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Anatomical consideration with hemorrhagic complication during intraoral vertical ramus osteotomy (IVRO): A cadaveric study
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P27 - Poster session: Tuesday, April 27, 1999
46. Anatomical Consideration with Hemorrhagic Complication During Intraoral Vertical Ramus Osteotomy (IVRO): A Cadaveric Study
ments. As for the inferior alveolar artery and nerve, the mandibular ramus is recommended to be sectioned less than 7 mm from the posterior border of the ramus.
Hattori, H., Suzuki, T., Miyamaru, M., Segami, N. Department of OMS, Kanazawa Medical University, Uchinaba, Japan
47. Three Dimensional Analysis of Growth and Development of Maxilla in Unilateral CLP Children Undergoing Two-Stage Palatoplasty
Purpose Intraoral vertical ramus osteotomy (IVRO) has become more popular in correction of mandibular prognathism. It has major advantages to improve function and resolve symptoms in temporomandibular disorders. On the other hand, IVRO has a lower incidence of complication, in which, potential major hemorrhage may occur by means of damage to the maxillary artery. The purpose of this anatomical study was to investigate the risk of damage to the maxillary artery during IVRO procedure.
Motohashii, Y, Nakano, Y, Uchiyama, T.., Saito, C
Materials and methods The maxillary artery of 9 adult cadavers (18 sides) of both sexes were identified at the termination of the external carotid artery. These specimens had been partially dissected previously and only 15 sides were usable for this study. They comprised 5 males and 3 females, with a mean age of 64 years old (30-89). After the mandibular ramus and condyle were removed from each specimen, the artery was dissected. Careful distraction of vessels was applied from their original position. On 16 specimens, the distance from the osteotomy line of IVRO to the maxillary artery, as well as the external diameter of the maxillary artery were measured. The distance from the mandibular foramen to posterior border of the ascending ramus were also measured. Results On the basis of dissection of 15 maxillary arteries, the maxillary artery passed laterally to the lateral pterygoid muscle on all sides. On the sagittal plane, the distance from the osteotomy line of IVRO to the maxillary artery was minimal at the midsigmoid area. The mean distance from the osteotomy line of IVRO at the sigmoid notch to the maxillary artery on the sagittal plane was - 2 . 9 -+ 14.5 mm. The range of measurement was from - 1 0 mm to 6.0 mm (a minus sign means the maxillary artery ran over the plane of sigmoid notch). On the frontal plan, the distance was also minimal at the midsigmoid area, and it was distributed from 0.5 mm to 1.0 mm. The mean diameter of maxillary artery at the part os sigmoid notch was 3.9 + 10.58 mm, ranging from 3.0 mm to 5.0 mm. Additionally, the mean distance from the foramen to posterior border of the mandibular ramus at 20 mm below the sigmoid notch was 16+-14.3 mm, ranging from 8.0 mm to 23 ram. Conclusion These data indicate that IVRO operation is potentially including major hemorrhage associated with the maxillary artery because of its closest location to the osteotomy line. Therefore, during the osteotomy at the midsigrnoid area, the maxillary artery should be protected by appropriate instru-
Second Department of Oral and Maxillofacial Surgery, Tokyo Dental College Introduction Two-stage patatoplasty using Perko and early orthopedics by the Hotz resin plate is known as Zurich's system. This system interferes with maxillofacial growth less than the other treatments. However, few studies on the growth and development of the maxilla following this treatment have been reported in Japan. The object of this study was to evaluate the craniofacial morphology of the unilateral cleft lip and palate in children resulting from this management in Tokyo Dental College since 1982. Material and method Three dimensional measurement of the alveolar arch, palate and palate surface area was performed by a laser digitizer and computer system using maxillary plaster models from before hard palate closure (phase 1), and just before orthodontic treatment (phase 3), in 45 children (consecutive series of children (n=20)) with complete UCLP without associated malformations who had undergone the Zurich's system in our clinic. Plaster model occlusion was estimated by Hurldert's score. Result This study showed a correlation between the alveolar arch, palate and palate surface area measurements and the occlusion score. The form of the alveolar arch and palate in the patient group was considerably different than that of the normal group.
48. Ultrastructural Changes of the Condylar Cartilage in an Animal Model of Disc Displacement
Long, X., Li, J. School of Stomatology, Hubei Medical University, Wuhan, Peoples Republic of China Objectives Observing the ultrastructural changes of the anterior disc displacement of temporomandibular joint in an animal model, to understand the progress of pathologic changes of anterior disc displacement.
