mandibular setback surgery in patients with mandibular prognathism and anterior open bite

  • Lee, Kyungjin;Hwang, Soon Jung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.51.1-51.8
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    • 2019
  • Purpose: It has been reported before that the amount of pharyngeal airway space (PAS) significantly decreases following mandibular setback (MS) surgery in patients with mandibular prognathism (MP). Further, MP patients with an anterior open-bite (AOB) presentation may show a larger decrease in PAS compared with those without AOB. However, studies on postoperative PAS changes in MP patients with AOB remain rare. This study sought to evaluate changes in PAS and hyoid bone positioning following MS surgery in MP patients with and without AOB. Patients and methods: Twenty patients who underwent two jaw surgery involving MS movement were included. Patients were divided into a non-AOB group (n = 10; overbite > 2 mm) and an AOB group (n = 10; overbite < - 4 mm). Three-dimensional changes in PAS and hyoid bone positioning were compared and statistically evaluated pre- and postoperatively using computed tomography (CT). Results: The mean magnitude of MS was 6.0 ± 2.8 mm and 5.6 ± 3.2 mm in the non-AOB group and AOB group, respectively. The oropharyngeal volume and upper hypopharyngeal volume were significantly reduced after surgery in both the groups (p = 0.006 and p = 0.003), while the retroglossal cross-sectional area was significantly reduced only in the AOB group (p = 0.028). Although the AOB group showed a larger decrease in PAS, the difference was not statistically significant between the groups. The position of the hyoid bone showed significant posterior and inferior displacement only in the AOB group, while the vertical displacement of the hyoid bone showed a statistically significant difference between the two groups. Conclusion: PAS was significantly decreased after MS in both the groups, while only the AOB group presented a statistically significant reduction in the retroglossal cross-sectional area. Vertical displacement of the hyoid bone showed a statistically significant difference between the groups, while the PAS change was not. Surgeons should be aware of potential postoperative airway problems that may arise when performing MS surgeries.

CHANGES OF THE HYOID BONE POSITION AND THE UPPER AIRWAY DIMENSION AFTER ORTHOGNATHIC SURGERY IN SKELETAL CLASS III PATIENTS (골격성 3급 부정교합자의 악교정 수술 후 설골 위치와 상기도 크기의 변화)

  • Kim, Ji-Yong;Ahn, Je-Young;Lim, Jae-Hyung;Huh, Jong-Ki;Park, Kwang-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.1
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    • pp.27-34
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    • 2006
  • After orthognathic surgery in skeletal class III patients, the hyoid bone position and the upper airway dimension could be changed due to mandibular setback. There has been many studies about airway dimension of the patients with skeletal class II malocclusion or obstructive sleep apnea. but not with skeletal class III. The purpose of this study was to examine the change of position of the hyoid bone and the consequent change of airway space as the result of retrusion of mandible after orthognathic surgery in skeletal Cl III malocclusion patients. It is also to apply this results in predicting, diagnosing and treating the subsequent obstructive sleep apnea. Forty patients who were diagnosed as skeletal Cl III maloccusion, received orthoganthic surgery of both jaws including mandibular setback, and were followed up post-operatively for more than 6 months were selected. There were 10 male patients 30 female patients. The preoperative and postoperative lateral cephalograms were traced and the distances and angles were measured. The nasopharyngeal space increased postoperatively while the oropharyngeal space decreased. Except for the change of oroparyngeal space, the changes in male patients were greater than female patients. The hyoid bone moved in the posterior-inferior direction, and the change was greater in males than in females. If the postoperative mandibular setback is great, then a significant decrease of airway space and posterior and inferior movement of the hyoid bone were observed. This can result in symptoms related to obstructive sleep apnea. This result should be considered in the diagnosis and treatment planning of orthognathic surgery patients.

