- Email: [email protected]
Evaluation of Skeletal Class III Malocclusion patients treated with BSSRO in Surgery-First Approach
Poster Session References: 1. Gateno J, Xia JJ, Teichgraeber JF: Effect of facial asymmetry on 2-dimensional and 3-dimensional cephalometric measurements. J Oral Maxillofac Surg 69:655-662,2011 2. Moriyama.S, Furuta.S, Kita. R, et al: Method of Craniomaxillofacial Superimposition by Six-Degrees-of-Freedom Search,Jpn.J.Jaw Deform.22(3):193-199,August,2012
POSTER 138 Application of Resorbable Plates: Japanese Experience M. Shikimori: Asahi University School of Dentistry, Division of Oral Pathogenesis and Diseases Control Statement of the Problem: Plates or screws are used in osteosynthesis for jaw deformities. They are constructed of either titanium or absorbable materials. Various types of titanium plates have been developed and are widely used. They are removed approximately one year following osteosynthesis. Use of absorbable plates began around 1995 in Japan. When introduced, absorbable plates were expected to be widelyaccepted because they do not require removal. However, due to their complicated manipulation and high cost, they are used less than their titanium counterparts. This report presents an overview of plate application in osteosynthesis for jaw deformities, actual status and issues regarding absorbable plates in Japan. Materials and Methods: The following materials and methods were used to evaluate the status of absorbable plates Japan; relevant issues are discussed: (1) Published documents on absorbable plates used in Japan. (2) Number of published articles and presentations on absorbable plates in Japanese academic meetings that were archived in the Japana Centra Revuo medicina (Ichishi) database. (3) Materials used in osteosynthesis for jaw deformity used in Japan, as documented by past publications. (4) Efforts for improving operability Results: (1) Absorbable plates used in Japan. Absorbable plates began to be used about 1995 in Japan; improvements have been made since then. At present, three types of plates from three companies are available: PLLAPGA, u-HA/PLLA and PLLA. (2) Number of published articles and presentations on absorbable plate from Japanese academic meetings. The search results comprising the past five years for the retrieval key ‘‘absorbable plate’’ from the IchushiWeb database located 34 publications and 59 academic presentations. When the search period was undefined, 60 publications and 100 academic presentations were located. Thus, research on this topic is somewhat limited.
AAOMS 2014
(3) Materials used for osteosynthesis in Japan. According to a study by Kobayashi T, Saito T, et al., miniplates were used in 70.3% of osteosynthesis cases, screws in 13.5%, miniplates or screws in 11.2%, miniplates or intraosseous wiring in 2.2%, miniplates, screws, or intraosseous wiring in 1.1%, and intraosseous wiring in 1.1% for jaw deformity treatment in Japan from April 2006 to March 2007. Miniplates were primarily used; however, the ratio between titanium plates and absorbable plates used was not described. A study by Yamada S et al. reported that 56 cases of sagittal split osteotomy SSRO) from 1991 through 2006 used the Obwegeser-Dal Pont method for osteosynthesis; metal screws were used in 42.2% of cases; metal plates alone were used in 27.7%; a PLLA alone was used in 12.0%; bone suture with wire was used in 4.8%; and PLLA screws alone were used in 1.2%. Titanium plates surpassed absorbable plates in number of applications. The reason may include the following disadvantages of absorbable plates: poor operability, difficult confirmation of indications and contraindications, and the possibility of complications including infection and breakage. Conclusions: Absorbable plates require improvement in quality and operability. Improved absorbable plates will be more clinically applicable and have a wider range of indications. In addition, these improved plates will provide quality of life improvements to patients with deformities. References: 1. T Kobayashi, T Saito, K Omura, et al. Treatment of Jaw Deformity: A Nationwide Survey of the Situation in Japan. Jpn J Jaw Deform, 18(2008), p237 2. S Yamada, G Kawasaki, M Baba, et al. A clinicostatistical ivestigation of orhognathic srgery. Jpn J Oral Diag 19(2006), p 213
