Summary
Background
Orthognathic surgery is widely used to correct congenital and acquired dentofacial
discrepancies. Various surgical procedures have been advocated for correction of mandibular
prognathism. In this study, a modified intraoral vertical ramus osteotomy has been
developed for surgical correction of mandibular prognathism. The aim of this study
is to identify contributing factors to skeletal change by analysing cephalometric
changes after modified intraoral vertical ramus osteotomy.
Methods
Forty-one patients, treated for absolute mandibular prognathism by bilateral modified
intraoral vertical ramus osteotomy, were evaluated cephalometrically with reference
to the menton point. A set of four standardised lateral cephalograms were obtained
from each subject preoperatively (T1) and immediately postoperatively (T2), prior
to removal of maxillomandibular fixation (T3), and at 1-year postoperatively (T4).
The mean setback of the menton was 12.4 mm in the horizontal direction. Relapse was defined as forward movement of the menton
during the 1-year follow-up.
Results
The highly significant backward movements in a horizontal direction were observed
during the maxillomandibular fixation period (T3–T2). Moreover, highly significant
forward movement was observed following the maxillomandibular fixation period (T4–T3).
After 1-year follow-up (T4–T2), the mean changes of the menton were 0.1 mm backward in the horizontal direction.
Conclusions
In this series, the mean skeletal change compared with the amount of setback was less
than 1% (0.1/12.4 mm) in backward movement. The results suggest that the modified intraoral vertical
ramus osteotomy technique is useful and the more stable approach for correction of
severe mandibular prognathism.
Keywords
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References
- Mandibular excess.Surgical correction of dentofacial deformities. W.B. Saunders, Philadelphia1980 (p. 844–1013)
- Historical development of orthognathic surgery.J Craniomaxillofac Surg. 1996; 24: 195-204
- The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty. Part I. Surgical procedures to correct mandibular prognathism and reshaping of the chin.Oral Surg Oral Med Oral Pathol. 1957; 10: 677-689
- Retromolar osteotomy for the correction of prognathism.J Oral Surg Anesth Hosp Dent Serv. 1961; 19: 42-47
- Modification in the sagittal osteotomy of the mandible.J Oral Surg. 1977; 35: 157-159
- Biological basis for modification of the sagittal ramus split operation.J Oral Surg. 1977; 35: 362-369
- Surgical correction of mandibular prognathism by intraoral subcondylar osteotomy.J Oral Surg Anesth Hosp Dent Serv. 1964; 22: 197-202
- Subcondylar oseotomy of the mandible and the intraoral approach.Br J Oral Surg. 1968; 6: 134-136
- Further refinement and evaluation of intraoral vertical ramus osteotomy.J Oral Maxillofac Surg. 1987; 45: 684-688
- Skeletal alterations following TOVRO or BSSO procedure.Int J Adult Orthod Orthognath Surg. 1986; 1: 203-213
- Stability after surgical–orthodontic correction of skeletal class in malocclusion. I. Mandibular setback.Int J Adult Orthod Orthognath Surg. 1991; 6: 7-18
- The sagittal split ramus osteotomy as the preferred treatment for mandibular prognathism.J Oral Maxillofac Surg. 2000; 58: 310-312
- Intraoral vertical ramus osteotomy as the preferred treatment for mandibular prognathism.J Oral Maxillofac Surg. 2000; 58: 313-315
- Neurosensory disturbance after sagittal split and intraoral vertical ramus osteotomy: as reported in questionnaires and patients' records.Int J Oral Maxillofac Surg. 2005; 34: 247-251
- Cephalometric for orthognathic surgery.J Oral Surg. 1978; 36: 269-277
- Condylar displacement after oblique sliding osteotomy of the mandibular rami. A stereometric and plain radiographic study.J Crainomaxillofac Surg. 1988; 16: 301-307
- Tomographic assessment of alterations of the temporomandibular joint after surgical correction of mandibular prognathism.Int J Adult Orthod Orthognath Surg. 1991; 6: 105-112
- Three-dimensional confuted tomography evaluation of postsurgical condylar displacement after mandibular osteotomy.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998; 85: 371-376
- Condylar and temporomandibular joint disc positions after mandibular osteotomy for prognathism.J Oral Maxillofac Surg. 2002; 60 ([discussion 1432–1434]): 1424-1432
- Movement of the proximal and distal segments after mandibular ramus osteotomies.J Oral Surg. 1978; 36: 263-268
- Surgical correction of mandibular prognathism by the oblique sliding osteotomy. A clinical and radiological follow-up study of 112 consecutive cases.Scand J Plast Reconstr Surg. 1979; 13: 453-460
- Overcorrection and relapse after the intraoral vertical ramus osteotomy.Oral Surg Oral Med Oral Pathol. 1982; 54: 382-384
- Stability of sagittal split ramus osteotomy used to correct Class III malocclusion: review of the literature.Int J Adult Orthod Orthognath Surg. 2001; 16: 121-129
Article info
Publication history
Published online: June 24, 2006
Accepted:
April 4,
2006
Received:
January 10,
2006
Identification
Copyright
© 2006 The British Association of Plastic Surgeons. Published by Elsevier Inc. All rights reserved.
