• 제목/요약/키워드: skeletal plate

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Bioabsorbable osteofixation for orthognathic surgery

  • Park, Young-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제37권
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    • pp.6.1-6.9
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    • 2015
  • Orthognathic surgery requires stable fixation for uneventful healing of osteotomized bony segments and optimal remodeling. Titanium plates and screws have been accepted as the gold standard for rigid fixation in orthognathic surgery. Although titanium osteofixation is the most widely used approach, the use of bioabsorbable devices has been increasing recently. Biodegradation of bioabsorbable devices eliminates the need for a second operation to remove metal plates and screws. However, long-term stability and relapse frequency in bioabsorbable osteofixation are still insufficiently studied, especially in cases of segmental movements of great magnitude or segmental movements to a position where bony resistance exists. This paper reviews the background, techniques, and complications of bioabsorbable osteofixation and compares bioabsorbable and titanium osteofixation in orthognathic surgery in terms of skeletal stability.

Three-dimensional finite element analysis on the effects of maxillary protraction with an individual titanium plate at multiple directions and locations

  • Fan Wang;Qiao Chang;Shuran Liang;Yuxing Bai
    • 대한치과교정학회지
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    • 제54권2호
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    • pp.108-116
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    • 2024
  • Objective: A three-dimensional-printed individual titanium plate was applied for maxillary protraction to eliminate side effects and obtain the maximum skeletal effect. This study aimed to explore the stress distribution characteristics of sutures during maxillary protraction using individual titanium plates in various directions and locations. Methods: A protraction force of 500 g per side was applied at forward and downward angles between 0° and 60° with respect to the Frankfort horizontal plane, after which the titanium plate was moved 2 and 4 mm upward and downward, respectively. Changes in sutures with multiple protraction directions and various miniplate heights were quantified to analyze their impact on the maxillofacial bone. Results: Protraction angle of 0-30° with respect to the Frankfort horizontal plane exhibited a tendency for counterclockwise rotation in the maxilla. At a 40° protraction angle, translational motion was observed in the maxilla, whereas protraction angles of 50-60° tended to induce clockwise rotation in the maxilla. Enhanced protraction efficiency at the lower edge of the pyriform aperture was associated with increased height of individual titanium plates. Conclusions: Various protraction directions are suitable for patients with different types of vertical bone surfaces. Furthermore, when the titanium plate was positioned lower, the protraction force exhibited an increase.

Le Fort I 상악골전진술 후 안정성에 관한 연구 (THE SKELETAL STABILITY OF LE FORT I MAXILLARY ADVANCEMENT)

  • 서민교;구성영;김은주;임대호;신효근;고승오
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제32권2호
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    • pp.149-153
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    • 2010
  • The purpose of this retrospective study was to evaluate relapse, comparing large and small maxillary advancements with four-plate rigid fixation and without bone grafting. All patients had skeletal class III malocclusion, and underwent bimaxillary surgery. Standardized cephalometric analysis by one examiner was performed on serial radiographs of 14 patients immediately before surgery, and within 1 week and at least 6 months postoperatively (mean 10 months). The group was divided into two subsets to determine whether the magnitude of relapse. In group 1 ($\leq$ 5 mm, n = 8), the average advancement was $4.0{\pm}0.9\;mm$, with a mean relapse of $0.1{\pm}0.5\;mm$. In group 2 (6-8 mm, n = 4), the average advancement was $6.8{\pm}0.9\;mm$, with a mean relapse of $0.7{\pm}0.4\;mm$. There was no statistical difference in the measured relapse among the groups. Maxillary advancement with a 1-piece Le Fort I osteotomy is a relatively stable procedure.

구순구개열 환자의 Le Fort I 골절단술 후 상악골의 위치적 안정성에 관한 연구 ; 예비보고 (Skeletal Stability after Le Fort I Osteotomy in the Cleft Patients; Preliminary Report)

  • 김명진;유호석;김종원;김규식
    • 대한구순구개열학회지
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    • 제2권1_2호
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    • pp.15-22
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    • 1999
  • It is well known that the postoperative skeletal instability after Le Fort I osteotomy for advancement of maxilla in the cleft patients is one of the major surgical problems. So we had tried to compare the amount of relapse after Le Fort I advancement surgery in the horizontal and vertical positional change, angular change of reference points between cleft patients and non-cleft patients. Longitudinal records of 10 consecutive cleft patients (test group) and 20 non-cleft patients (control group) were analyzed. Lateral cephalograms were taken preoperatively, immediately postoperatively, and 2, 6, 12 months postoperatively. We measured horizontal and vertical changes (ANS, PNS, AI) and angular change (SNA) of the reference points and lines. In the test group, horizontal relapse of ANS, PNS, AI point are 36.4%, 37.5%, 32.0% respectively at 12 months postoperatively. The vertical relapse of ANS, PNS, AI are 25.3%, 32.3%, 39.1% respectively at 12 months postoperatively. The angular change of SNA is 33.6% at 12 months postoperatively. In the control group, horizontal relapse of ANS, PNS, AI point are 23.8%, 30.2%, 21.7% respectively at 12 months postoperatively. The vertical relapse of ANS, PNS, AI are 22.7%, 27.3%, 25.1% respectively at 12 months postoperatively. The angular change of SNA is 22.2% at 12 months postoperatively. The cleft patients have a larger tendency of skeletal and dental relapse compared with non-cleft patients after Le Fort I surgery. So the oral and maxillofacial surgeons must keep in mind these facts in order to minimize the relapse phenomenon from the beginning of surgical planning to postoperative care.