The study of stability of absorbable internal fixation after mandibular bilateral sagittal split ramal osteotomy (하악골 양측 하악지 시상분할 골절단술 후 흡수성 고정의 안정성에 관한 연구)

  • Choi, Byoung-Hwan;Park, Su-Won;Jang, Soo-Mi;Son, Han-Na;Park, Bong-Chan;Son, Jang-Ho;Cho, Yeong-Cheol;Sung, Iel-Yong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.4
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    • pp.255-261
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    • 2010
  • Introduction: To evaluate the skeletal stability after a bilateral sagittal split osteotomy (BSSO) setback of the mandible fixed with a biodegradable internal fixation device or metal internal fixation device. Materials and Methods: Thirty consecutive patients underwent mandibular setback via BSSO. Fifteen patients were fixed with a biodegradable internal fixation device or metal internal fixation device respectively. Posteroanterior (PA) and lateral cephalograms were taken preoperatively and at two days, 5.5 months and 14.5 months postoperatively. The relevant skeletal points were traced and digitized to evaluate the skeletal changes postoperatively. The relapse rates were analyzed and compared statistically. Results: There was no statistically significant differences in postoperative stability between the two groups.(P<0.05) Conclusion: The biodegradable internal fixation device may make an effective device alternative to a metal internal fixation device for setback BSSO.

Immediate Fixation after Maxillary Distraction with Mandibular Setback Surgery in Cleft Lip and Palate Patient : Case Reports (구순구개열 환자에서 상악골 신장술 후 상악골의 견고고정과 하악 후방이동 수술의 동시시행 : 증례보고)

  • Song, Won-Wook;Lee, Hyo-Ji;Kim, Sung-Won;Jung, Jin-Hwan;Lee, Seul-Ki;Jeong, You-Min;Kim, Jong-Ryoul
    • Korean Journal of Cleft Lip And Palate
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    • v.12 no.2
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    • pp.85-94
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    • 2009
  • Cleft lip and palate patients show midface hypoplasia, maxillary hypoplasia due to scar of previous surgery, and manifest as a class III malocclusion, retruded midface and shallow palate. These deformities have been treated with traditional orthognathic surgery. Although conventional Le Fort I osteotomy was performed on most cleft patinets with midface hypoplasia, it showed limited amount of maxillary advancement and high relapse tendency. Recently, when great amount of advancement are required in severe maxillary hypoplasia, distraction osteogenesis using RED system is widely used. But, several months of consolidation period is needed after distraction osteogenesis, occlusal relationship is not stable until mandibular setback surgery has done in mandibular hyperplasia cases and during these period, patients may feel discomfort. We present clinical cases of immediate rigid internal fixation after completion of maxillary distraction using RED system and simultaneous mandibular setback procedure in adult cleft and lip patients who show both maxillary hypoplasia and mandibular prognathism.

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New method for an evaluation of the esthetical improvements resulting from a mandibular angle reduction

  • Kim, Joo-Hwan;Han, Se-Jin;Kim, Moon-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.4
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    • pp.239-246
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    • 2017
  • Objectives: This paper proposes Han's ratio as an objective and quantitative comparative result obtained from pre and postoperative data in patients with a mandibular angle reduction. Materials and Methods: Thirty patients, 12 men and 18 women, who visited the Department of Oral and Maxillofacial Surgery with the chief complaints of skeletal mandibular prognathism and prominent mandibular angle were selected. The subjects were classified into 3 groups according to the types of surgical procedures involved. Group A consisted of patients who underwent mandibular angle resection and mandibular setback. Group B was comprised of patients with mandibular angle resection, mandibular setback and genioplasty. Group C consisted of patients with mandibular angle resection, mandibular setback, Le Fort I osteotomy, and genioplasty. The landmarks placed in pre and postoperative frontal photographs were used to obtain the Han's ratio in each group. The Han's ratios were compared pre- and postoperation and according to the surgical techniques applied. Results: Of the 3 groups who had undergone a mandibular angle resection, all showed a statistically significant increase in Han's ratio. On the other hand, there was no statistically significant difference based on the surgical techniques used. Conclusion: The ratio of the lateral lower face proposed in this study is a potential indicator of postoperative esthetic enhancement in mandibular angle reduction surgery.

