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
Background:Unfavorable fractures are among the most common complications of bilateral sagittal split ramus osteotomy(BSSRO).This study aimed to evaluate unfavorable fracture patterns during BSSRO and assess the relate...Background:Unfavorable fractures are among the most common complications of bilateral sagittal split ramus osteotomy(BSSRO).This study aimed to evaluate unfavorable fracture patterns during BSSRO and assess the related risk factors and treatment measures.Methods:The clinical records and radiographs of 679 patients(1358 sides)who underwent BSSRO at Shanghai Ninth People’s Hospital between September 2013 and December 2021 were examined.Results:Patients with unfavorable fractures who underwent surgical restoration were studied.The incidence of unfavorable fractures was 0.8%(n¼11),with the highest rate in the third year.The unfavorable fractures were divided into three types by location and clinical treatment:(1)SSRO could still be completed after buccal/lingual plate unfavorable fracture(0.6%,n=8);(2)condylar/coronoid process fractures/intermaxillary fixation needed(0.1%,n=2);(3)additional osteotomy required(0.07%,n=1).Conclusion:These results suggest that as a surgeon’s experience increases,the rate of unfavorable fractures may decrease.The novel classification of unfavorable fractures for SSRO might be useful for surgeons to make appropriate treatment choices during orthognathic surgery.展开更多
Aim:To present a simple technical modification of a medial osteotomy cut which prevents its misdirection and overcomes various anatomical variations as well as technical problems.Methods:The medial osteotomy cut is mo...Aim:To present a simple technical modification of a medial osteotomy cut which prevents its misdirection and overcomes various anatomical variations as well as technical problems.Methods:The medial osteotomy cut is modified in the posterior half at an angle of 15°-20°following novel landmarks.Results:The proposed cut exclusively directs the splitting forces downwards to create a favorable lingual fracture,preventing the possibility of an upwards split which would cause a coronoid or condylar fracture.Conclusion:This modification has proven to be successful to date without encountering the complications of a bad split or nerve damage.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.
基金the University-Industry Collaborative Education Program of the Ministry of Education of China(grant no.201801301030).
文摘Background:Unfavorable fractures are among the most common complications of bilateral sagittal split ramus osteotomy(BSSRO).This study aimed to evaluate unfavorable fracture patterns during BSSRO and assess the related risk factors and treatment measures.Methods:The clinical records and radiographs of 679 patients(1358 sides)who underwent BSSRO at Shanghai Ninth People’s Hospital between September 2013 and December 2021 were examined.Results:Patients with unfavorable fractures who underwent surgical restoration were studied.The incidence of unfavorable fractures was 0.8%(n¼11),with the highest rate in the third year.The unfavorable fractures were divided into three types by location and clinical treatment:(1)SSRO could still be completed after buccal/lingual plate unfavorable fracture(0.6%,n=8);(2)condylar/coronoid process fractures/intermaxillary fixation needed(0.1%,n=2);(3)additional osteotomy required(0.07%,n=1).Conclusion:These results suggest that as a surgeon’s experience increases,the rate of unfavorable fractures may decrease.The novel classification of unfavorable fractures for SSRO might be useful for surgeons to make appropriate treatment choices during orthognathic surgery.
文摘Aim:To present a simple technical modification of a medial osteotomy cut which prevents its misdirection and overcomes various anatomical variations as well as technical problems.Methods:The medial osteotomy cut is modified in the posterior half at an angle of 15°-20°following novel landmarks.Results:The proposed cut exclusively directs the splitting forces downwards to create a favorable lingual fracture,preventing the possibility of an upwards split which would cause a coronoid or condylar fracture.Conclusion:This modification has proven to be successful to date without encountering the complications of a bad split or nerve damage.
