- Email: [email protected]
Accuracy of orthognathic surgical planning and prediction of hard and soft tissue positional changes
472 Free Papers—Oral Presentations frame has negative effect on the patient’s social life. Conclusions: Anterior maxillary segmental distraction provides an effective alternative to correct the hypoplastic maxilla and severe dental crowding in cleft lip and palate patients. It has some advantages such as it can greatly improve the midface convexity and simultaneously maintain the velopharyngeal function, eliminating the possible negative effects on the patient’s speech of traditional maxillary advancement by Le Fort I osteotomy. It can also increase the upper dental arch length to create space for the alignment of the severe dental crowding without extraction of teeth. But the relatively higher risk of dental root injury during the vertical interdental osteotomy procedure is the disadvantage of this method. Further research is needed to probe into the minimal surgical procedure, ideal distraction device, the long-term stability and its influence on maxilla development in adolescent patient for anterior maxillary segment distraction.
maximally preserved. Lateral cephalograms, lateral and frontal photographs taken pre- and postoperatively were analysed. All the patients were followed up for at least 6 months. Results: All thirty two patients were satisfied with aesthetic outcome. The upper lip protrusions and tooth exposure improved significantly. Cephalometric and photograph analysis showed that the ratio of upper lip to maxillary incisor retraction was 0.64:1, and the nasolabial angle and philtrum length were significantly increased (P < 0.05) while vermilion length was decreased. The height of nasal tip and nasal width (alar base to alar base) did not change significantly. Conclusion: The modified anterior subapical maxillary osteotomy is simple procedure leading to no significant postoperative nasal change. It provides a promising alternative in the treatment of maxillary protrusion.
doi:10.1016/j.ijom.2009.03.268
O8.22 Accuracy of orthognathic surgical planning and prediction of hard and soft tissue positional changes
O8.21 Aesthetic evaluation after the modified anterior segmental osteotomy on the maxilla protrusion Z. Wu ∗ , Z. Li, Y. Dong, S. Yeweng, X. Yang, Z. Li Department of Oral and Maxillofacial Surgery, Key Laboratory for Oral Biomedical Engineering of the Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
Background and Objectives: The main goals of orthogenetic surgery are to achieve functional occlusion and improve patient’s profile. The unintended nasal change in association with anterior maxillary osteotomy is always a challenge. The purpose of this study was to improve the anterior maxillary segmental osteotomy resulting in less postoperative unintended nasal change. Methods: Thirty two patients who were diagnosed as maxillary protrusion underwent modified anterior subapical maxillary osteotomy. The design of the modified approach was based on the anterior mandibular subapical osteotomy. The horizontal osteotomy connecting the vertical osteotomy lines on both right and left sides was performed inferior to the piriform aperture and 3 mm over the apex. The integrity of piriform aperture was
cephalometric positions was carried out by two-tailed t test for paired observations. Results: The average accuracy of the planned and predicted hard and soft tissue outcome was relatively high varying from 0.0 mm to 0.8 mm. At the cephalometric reference points where statistically significant inaccuracies were revealed, these inaccuracies varied from 0.2 mm to 2.2 mm. However, the variability of the predicted hard and soft tissue individual outcome was relatively high as indicated by the standard deviations of the mean differences, which varied from 0.6 mm to 3.9 mm. Conclusions: The current study demonstrates from an average point of view relatively high predictability of the immediately postsurgical outcome. However, the variability of the predicted individual outcome seems to be relatively high. doi:10.1016/j.ijom.2009.03.270
doi:10.1016/j.ijom.2009.03.269
O. Donatsky ∗ , J. Bjoern-Joergensen, N.U. Hermund, H. Nielsen, M. Holmqvist-Larsen, P.H. Nerder Department of Oral and Maxillofacial Surgery, Rigshospitalet, Section Hilleroed, University of Copenhagen, Dyrehavevej, Hilleroed, Denmark
Background and Objectives: The purpose of the present study was to evaluate the immediately postsurgical outcome of planned and predicted mandibular, maxillary and soft tissue profile positional changes in 100 prospectively and consecutively planned and predicted patients. Methods: One hundred patients with different dentofacial deformities were prospectively and consecutively included. Cephalograms were preoperatively computerised traced and analysed. Treatment plans and prediction tracings were produced by computerised, surgical interactive simulation using the TIOPS planning system. The planned hard tissue positional changes were transferred to model surgery in a three-dimensional articulator system and finally to surgery. Five to six weeks after surgery, the actually obtained hard and soft tissue profile changes were cephalometric assessed. Statistical analysis of the mean differences between planned and predicted and the actually obtained hard and soft tissue
O8.23 Orthognathic surgery with facial plastic surgery: yes or no? F. Sarkarat Department of Oral and Maxillofacial Surgery, Buali Hospital, Azad University of Tehran, Tehran, Iran
Background and Objectives: Facial harmony is the main aim of all facial surgical procedures. By the other words Beautiful face is the harmonic face. Multiple factors contribute to the aesthetically pleasing face including skin soft tissue and bony contours. Methods: In this lecture we will describe the facial contouring procedures like malar augmentation, chin enhancement, filler injection and rhinoplasty in the orthognathic cases as the adjunctive and necessary procedures. Conclusion: We will review the new methods, latest literature and many cases about the facial contouring procedures from the orthodontic and surgical aspects. doi:10.1016/j.ijom.2009.03.271
O8.24 The use of BioOss Collagen® in orthognathic surgery: clinical and histological results G. Bissolotti ∗ , L. Trevisiol, A. D’Agostino, P.F. Nocini Section of Dentistry and Maxillo-Facial Surgery, University of Verona, Piazzale L.A. Scuro, Italy
maximally preserved. Lateral cephalograms, lateral and frontal photographs taken pre- and postoperatively were analysed. All the patients were followed up for at least 6 months. Results: All thirty two patients were satisfied with aesthetic outcome. The upper lip protrusions and tooth exposure improved significantly. Cephalometric and photograph analysis showed that the ratio of upper lip to maxillary incisor retraction was 0.64:1, and the nasolabial angle and philtrum length were significantly increased (P < 0.05) while vermilion length was decreased. The height of nasal tip and nasal width (alar base to alar base) did not change significantly. Conclusion: The modified anterior subapical maxillary osteotomy is simple procedure leading to no significant postoperative nasal change. It provides a promising alternative in the treatment of maxillary protrusion.
