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Maxillofacial Plastic and Reconstructive Surgery

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Open Access 01-12-2022 | Research

Changes in facial width according to the ostectomy level of the proximal bone segment in intraoral vertical ramus osteotomy for mandibular prognathism

Authors: Sang-Hoon Kang, Min-Jun Kang, Min-Ji Kim, Moon-Key Kim

Published in: Maxillofacial Plastic and Reconstructive Surgery | Issue 1/2022

Abstract

Background

This study aimed to investigate the changes in facial width according to the ostectomy level of the proximal segment after orthognathic surgery using intraoral vertical ramus osteotomy (IVRO) in patients with mandibular prognathism.

Methods

The participants included 32 individuals who were diagnosed with class III malocclusion prior to surgery. All participants underwent orthognathic surgery using either version of IVRO. The surgery patients were categorized into two groups depending on the type of proximal bone-segment ostectomy technique used: patients whose osteotomy height was at the level of the mandibular tooth occlusal surface (the mandibular tooth surface–level group) and patients whose osteotomy height was at the level of the mandibular inferior border (the mandibular inferior border–level group). The distances between the mandibular width and soft tissue width at the height of the sigmoid notch, mandibular foramen, and alveolar bone and at the anterior-posterior location of the mandibular condyle, mandibular foramen, and coronoid process were compared between the groups. All data were compared to identify differences between preoperative and postoperative measurements.

Results

The postoperative change in facial soft tissue width at the intersection of the coronal plane with the coronoid process and the horizontal plane at the height of the mandibular alveolar bone in the group with osteotomy at the level of the mandibular occlusal surface differed significantly from that in the group with osteotomy at the level of the mandibular inferior border, with respective increases (mean ± SD) of 1.3 ± 3.5% and 4.7 ± 5.6%, compared to preoperative measurements (p = 0.050).

Conclusions

Proximal segment ostectomy at the level of the mandibular occlusal surface must be considered with regard to postoperative facial soft tissue width in vertical ramus osteotomy. Additionally, it is necessary to study the visual effect of the width of the mandible appearing small because of the posterior position of the mandible, even when the mandibular facial width is maintained.

Lee KT, Lai SS, Lin SS, Wu JH, Lee HE, Chen CM (2011) Changes in the transverse dimensions by vertical ramus osteotomy after mandibular prognathism correction. J Craniofac Surg 22(5):1602–1605. https://doi.org/10.1097/SCS.0b013e31822e5da9CrossRefPubMed

Razmara F, Mahmoodhashemi H, Zahraei S, Mahmoudhashemi A (2018) Changes of transverse mandibular width in set-back mandibular surgery: sagittal split versus intraoral verticosagittal osteotomy. Int J Clin Med 09(05):400–407. https://doi.org/10.4236/ijcm.2018.95034CrossRef

Rokutanda S, Yamada S, Yanamoto S, Omori K, Fujimura Y, Morita Y et al (2018) Comparison of osseous healing after sagittal split ramus osteotomy and intraoral vertical ramus osteotomy. Int J Oral Maxillofac Surg 47(10):1316–1321. https://doi.org/10.1016/j.ijom.2018.05.013CrossRefPubMed

Choi YJ, Ha YD, Lim H, Huh JK, Chung CJ, Kim KH (2016) Long-term changes in mandibular and facial widths after mandibular setback surgery using intraoral vertical ramus osteotomy. Int J Oral Maxillofac Surg 45(9):1074–1080. https://doi.org/10.1016/j.ijom.2016.04.006CrossRefPubMed

Ghai S, Sharma Y, Jain N, Satpathy M, Pillai AK (2018) Use of 3-D printing technologies in craniomaxillofacial surgery: a review. Oral Maxillofac Surg 22(3):249–259. https://doi.org/10.1007/s10006-018-0704-zCrossRefPubMed

Ko JM, Choi JY, Baek SH (2015) Evaluation of lip cant change by 2-jaw surgery in class III asymmetry cases using three-dimensional facial scan in conjunction with computed tomographic images. J Craniofac Surg 26(4):e283–e288. https://doi.org/10.1097/scs.0000000000001555CrossRefPubMed

Al-Hiyali A, Ayoub A, Ju X, Almuzian M, Al-Anezi T (2015) The impact of orthognathic surgery on facial expressions. J Oral Maxillofac Surg 73(12):2380–2390. https://doi.org/10.1016/j.joms.2015.05.008CrossRefPubMed

Benson KJ, Laskin DM (2001) Upper lip asymmetry in adults during smiling. J Oral Maxillofac Surg 59(4):396–398. https://doi.org/10.1053/joms.2001.21874CrossRefPubMed

Kang SH, Kim YH, Won YJ, Kim MK (2016) Novel three-dimensional position analysis of the mandibular foramen in patients with skeletal class III mandibular prognathism. Imaging Sci Dent 46(2):77–85. https://doi.org/10.5624/isd.2016.46.2.77CrossRefPubMedPubMedCentral

10.

Choi SJ, Sim YS, Han JJ, Kook MS, Park HJ, Oh HK (2020) Evaluation of bone remodeling after simultaneous sagittal split ramus osteotomy and mandibular angle ostectomy in patients with mandibular prognathism. J Oral Maxillofac Surg 78(11):2071.e1–2071.e11. https://doi.org/10.1016/j.joms.2020.05.044CrossRef

11.

Jung YS, Kim SY, Park SY, Choi YD, Park HS (2010) Changes of transverse mandibular width after intraoral vertical ramus osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 110(1):25–31. https://doi.org/10.1016/j.tripleo.2009.11.004CrossRefPubMed

12.

Song SH, Kim JY, Lee SH, Park JH, Jung HD, Jung YS (2019) Three-dimensional analysis of transverse width of hard tissue and soft tissue after mandibular setback surgery using intraoral vertical ramus osteotomy: a retrospective study. J Oral Maxillofac Surg 77(2):407.e1–407.e6. https://doi.org/10.1016/j.joms.2018.10.008CrossRef

13.

Jung HD, Kim SY, Park HS, Jung YS (2014) Modification of intraoral vertical ramus osteotomy. Br J Oral Maxillofac Surg 52(9):866–867. https://doi.org/10.1016/j.bjoms.2014.04.020CrossRefPubMed

14.

Hong KE, Shin ES, Park J, Yun JE, Kim CH, Kim JH et al (2021) Is distal segment ostectomy essential for stabilization of the condylar position in patients with facial asymmetry? Maxillofac Plast Reconstr Surg 43(1):41. https://doi.org/10.1186/s40902-021-00325-3CrossRefPubMedPubMedCentral

Title: Changes in facial width according to the ostectomy level of the proximal bone segment in intraoral vertical ramus osteotomy for mandibular prognathism
Authors: Sang-Hoon Kang
Min-Jun Kang
Min-Ji Kim
Moon-Key Kim
Publication date: 01-12-2022
Publisher: Springer Nature Singapore
Published in: Maxillofacial Plastic and Reconstructive Surgery / Issue 1/2022
Electronic ISSN: 2288-8586
DOI: https://doi.org/10.1186/s40902-022-00347-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Changes in facial width according to the ostectomy level of the proximal bone segment in intraoral vertical ramus osteotomy for mandibular prognathism

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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