POSTER 139 Evaluation of Skeletal Class III Malocclusion patients treated with BSSRO in Surgery-First Approach J. H. Lee: Seoul St.Mary’s Dental Hospital, The Catholic University of Korea, J. U. Park, J. H. Lee, K. H. Kim Purpose: Surgical-orthodontic treatment that eliminates or minimizes presurgical orthodontics, known as Surgery First Approach(SFA), has lately been gaining popularity in East Asian countries. However, its efficacy has yet been thoroughly proven in the literature. The purpose of this study is to evaluate treatment results of skeletal class III malocclusion patients treated with BSSRO in SFA. Patients and Methods: 30 skeletal class III patients who had BSSRO in SFA were included in the study. Lateral cephalometric radiography was taken preoperatively and 1 month and 6 month postoperatively. Pogonion(Pog)
e-129
Poster Session and B point(B) were marked as skeletal landmarks and soft tissue pogonion(Pog’), soft tissue B point(B’) and Lower lip(LL) were marked as soft tissue landmarks. Overjet, overbite and lower incisor axis angle(L1 axis) were measured to assess dental relationship. To test for significance between measurements from each time period, a repeated-measured analysis of variance (ANOVA) was performed. When significant, post-hoc tests with the Bonferroni correction were done(a=0.05). Results: Pogonion and B point showed significant posterior movement in 1 month postsurgery. Vertically, Pogonion moved superiorly after surgery and B point moved superiorly during postoperative orthodontic treatment period. All the soft tissue landmarks moved posteiorly. Overjet and overbite were changed to be within norm. Lower incisor showed labial inclination during postoperative orthodontic treatment period. Conclusions: After the surgery, all the skeletal and soft tissue landmark measurement changes were coherent with the treatment objectives. Also, the treatment results were stable throughout postoperative orthodontics period. Overjet and overbite were normalized and lower incisor angle were changed to be more labially inclined. References: 1. Baek S-H, Ahn H-W, Kwon Y-H, Choi J-Y. Surgery-first approach in skeletal class III malocclusion treated with 2-jaw surgery: evaluation of surgical movement and postoperative orthodontic treatment. J Craniofac Surg 2010;21:332–8. 2. Hernandez-Alfaro F, Guijarro-Martı´nez R, Molina-Coral A, Badı´aEscriche C. ‘ Surgery first’’ in bimaxillary orthognathic surgery. J Oral Maxillofac Surg 2011;69:e201–207. 3. Nagasaka H, Sugawara J, Kawamura H, Nanda R. ‘ Surgery first’’ skeletal Class III correction using the Skeletal Anchorage System. J Clin Orthod 2009;43:97–105.
POSTER 140 The effect of tractive force using a temporary anchorage device (screw type) on the alveolar bone-Stress Analysis using the Three-Dimensional Finite Element Method A. Nakajima: Osaka Dental University, M. Nakajima, Y. Shoju, K. Kakudo Statements of the Problem: Temporary anchorage devices (TAD) have been used for tooth intrusion and distal movement in recent years, and their clinical usefulness has been recognized. One of the advantages of using TAD in orthodontic treatment is shortening of the treatment period. A three-dimensional model of the maxilla was constructed to evaluate the utility of TAD, and stress change affecting the alveolar bone after the extraction of the first premolar was investigated using a three-dimensional finite element method. e-130
Materials and Methods: An outline of the model was fabricated from CT image data with extracted contours using the stress analysis software MECHANICAL FINDER version 6.2, followed by the construction of a threedimensional maxillary model and fabrication of an extracted maxillary first premolar model. Four chronological models, immediately after tooth extraction, and after 1, 3, and 6 months, were fabricated by changing the CT values of the extracted area based on this model. A TAD was constructed in the mesial area of the upper first molar using SolidWorks (Solid Works Corporation.). Method of Data Analysis: The upper first molar was constrained, and the upper canine was pulled in a distal direction towards a constructed anchor at 1 N to analyze stress change affecting the alveolar bone of the extracted area. Results: Stress affecting the alveolar bone of the extracted area peaked immediately after tooth extraction, gradually decreased from 1 to 6 months, and reached a minimum at 6 months. Similarly, the amount of tooth displacement peaked immediately after tooth extraction, and gradually decreased from 1 to 6 months, and reached a minimum at 6 months. Conclusions: The results suggest that it is more beneficial to apply tractive force in an early stage after tooth extraction for distal tooth movement using TAD. References: 1. Ozaki K, Nakajima M, Kakudo K. Biomechanical analysis of corcicotomy. Jpn Journal of Osaka Dental University 2013;47-1 2. Motohashi T, Nakajima M, Kakudo K. Three-demensional finite element stress analysis on compression osteogenesis. Jpn J Jaw Deform 2007; 17: 1-8.
