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Maxillary orthognathic osteotomy with piezoelectric device without vestibular horizontal mucosal incision to avoid alar base widening
21st ICOMS 2013 - Abstracts: Oral Papers
1337
T26.OR056
T26.OR058
Carving faces-with orthognathic surgery
Maxillary orthognathic osteotomy with piezoelectric device without vestibular horizontal mucosal incision to avoid alar base widening
M. Shaik J. Shimada St. Joseph Dental College, India Introduction: The aim of the present paper is to access the aesthetic facial profile and outcome with orthognathic surgical procedures. The artistic aspect of orthognathic surgery has been developing for decades. The scientific aspect of these procedures has been investigated by clinical and academic surgeons around the world. Materials and methods: 20 patients were reported with dentofacial deformities. All 20 cases were operated according to surgical protocol. Results: All cases were operated at St. Joseph General Hospital, India. Surgical outcome was successful with good facial aesthetic providing good occlusion and function. Conclusion: We present our experience in the field of orthognathic surgery. The possible surgical procedures made us to carve new faces with better results. http://dx.doi.org/10.1016/j.ijom.2013.07.581 T26.OR057 To identify trends between specific parameters of dentofacial deformity and progression to orthognathic surgery P. Sharma ∗ , K. Fan, L. O’Higgins, F. Wong King’s College Hospital, United Kingdom Aims: To quantify dentofacial deformity as defined by clinical examination and cephalometric meaurements. To compare those opting for surgical and conservative treatment. To identify parameters that significantly correlate with treatment choice. Sample: A pilot study of 57 patients measured the following parameters: gender, racial, anteroposterior relationship, vertical relationship, transverse relationship, ANB, lip competence, overjet, overbite and crowding and identified the following variables as significant in progression to surgery: • • • • • •
Female Clinically class II (AP) Overjet >6 mm Severe skeletal class II (ANB) Severe skeletal class III (ANB) Skeletal class III and AOB
This study will examine all patients (320) referred to the joint orthognathic clinic at Kings College Hospital between 2005 and 2012. http://dx.doi.org/10.1016/j.ijom.2013.07.582
Division of First Oral and Maxillofacial Surgery, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Japan Alar base widening and nasal tip upward movement are undesirable soft tissue changes taken place after maxillary orthognathic surgery. With the use of piezoelectric device (PED), maxillary anterior alveolar osteotomy and Le Fort I type osteotomy are performed without making horizontal vestibular mucosal incision to preserve the soft tissue shape. Methods: For anterior alveolar osteotomy, a pair of 3-cm mucoperiosteal incision is made from the premolar area in a slightly posterosuperior direction. Any premolar teeth to be extracted are extracted carefully. The buccal cortical bone is removed by osteotomy using a saw-type tip attached to a piezoelectric device (PED) at the same width as the distance of posterior repositioning. The osteotomy line is elongated in an L-shape toward the piriform aperture from a position approximately 5 mm superior to the apex of the canine tooth, and then the palatine bone is removed from the side of the removed buccal bone. For Le Fort I type osteotomy, horizontal vestibular mucosal incisions from canine to molar area are made in both sides. Osteotomy to move total maxillary alveolar segment is made with PED only in the maxillary anterior and posterior bony wall portion. Down fracture is performed with a pair of separators without a pterygomaxillary suture and nasal septum osteotomy. The bone fragments can be repositioned without dissecting the nasal septum, and a alar base cinch suture is no need. Results and discussion: The use of bone burs and bone saws results frequently in heavy bleeding. A little bleeding is encountered with this method. Because the present surgical technique preserves blood supply to the bone fragments being repositioned from both the palatal and buccal mucosa, the method is safe and offers favourable outcomes. Furthermore, the soft tissue shape of upper lip and nose is preserved without the use of alar base cinch suture. http://dx.doi.org/10.1016/j.ijom.2013.07.583 T26.OR059 Comparison in the assessment of facial aesthetics and personality traits between patients with a dysgnathia and a naive control group K. Sinko 1,∗ , R. Jagsch 2 , J. Dmyterko 3 , G. Millesi 1 1 Department 2 3