doi:10.1016/j.ijom.2009.03.268
O8.22 Accuracy of orthognathic surgical planning and prediction of hard and soft tissue positional changes
O8.21 Aesthetic evaluation after the modified anterior segmental osteotomy on the maxilla protrusion Z. Wu ∗ , Z. Li, Y. Dong, S. Yeweng, X. Yang, Z. Li Department of Oral and Maxillofacial Surgery, Key Laboratory for Oral Biomedical Engineering of the Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
Background and Objectives: The main goals of orthogenetic surgery are to achieve functional occlusion and improve patient’s profile. The unintended nasal change in association with anterior maxillary osteotomy is always a challenge. The purpose of this study was to improve the anterior maxillary segmental osteotomy resulting in less postoperative unintended nasal change. Methods: Thirty two patients who were diagnosed as maxillary protrusion underwent modified anterior subapical maxillary osteotomy. The design of the modified approach was based on the anterior mandibular subapical osteotomy. The horizontal osteotomy connecting the vertical osteotomy lines on both right and left sides was performed inferior to the piriform aperture and 3 mm over the apex. The integrity of piriform aperture was
cephalometric positions was carried out by two-tailed t test for paired observations. Results: The average accuracy of the planned and predicted hard and soft tissue outcome was relatively high varying from 0.0 mm to 0.8 mm. At the cephalometric reference points where statistically significant inaccuracies were revealed, these inaccuracies varied from 0.2 mm to 2.2 mm. However, the variability of the predicted hard and soft tissue individual outcome was relatively high as indicated by the standard deviations of the mean differences, which varied from 0.6 mm to 3.9 mm. Conclusions: The current study demonstrates from an average point of view relatively high predictability of the immediately postsurgical outcome. However, the variability of the predicted individual outcome seems to be relatively high. doi:10.1016/j.ijom.2009.03.270
doi:10.1016/j.ijom.2009.03.269
O. Donatsky ∗ , J. Bjoern-Joergensen, N.U. Hermund, H. Nielsen, M. Holmqvist-Larsen, P.H. Nerder Department of Oral and Maxillofacial Surgery, Rigshospitalet, Section Hilleroed, University of Copenhagen, Dyrehavevej, Hilleroed, Denmark
Background and Objectives: The purpose of the present study was to evaluate the immediately postsurgical outcome of planned and predicted mandibular, maxillary and soft tissue profile positional changes in 100 prospectively and consecutively planned and predicted patients. Methods: One hundred patients with different dentofacial deformities were prospectively and consecutively included. Cephalograms were preoperatively computerised traced and analysed. Treatment plans and prediction tracings were produced by computerised, surgical interactive simulation using the TIOPS planning system. The planned hard tissue positional changes were transferred to model surgery in a three-dimensional articulator system and finally to surgery. Five to six weeks after surgery, the actually obtained hard and soft tissue profile changes were cephalometric assessed. Statistical analysis of the mean differences between planned and predicted and the actually obtained hard and soft tissue
O8.23 Orthognathic surgery with facial plastic surgery: yes or no? F. Sarkarat Department of Oral and Maxillofacial Surgery, Buali Hospital, Azad University of Tehran, Tehran, Iran
Background and Objectives: Facial harmony is the main aim of all facial surgical procedures. By the other words Beautiful face is the harmonic face. Multiple factors contribute to the aesthetically pleasing face including skin soft tissue and bony contours. Methods: In this lecture we will describe the facial contouring procedures like malar augmentation, chin enhancement, filler injection and rhinoplasty in the orthognathic cases as the adjunctive and necessary procedures. Conclusion: We will review the new methods, latest literature and many cases about the facial contouring procedures from the orthodontic and surgical aspects. doi:10.1016/j.ijom.2009.03.271
O8.24 The use of BioOss Collagen® in orthognathic surgery: clinical and histological results G. Bissolotti ∗ , L. Trevisiol, A. D’Agostino, P.F. Nocini Section of Dentistry and Maxillo-Facial Surgery, University of Verona, Piazzale L.A. Scuro, Italy