POSTER 141 Retrospective Assessment of Patient Satisfaction After Orthognathic Surgery K. Kufta: Harvard School of Dental Medicine, Z. S. Peacock, S. K. Chuang, L. M. Levin Orthognathic correction of dentofacial deformities can have a dramatic effect on a patient’s life with potential for improvements in function and appearance. After orthognathic surgery, patients have been reported to be dissatisfied with biting (62%), chewing (55%), numbness (53%), and facial swelling (34%).1 Patients are nearly 8 times more likely to be satisfied when others have noticed a change in appearance.2 Few other data exists on what particular changes are related to overall satisfaction. Postoperative patient satisfaction studies provide opportunities to improve communication with the patient prior to the operation and tailor treatment to match expectations. The purpose of this study was to compare overall patient satisfaction with specific categories of satisfaction: (1) appearance, (2) functional abilities, (3) general health, AAOMS 2014
POSTER 138 Application of Resorbable Plates: Japanese Experience M. Shikimori: Asahi University School of Dentistry, Division of Oral Pathogenesis and Diseases Control Statement of the Problem: Plates or screws are used in osteosynthesis for jaw deformities. They are constructed of either titanium or absorbable materials. Various types of titanium plates have been developed and are widely used. They are removed approximately one year following osteosynthesis. Use of absorbable plates began around 1995 in Japan. When introduced, absorbable plates were expected to be widelyaccepted because they do not require removal. However, due to their complicated manipulation and high cost, they are used less than their titanium counterparts. This report presents an overview of plate application in osteosynthesis for jaw deformities, actual status and issues regarding absorbable plates in Japan. Materials and Methods: The following materials and methods were used to evaluate the status of absorbable plates Japan; relevant issues are discussed: (1) Published documents on absorbable plates used in Japan. (2) Number of published articles and presentations on absorbable plates in Japanese academic meetings that were archived in the Japana Centra Revuo medicina (Ichishi) database. (3) Materials used in osteosynthesis for jaw deformity used in Japan, as documented by past publications. (4) Efforts for improving operability Results: (1) Absorbable plates used in Japan. Absorbable plates began to be used about 1995 in Japan; improvements have been made since then. At present, three types of plates from three companies are available: PLLAPGA, u-HA/PLLA and PLLA. (2) Number of published articles and presentations on absorbable plate from Japanese academic meetings. The search results comprising the past five years for the retrieval key ‘‘absorbable plate’’ from the IchushiWeb database located 34 publications and 59 academic presentations. When the search period was undefined, 60 publications and 100 academic presentations were located. Thus, research on this topic is somewhat limited.
AAOMS 2014
(3) Materials used for osteosynthesis in Japan. According to a study by Kobayashi T, Saito T, et al., miniplates were used in 70.3% of osteosynthesis cases, screws in 13.5%, miniplates or screws in 11.2%, miniplates or intraosseous wiring in 2.2%, miniplates, screws, or intraosseous wiring in 1.1%, and intraosseous wiring in 1.1% for jaw deformity treatment in Japan from April 2006 to March 2007. Miniplates were primarily used; however, the ratio between titanium plates and absorbable plates used was not described. A study by Yamada S et al. reported that 56 cases of sagittal split osteotomy SSRO) from 1991 through 2006 used the Obwegeser-Dal Pont method for osteosynthesis; metal screws were used in 42.2% of cases; metal plates alone were used in 27.7%; a PLLA alone was used in 12.0%; bone suture with wire was used in 4.8%; and PLLA screws alone were used in 1.2%. Titanium plates surpassed absorbable plates in number of applications. The reason may include the following disadvantages of absorbable plates: poor operability, difficult confirmation of indications and contraindications, and the possibility of complications including infection and breakage. Conclusions: Absorbable plates require improvement in quality and operability. Improved absorbable plates will be more clinically applicable and have a wider range of indications. In addition, these improved plates will provide quality of life improvements to patients with deformities. References: 1. T Kobayashi, T Saito, K Omura, et al. Treatment of Jaw Deformity: A Nationwide Survey of the Situation in Japan. Jpn J Jaw Deform, 18(2008), p237 2. S Yamada, G Kawasaki, M Baba, et al. A clinicostatistical ivestigation of orhognathic srgery. Jpn J Oral Diag 19(2006), p 213
POSTER 139 Evaluation of Skeletal Class III Malocclusion patients treated with BSSRO in Surgery-First Approach J. H. Lee: Seoul St.Mary’s Dental Hospital, The Catholic University of Korea, J. U. Park, J. H. Lee, K. H. Kim Purpose: Surgical-orthodontic treatment that eliminates or minimizes presurgical orthodontics, known as Surgery First Approach(SFA), has lately been gaining popularity in East Asian countries. However, its efficacy has yet been thoroughly proven in the literature. The purpose of this study is to evaluate treatment results of skeletal class III malocclusion patients treated with BSSRO in SFA. Patients and Methods: 30 skeletal class III patients who had BSSRO in SFA were included in the study. Lateral cephalometric radiography was taken preoperatively and 1 month and 6 month postoperatively. Pogonion(Pog)