Qualitative correlation between postoperatively increased vertical dimension and mandibular position in skeletal class III using partial-least-square path modeling

  • Kim, Na-Ri;Park, Soo-Byung;Lee, Jihyun;Choi, Youn-Kyung;Shin, Sang Min;Choi, Yong-Seok;Kim, Yong-Il
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.39
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    • pp.15.1-15.7
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    • 2017
  • Background: This study constructed a partial-least-square path-modeling (PLS-PM) model and found the pathway by which the postsurgical vertical dimension (VD) affects the extent of the final mandibular setback on the B point at the posttreatment stage for the skeletal class III surgery-first approach (SFA). Methods: This study re-analyzed the data from the retrospective study by Lee et al. on 40 patients with skeletal class III bimaxillary SFA. Variables were obtained from cone beam computed tomography (CBCT)-generated cephalograms. Authors investigated all variables at each time point to build a PLS-PM model to verify the effect of the VD on the final setback of the mandible. Results: From PLS-PM, an increase in $VD_{10}$ was found to decrease the absolute value of the final setback amount of the mandible, which reflects the postsurgical physiological responses to both surgery and orthodontic treatment, which, in turn, can be interpreted as an increase in postoperative mandibular changes. Conclusions: To resolve the issue of collinear cephalometric data, the present study adopted PLS-PM to assess the orthodontic treatment. From PLS-PM, it was able to summarize the effect of increased postsurgery occlusal vertical dimension on the increased changeability of the B point position at the posttreatment stage.

The Effect of the Varieties and Particle Size on the Properties of Rice Flour (품종 및 입자크기가 쌀가루의 특성에 미치는 영향)

  • Kum, Jun-Seok;Lee, Hyun-Yu
    • Korean Journal of Food Science and Technology
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    • v.31 no.6
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    • pp.1542-1548
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    • 1999
  • Seven rice varieties(Suweonjo, Suweon232, BG276-5, IR44, IR41999-139, Suweon230 and Yongjubyeo) were used to study the effect of particle size on the physicochemical properties(proximate analysis, color values, amylogram, water absorption index and water solubility index) of rice flours. Suweonjo had the highest amylose content (27.07%) and Yongjubyeo had the lowest one (17.17%). Suweonjo had the highest protein content (11.36%) and IR44 had the lowest one (6.75%). Protein content of rice flours prepared in a pin mill was decreased as particle size of rice flours decreased. L value of rice flour was increased as particle size of rice flours decreased while b value and ${\Delta}E$ value decreased. Maximum viscosity, cold paste viscosity, breakdown, total setback in amylogram properties were increased as particle size of rice flours decreased while initial paste temperature decreased. Water absorption index (WAI) and water solubility index (WSI) were increased as particle size of rice flour decreased.

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The effects of mandibular setback osteotomy on the oropharyngeal airway space in mandibular prognathic patients (하악전돌 환자에서 하악골 후퇴수술이 기도공간에 미치는 영향)

  • Kim, Hyo-Young;Choi, Hyun-Gue;Kim, Eun-Kyung;Kim, Jong-Ghee
    • The korean journal of orthodontics
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    • v.27 no.5 s.64
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    • pp.733-741
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    • 1997
  • As a result of surgical orthodontic treatment of mandibular prognathism, changes take place in the skeletal and soft orofacial components. Although some investigators had stated that permanent reduction of airway space was observed after mandibular setback surgery, it was not clear that this permanent reduction was sustained during long-term follow-up. The purpose of this study was to assess the changes in oropharyngeal airway space and soft tissue orofacial component following the mandibular setback surgery and during the follow-up period. The correlation between the changes of the oropharyngeal airway space and the changes of other soft tissue orofacial component was also assessed. The findings of this study were as follows ; 1. The oropharyngeal airway space area decreased following mandibular setback surgery for mandibular prognathism and continued to decrease during the follow-up period(p<0.05). 2. The pharyngeal depth at Xi point level and the 2nd cervical vertebra point level decreased after the surgery and remained during the follow-up period(p<0.05). The decrease of these pharyngeal depth was correlated with the decrease of oropharyngeal airway space area(p<0.01). 3. The decrease of pharyngeal depth at the 3rd and 4th cervical vertebra point level was not significant after the surgery and during the follow up period. 4. The hyoid bone moved downward after the surgery(p<0.05), but returned to its original position during the follow-up period. 5. The length & height of tongue and the Position of epiglottis base did not change significantly(p>0.05). 6. The soft palate was displaced posteriorly after the surgery and remained to its changed position during the follow-up period(p<0.05) due to posterior displacement of tongue. The changes of soft palate were significantly correlated with the decrease of oropharyngeal airway space area(p<0.01). 7. The narrowing of oropharyngeal airway space was due to the posterior displacement of tongue above the level of epiglottis tip. The posterior displacement of tongue following mandibular setback osteotomy remained during the follow-up period.

