Aim: This study was performed to evaluate the movement of the proximal segment following different methods of ramus osteotomy that is one of the side effects of orthognathic surgery. Theoretically, with intraoral vert...Aim: This study was performed to evaluate the movement of the proximal segment following different methods of ramus osteotomy that is one of the side effects of orthognathic surgery. Theoretically, with intraoral verticosagittal ramus osteotomy, it can minimize the movement of the proximal segment. The changes in the intergonal distance of mandible and the angle of the ramus flaring in two methods of osteotomy have been compared in this study. Materials and Methods: In this randomized clinical trial, included 60 patients (32 males) with mandibular prognathism and without any asymmetry were selected and divided into two groups (n = 30). One group underwent bilateral sagittal split ramus osteotomy technique to achieve mandibular setback and the other by the intraoral verticosagittal ramus osteotomy technique. Intergonial width and inner-ramal angle in the transverse plane were measured on radiographs preoperatively and 1 and 12 weeks postoperatively. Data were analyzed using covariance test with the significance level set at P 0.1). Conclusion: Considering our findings, there was no significant difference between two ramus osteotomy techniques regarding changes in mandibular width and inter-ramal flaring angle.展开更多
In the evaluation of the beauty and functional integrity of the lower face, the oral cavity, teeth, mandible, maxilla, and the size and position of the tongue are important. The tongue locates forward and is larger th...In the evaluation of the beauty and functional integrity of the lower face, the oral cavity, teeth, mandible, maxilla, and the size and position of the tongue are important. The tongue locates forward and is larger than normal in prognathism, in which the jaw protrudes from the skull. It is not clear whether an enlarged tongue causes the open bite, protrusion or dental arch misalignment, or is a result of them. Here, we report two patients with mandibular prognathism and relative macroglossia, which were treated by mandibular setback surgery using a bilateral sagittal split osteotomy (BSSO) and excision of the tongue. This procedure achieved aesthetic improvement of the face and dentition.展开更多
Neuropathic pain is characterized by spontaneous and provoked pain and other signs reflecting neural damage.Aberrant regeneration following peripheral nerve lesions leaves neurons unusually sensitive and prone to spon...Neuropathic pain is characterized by spontaneous and provoked pain and other signs reflecting neural damage.Aberrant regeneration following peripheral nerve lesions leaves neurons unusually sensitive and prone to spontaneous pathological activity,abnormal excitability and heightened sensitivity to stimuli.This review covers the current understanding of neuropathic pain after bilateral sagittal split osteotomy(BSSO)of the lower jaw.The reported incidence of neuropathic pain after mandibular osteotomies is less than 1%,while the incidence in patients with iatrogenic inferior alveolar nerve(IAN)injuries during BSSO can be as high as 45%.The factors which modulate the healing process toward neuropathic pain during or after nerve damage have not yet been elucidated.Patients at highest risk for developing post-BSSO neuropathic pain are older than 45 years and have undergone procedures involving IAN compression,partial severance,or complete discontinuity of the lingual nerve with a proximal stump neuroma,patients with nerve injury repair delayed longer than 12 months and patients with chronic illnesses that compromise healing or increase risk for peripheral neuropathy.Although neuropathic pain tends to be long-lasting,some patients can recover completely.Preventive measures include risk assessment prior to surgery,prevention of nerve damage during surgery,and early repair of nerve injury.展开更多