e-129
Poster Session and B point(B) were marked as skeletal landmarks and soft tissue pogonion(Pog’), soft tissue B point(B’) and Lower lip(LL) were marked as soft tissue landmarks. Overjet, overbite and lower incisor axis angle(L1 axis) were measured to assess dental relationship. To test for significance between measurements from each time period, a repeated-measured analysis of variance (ANOVA) was performed. When significant, post-hoc tests with the Bonferroni correction were done(a=0.05). Results: Pogonion and B point showed significant posterior movement in 1 month postsurgery. Vertically, Pogonion moved superiorly after surgery and B point moved superiorly during postoperative orthodontic treatment period. All the soft tissue landmarks moved posteiorly. Overjet and overbite were changed to be within norm. Lower incisor showed labial inclination during postoperative orthodontic treatment period. Conclusions: After the surgery, all the skeletal and soft tissue landmark measurement changes were coherent with the treatment objectives. Also, the treatment results were stable throughout postoperative orthodontics period. Overjet and overbite were normalized and lower incisor angle were changed to be more labially inclined. References: 1. Baek S-H, Ahn H-W, Kwon Y-H, Choi J-Y. Surgery-first approach in skeletal class III malocclusion treated with 2-jaw surgery: evaluation of surgical movement and postoperative orthodontic treatment. J Craniofac Surg 2010;21:332–8. 2. Hernandez-Alfaro F, Guijarro-Martı´nez R, Molina-Coral A, Badı´aEscriche C. ‘ Surgery first’’ in bimaxillary orthognathic surgery. J Oral Maxillofac Surg 2011;69:e201–207. 3. Nagasaka H, Sugawara J, Kawamura H, Nanda R. ‘ Surgery first’’ skeletal Class III correction using the Skeletal Anchorage System. J Clin Orthod 2009;43:97–105.
POSTER 140 The effect of tractive force using a temporary anchorage device (screw type) on the alveolar bone-Stress Analysis using the Three-Dimensional Finite Element Method A. Nakajima: Osaka Dental University, M. Nakajima, Y. Shoju, K. Kakudo Statements of the Problem: Temporary anchorage devices (TAD) have been used for tooth intrusion and distal movement in recent years, and their clinical usefulness has been recognized. One of the advantages of using TAD in orthodontic treatment is shortening of the treatment period. A three-dimensional model of the maxilla was constructed to evaluate the utility of TAD, and stress change affecting the alveolar bone after the extraction of the first premolar was investigated using a three-dimensional finite element method. e-130
Materials and Methods: An outline of the model was fabricated from CT image data with extracted contours using the stress analysis software MECHANICAL FINDER version 6.2, followed by the construction of a threedimensional maxillary model and fabrication of an extracted maxillary first premolar model. Four chronological models, immediately after tooth extraction, and after 1, 3, and 6 months, were fabricated by changing the CT values of the extracted area based on this model. A TAD was constructed in the mesial area of the upper first molar using SolidWorks (Solid Works Corporation.). Method of Data Analysis: The upper first molar was constrained, and the upper canine was pulled in a distal direction towards a constructed anchor at 1 N to analyze stress change affecting the alveolar bone of the extracted area. Results: Stress affecting the alveolar bone of the extracted area peaked immediately after tooth extraction, gradually decreased from 1 to 6 months, and reached a minimum at 6 months. Similarly, the amount of tooth displacement peaked immediately after tooth extraction, and gradually decreased from 1 to 6 months, and reached a minimum at 6 months. Conclusions: The results suggest that it is more beneficial to apply tractive force in an early stage after tooth extraction for distal tooth movement using TAD. References: 1. Ozaki K, Nakajima M, Kakudo K. Biomechanical analysis of corcicotomy. Jpn Journal of Osaka Dental University 2013;47-1 2. Motohashi T, Nakajima M, Kakudo K. Three-demensional finite element stress analysis on compression osteogenesis. Jpn J Jaw Deform 2007; 17: 1-8.
POSTER 141 Retrospective Assessment of Patient Satisfaction After Orthognathic Surgery K. Kufta: Harvard School of Dental Medicine, Z. S. Peacock, S. K. Chuang, L. M. Levin Orthognathic correction of dentofacial deformities can have a dramatic effect on a patient’s life with potential for improvements in function and appearance. After orthognathic surgery, patients have been reported to be dissatisfied with biting (62%), chewing (55%), numbness (53%), and facial swelling (34%).1 Patients are nearly 8 times more likely to be satisfied when others have noticed a change in appearance.2 Few other data exists on what particular changes are related to overall satisfaction. Postoperative patient satisfaction studies provide opportunities to improve communication with the patient prior to the operation and tailor treatment to match expectations. The purpose of this study was to compare overall patient satisfaction with specific categories of satisfaction: (1) appearance, (2) functional abilities, (3) general health, AAOMS 2014