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A study on the mandibular setback osteotomy and reduction genioplasty in mandibular prognathism with long anterior facial height (과도한 하안면 고경을 동반하는 하악전돌증환자의 하악골 후퇴술과 이부 감소 성형술식에 관한 연구)

  • Chang, Young-Il;Im, Dong-Hyuk;Suhr, Jeong-Hoon;Kim, Tae-Woo
    • The korean journal of orthodontics
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    • v.30 no.3 s.80
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    • pp.343-355
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    • 2000
  • The purpose of this study was to evaluate the amount and interrelationship of hard and soft tissue changes after mandibular setback osteotomy and reduction genioplasty in mandibular prognathism with long anterior facial height. The control group (Group A) consisted of 20 patients who had severe horizontal discrepancy. They experienced Presurgical orthodontic treatment and orthognathic surgery via mandibular setback. The experimental group (Group B) consisted of 20 patients who had severe horizontal and vertical discrepancy. They experienced presurgical orthodontic treatment and orthognathic surgery via mandibular setback and reduction genioplasty. The presurgical and postsurgical lateral cephalograms were evaluated. The computerized statistical analysis was tarried on with EXCEL 97 program. The results were as follows : 1. The correlation of hard and soft tissue horizontal changes in lower 2/3 of lower anterior facial height were high for both groups. The correlation coefficients of hard tissue changes and Ls, Stm, Li changes in Group B were moderately higher than Group A. 2. The correlation of hard and soft tissue vortical changes in Group B were lower than Group A. (except for pointB-Ils, Me-Me') 3. The ratio for soft tissue to Pog in Group B was lower than Group A. The ratios of hard and soft tissue vertical changes were 32% at Ils, 54% at Pog', and 60% at Me'. 4. The ratio of lower anterior facial height to total anterior facial height was reduced for both groups. But ratio of upper 1/3 of lower anterior facial height to total anterior facial height did not changed significantly in Group B. 5. Reduction genioplasty combined with mandibular setback procedure showed no change in upper one third(Sn-Stm) and significant decrease(Stm-Me') in the lower two thirds of the soft-tissue anterior lower facial height

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The Properties of Rice Flours Prepared by Dry- and Wet-Milling of Soaked Glutinous and Normal Grains (수침과 건조조건을 달리하여 만든 찹쌀가루와 멥쌀가루의 특성)

  • Kim, Wan-Soo;Shin, Mal-Shick
    • Korean journal of food and cookery science
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    • v.23 no.6
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    • pp.908-918
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    • 2007
  • To prepare ready-to-use rice flour as de novo material for processed rice foods, glutinous(W) and normal rice grains (N) were soaked for 1, 8, and 12 hours prior to processing. One half (DG) was air-dried and milled, and the other (WG) was milled and air-dried. General, morphological and pasting properties of the flours (NDG, NWG, WDG, WWG) were compared to those of a control (raw milled rice without soaking). The general compositions of the rice flours varied with soaking. Crude ash was considerably decreased at the beginning of soaking (1 hour). With the soaking, the rice flour, having polygonal shaped particles and a layered surface, acquired particles with smooth edges, which were then uniformly distributed. Additionally, the WG flour was lighter and had a lower ${\Delta}E$ value than the DG flour, due to a higher L and less +b as a result of soaking. Compared to the control, the WBC of the normal rice flour was decreased significantly with soaking, and the WG flour had significantly lower WBCs than the DG flour. Stirring number (SN), an indicator of ${\alpha}-amylase$ activity, was highly and significantly correlated with WBC (r=-0.85, p=0.0001) in the normal rice flour. At $80^{\circ}C$, the SP and solubility of all the soaked rice flours were much higher than those of the control. Positive (r=+0.85, p=0.0001) and negative (r=-0.61, p=0.02) correlations between the SP and solubility of the normal and glutinous rice flours were found, respectively. Using RVA, the pasting temperature of NDG was lower than that of NWG (p<0.0001). The peak viscosities of all the soaked flours were significantly decreased with soaking (p<0.0l), with the highest viscosity in the normal rice flour soaked for 8 hrs. Total setback, indicative of retrogradation, was lower in NDG than in NWG, with the lowest setback at 8 hrs of' soaking. Based on these finding, the NDG flour with 8 hrs of soaking was less damaged, and had a lower total setback and lower pasting temperature, which would make it an appropriate rice flour for commercial mass production.