P27 - Poster session: Tuesday, April 27, 1999
46. Anatomical Consideration with Hemorrhagic Complication During Intraoral Vertical Ramus Osteotomy (IVRO): A Cadaveric Study
ments. As for the inferior alveolar artery and nerve, the mandibular ramus is recommended to be sectioned less than 7 mm from the posterior border of the ramus.
Hattori, H., Suzuki, T., Miyamaru, M., Segami, N. Department of OMS, Kanazawa Medical University, Uchinaba, Japan
47. Three Dimensional Analysis of Growth and Development of Maxilla in Unilateral CLP Children Undergoing Two-Stage Palatoplasty
Purpose Intraoral vertical ramus osteotomy (IVRO) has become more popular in correction of mandibular prognathism. It has major advantages to improve function and resolve symptoms in temporomandibular disorders. On the other hand, IVRO has a lower incidence of complication, in which, potential major hemorrhage may occur by means of damage to the maxillary artery. The purpose of this anatomical study was to investigate the risk of damage to the maxillary artery during IVRO procedure.
Motohashii, Y, Nakano, Y, Uchiyama, T.., Saito, C
Materials and methods The maxillary artery of 9 adult cadavers (18 sides) of both sexes were identified at the termination of the external carotid artery. These specimens had been partially dissected previously and only 15 sides were usable for this study. They comprised 5 males and 3 females, with a mean age of 64 years old (30-89). After the mandibular ramus and condyle were removed from each specimen, the artery was dissected. Careful distraction of vessels was applied from their original position. On 16 specimens, the distance from the osteotomy line of IVRO to the maxillary artery, as well as the external diameter of the maxillary artery were measured. The distance from the mandibular foramen to posterior border of the ascending ramus were also measured. Results On the basis of dissection of 15 maxillary arteries, the maxillary artery passed laterally to the lateral pterygoid muscle on all sides. On the sagittal plane, the distance from the osteotomy line of IVRO to the maxillary artery was minimal at the midsigmoid area. The mean distance from the osteotomy line of IVRO at the sigmoid notch to the maxillary artery on the sagittal plane was - 2 . 9 -+ 14.5 mm. The range of measurement was from - 1 0 mm to 6.0 mm (a minus sign means the maxillary artery ran over the plane of sigmoid notch). On the frontal plan, the distance was also minimal at the midsigmoid area, and it was distributed from 0.5 mm to 1.0 mm. The mean diameter of maxillary artery at the part os sigmoid notch was 3.9 + 10.58 mm, ranging from 3.0 mm to 5.0 mm. Additionally, the mean distance from the foramen to posterior border of the mandibular ramus at 20 mm below the sigmoid notch was 16+-14.3 mm, ranging from 8.0 mm to 23 ram. Conclusion These data indicate that IVRO operation is potentially including major hemorrhage associated with the maxillary artery because of its closest location to the osteotomy line. Therefore, during the osteotomy at the midsigrnoid area, the maxillary artery should be protected by appropriate instru-
Second Department of Oral and Maxillofacial Surgery, Tokyo Dental College Introduction Two-stage patatoplasty using Perko and early orthopedics by the Hotz resin plate is known as Zurich's system. This system interferes with maxillofacial growth less than the other treatments. However, few studies on the growth and development of the maxilla following this treatment have been reported in Japan. The object of this study was to evaluate the craniofacial morphology of the unilateral cleft lip and palate in children resulting from this management in Tokyo Dental College since 1982. Material and method Three dimensional measurement of the alveolar arch, palate and palate surface area was performed by a laser digitizer and computer system using maxillary plaster models from before hard palate closure (phase 1), and just before orthodontic treatment (phase 3), in 45 children (consecutive series of children (n=20)) with complete UCLP without associated malformations who had undergone the Zurich's system in our clinic. Plaster model occlusion was estimated by Hurldert's score. Result This study showed a correlation between the alveolar arch, palate and palate surface area measurements and the occlusion score. The form of the alveolar arch and palate in the patient group was considerably different than that of the normal group.
48. Ultrastructural Changes of the Condylar Cartilage in an Animal Model of Disc Displacement
Long, X., Li, J. School of Stomatology, Hubei Medical University, Wuhan, Peoples Republic of China Objectives Observing the ultrastructural changes of the anterior disc displacement of temporomandibular joint in an animal model, to understand the progress of pathologic changes of anterior disc displacement.