目的:客观评价下颌失状劈开截骨术后下齿槽神经感觉障碍发生及自然恢复的发生率。方法:选择30例双侧下颌升支矢状截骨的患者在术前和术后1周、4周、2个月和6个月进行下齿槽神经感觉障碍的临床评价。30例患者均采用Semmes-Wei nst ei n...目的:客观评价下颌失状劈开截骨术后下齿槽神经感觉障碍发生及自然恢复的发生率。方法:选择30例双侧下颌升支矢状截骨的患者在术前和术后1周、4周、2个月和6个月进行下齿槽神经感觉障碍的临床评价。30例患者均采用Semmes-Wei nst ei n单丝测试法。结果:术后7天感觉障碍发生率为100%。在所有检测区域,术后6个月的测量结果与术前最接近。6个月时20例患者感觉恢复术前水平。左右侧及性别间感觉障碍恢复优秀率的差异在各个随访时期均无统计学意义(P>O.05)。结论:BSSO术后早期感觉功能障碍较为普遍,然而在术后6个月,大多数患者的神经功能可达到自然恢复。展开更多
文摘Aim: This study was performed to evaluate the movement of the proximal segment following different methods of ramus osteotomy that is one of the side effects of orthognathic surgery. Theoretically, with intraoral verticosagittal ramus osteotomy, it can minimize the movement of the proximal segment. The changes in the intergonal distance of mandible and the angle of the ramus flaring in two methods of osteotomy have been compared in this study. Materials and Methods: In this randomized clinical trial, included 60 patients (32 males) with mandibular prognathism and without any asymmetry were selected and divided into two groups (n = 30). One group underwent bilateral sagittal split ramus osteotomy technique to achieve mandibular setback and the other by the intraoral verticosagittal ramus osteotomy technique. Intergonial width and inner-ramal angle in the transverse plane were measured on radiographs preoperatively and 1 and 12 weeks postoperatively. Data were analyzed using covariance test with the significance level set at P 0.1). Conclusion: Considering our findings, there was no significant difference between two ramus osteotomy techniques regarding changes in mandibular width and inter-ramal flaring angle.
文摘In the evaluation of the beauty and functional integrity of the lower face, the oral cavity, teeth, mandible, maxilla, and the size and position of the tongue are important. The tongue locates forward and is larger than normal in prognathism, in which the jaw protrudes from the skull. It is not clear whether an enlarged tongue causes the open bite, protrusion or dental arch misalignment, or is a result of them. Here, we report two patients with mandibular prognathism and relative macroglossia, which were treated by mandibular setback surgery using a bilateral sagittal split osteotomy (BSSO) and excision of the tongue. This procedure achieved aesthetic improvement of the face and dentition.
文摘Neuropathic pain is characterized by spontaneous and provoked pain and other signs reflecting neural damage.Aberrant regeneration following peripheral nerve lesions leaves neurons unusually sensitive and prone to spontaneous pathological activity,abnormal excitability and heightened sensitivity to stimuli.This review covers the current understanding of neuropathic pain after bilateral sagittal split osteotomy(BSSO)of the lower jaw.The reported incidence of neuropathic pain after mandibular osteotomies is less than 1%,while the incidence in patients with iatrogenic inferior alveolar nerve(IAN)injuries during BSSO can be as high as 45%.The factors which modulate the healing process toward neuropathic pain during or after nerve damage have not yet been elucidated.Patients at highest risk for developing post-BSSO neuropathic pain are older than 45 years and have undergone procedures involving IAN compression,partial severance,or complete discontinuity of the lingual nerve with a proximal stump neuroma,patients with nerve injury repair delayed longer than 12 months and patients with chronic illnesses that compromise healing or increase risk for peripheral neuropathy.Although neuropathic pain tends to be long-lasting,some patients can recover completely.Preventive measures include risk assessment prior to surgery,prevention of nerve damage during surgery,and early repair of nerve injury.
文摘目的:客观评价下颌失状劈开截骨术后下齿槽神经感觉障碍发生及自然恢复的发生率。方法:选择30例双侧下颌升支矢状截骨的患者在术前和术后1周、4周、2个月和6个月进行下齿槽神经感觉障碍的临床评价。30例患者均采用Semmes-Wei nst ei n单丝测试法。结果:术后7天感觉障碍发生率为100%。在所有检测区域,术后6个月的测量结果与术前最接近。6个月时20例患者感觉恢复术前水平。左右侧及性别间感觉障碍恢复优秀率的差异在各个随访时期均无统计学意义(P>O.05)。结论:BSSO术后早期感觉功能障碍较为普遍,然而在术后6个月,大多数患者的神经功能可达到自然恢复。