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Functional evaluation of orthopedic and orthodontic treatment in a patient with unilateral posterior crossbite and facial asymmetry

  • Kwak, Yoon-Young;Jang, Insan;Choi, Dong-Soon;Cha, Bong-Kuen
    • 대한치과교정학회지
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    • 제44권3호
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    • pp.143-153
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    • 2014
  • An 8-years old boy with facial asymmetry and unilateral posterior crossbite on the left side received orthopedic and orthodontic treatment. During the first phase of treatment, the narrow maxillary arch was expanded using an acrylic plate. Then, the acrylic plate was used as a bite block with occlusal indentations from the construction bite that was obtained with the incisors in a coincident dental midline. After the position of the mandible was stabilized, the second phase of orthodontic treatment was initiated using fixed appliances for detailing of the occlusion. Skeletal symmetry, ideal occlusion, and coincident dental midlines were thus achieved. Functionally, occlusal force balance and masticatory muscle activity were improved, and the chewing patterns were normalized.

비글견에서 급속수술교정 치료 후 생물학적 효과에 대한 조직평가: 예비연구 (Histologic assessment of the biological effects after speedy surgical orthodontics in a beagle animal model: a preliminary study)

  • 김홍석;이영준;박영국;정규림;강윤구;추혜란;김성훈
    • 대한치과교정학회지
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    • 제41권5호
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    • pp.361-370
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    • 2011
  • Objective: Speedy surgical orthodontics (SSO), an innovative orthodontic treatment, involves the application of orthopedic forces against temporary skeletal anchorage devices following perisegmental corticotomy to induce movement of specific dental segments. Herein, we report the biological effects of SSO on the teeth and periodontal structures. Methods: Five beagle dogs were divided into 2 groups and their 6 maxillary incisors were retracted $en$ $masse$ by applying 500 g orthopedic force against a single palatal mini-plate. Retraction was performed without and with perisegmental corticotomy in groups I and II, respectively. All animals were killed on the 70th day, and their periodontal structures were processed for histologic analyses and scanning electronic microscopy (SEM). The linear distance between the third maxillary incisor and canine was used as a benchmark to quantify the retraction amount. Results: Retraction was markedly faster and retraction amount greater in group II than in Group I. Surprisingly, Group II did not show any root resorption despite extensive retraction, while Group I showed prominent root surface irregularities. Similarly, SEM showed multiple resorption lacunae in Group I, but not in Group II. Conclusions: SSO is an effective and favorable orthodontic approach for major en masse retraction of the maxillary anterior teeth.

소아기에 있어 키성장과 비만도, 골성숙도와의 상관성 연구 (A Study on Correlation between Height Growth, Obesity and Bone maturity in Childhood)

  • 최상락;김윤영;장은진;구진숙
    • 대한한의학회지
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    • 제40권1호
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    • pp.24-33
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    • 2019
  • Objectives: The purpose of this study is to analyze the causes of short stature through a clinical review of factors related to childhood height growth. So we can find the way to meet the needs of the heightism which is widely spread among modern people. Methods: Among 160 patients who came to Andong B oriental clinic for the purpose of growth therapy, 112 children whose height was smaller than other normal children were analyzed. When the children first came to the clinic, we checked their height and weight. The parents' height was recorded through a questionnaire. The relationship between obesity index and height growth was examined through growth plate test and Inbody test. We want to identify the genetic factors related to parental factors based on the data of the parent height. Results: For short stature children, weight was often normal or low. When we examined the relationship between parental genetic factors and child growth, we found that they were more influenced by father's height rather than mother's. We investigated the correlation between skeletal maturity and the five viscera. There was no apparent correlation between skeletal maturity and the five viscera but we found that there was some degree of relevance. Conclusions: For short stature children, the weight was often normal or low and parental genetic factors were more influenced by father than by mother. In the case of bone maturity it did not show a direct correlation between the five viscera.

상악 전방견인시 악안면골의 초기반응에 관한 Laser Holography연구 (A LASER HOLOGRAPHIC STUDY ON THE INITIAL REACTION OF MAXILLOFACIAL COMPLEX TO MAXILLARY PROTRACTION)

  • 강흥석
    • 대한치과교정학회지
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    • 제18권2호
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    • pp.367-385
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    • 1988
  • In case of skeletal Class III malocclusion with underdeveloped maxilla, the extraoral orthopedic force for the stimulation of maxillary growth or anterior reposition of the maxilla has been used clinically for the improvement of facial skeletal relationship. The purpose of this investigation was to examine the initial reaction of maxillofacial complex to the maxillary protraction by using extraoral orthopedic force. The dried human skull was used and this investigation was done by means of double exposure holographic interferometry. The protraction forces placed on the canine or the first molar were parallel, $10^{\circ}$ downward, $20^{\circ}$ downward to the occlusal plane. Fringe pattern of each protraction condition was compared and analized. The results were as follows: 1. Each maxillofacial bone displaced saparately. 2. More displacement was shown at the area of the teeth and the alveolar bone. 3. A counterclockwise rotation of the maxilla wa decreased by downward protraction and especially 20 degree downward protraction from the canine showed least rotation. 4. On the zygomatic arch, outward bend was observed and this effect was decreased by downward protraction. 5. On the zygomatic bone, the counter clockwise rotation was increased by the downward protraction. 6. When maxillary expansion was applied at the same time, outward and upward displacement with counterclockwise rotation was observed on the maxilla. 7. The lateral pterygoid plate of sphenoid bone was affected by maxillary protraction.

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