of Cranio-, Maxillofacial and Oral Surgery, Medical University, Vienna, Austria Department of Clinical Psychology, University Vienna, Austria Department of Radiology, Medical University, Vienna, Austria
Background and objectives: Improvement of facial aesthetics is one of the main reasons for orthognathic surgery. In respect of aesthetics and also the assignment of personality traits skeletal dysgnathia patients benefit markedly from orthognathic surgery. Aim of this study was to find out how patients, affected by a skeletal dysgnathia, rate photographs of patients with a skeletal dysgnathia before and after orthognathic surgery in respect of aesthetics and some personality traits, and if there is a difference to a naive control group. Another question was if skeletal Class II and Class III patients differ in their rating. Methods: 108 patients (61 with a skeletal Class II and 47 with a skeletal Class III) rated 40 profile photographs of women (8 skeletal Class II, pre and post surgery, 8 skeletal Class III, pre and post surgery and 8 skeletal Class I) on a 7-point Likert scale in respect of aesthetics and five personality traits. 92 naive volunteers rating the same photographs served as a control group. Results: There was found a significant improvement of facial aesthetics and the assignment of personality traits post surgery. Patients with a skeletal dysgnathia rated all preoperative pictures less critical than naive people. In respect to personality traits the differences to naive people were found less pronounced. There was no significant difference between the Class II and Class III patients’ rating. Conclusions: Patients with a skeletal Class II or Class III seem to be less critical in the assessment of facial aesthetics. In respect of the assignment of personality traits the results were less pronounced and similar to those of a naive control group. Key words: facial aesthetics; personality traits; orthognathic surgery http://dx.doi.org/10.1016/j.ijom.2013.07.584
1337
T26.OR056
T26.OR058
Carving faces-with orthognathic surgery
Maxillary orthognathic osteotomy with piezoelectric device without vestibular horizontal mucosal incision to avoid alar base widening
M. Shaik J. Shimada St. Joseph Dental College, India Introduction: The aim of the present paper is to access the aesthetic facial profile and outcome with orthognathic surgical procedures. The artistic aspect of orthognathic surgery has been developing for decades. The scientific aspect of these procedures has been investigated by clinical and academic surgeons around the world. Materials and methods: 20 patients were reported with dentofacial deformities. All 20 cases were operated according to surgical protocol. Results: All cases were operated at St. Joseph General Hospital, India. Surgical outcome was successful with good facial aesthetic providing good occlusion and function. Conclusion: We present our experience in the field of orthognathic surgery. The possible surgical procedures made us to carve new faces with better results. http://dx.doi.org/10.1016/j.ijom.2013.07.581 T26.OR057 To identify trends between specific parameters of dentofacial deformity and progression to orthognathic surgery P. Sharma ∗ , K. Fan, L. O’Higgins, F. Wong King’s College Hospital, United Kingdom Aims: To quantify dentofacial deformity as defined by clinical examination and cephalometric meaurements. To compare those opting for surgical and conservative treatment. To identify parameters that significantly correlate with treatment choice. Sample: A pilot study of 57 patients measured the following parameters: gender, racial, anteroposterior relationship, vertical relationship, transverse relationship, ANB, lip competence, overjet, overbite and crowding and identified the following variables as significant in progression to surgery: • • • • • •
Female Clinically class II (AP) Overjet >6 mm Severe skeletal class II (ANB) Severe skeletal class III (ANB) Skeletal class III and AOB
This study will examine all patients (320) referred to the joint orthognathic clinic at Kings College Hospital between 2005 and 2012. http://dx.doi.org/10.1016/j.ijom.2013.07.582
Division of First Oral and Maxillofacial Surgery, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Japan Alar base widening and nasal tip upward movement are undesirable soft tissue changes taken place after maxillary orthognathic surgery. With the use of piezoelectric device (PED), maxillary anterior alveolar osteotomy and Le Fort I type osteotomy are performed without making horizontal vestibular mucosal incision to preserve the soft tissue shape. Methods: For anterior alveolar osteotomy, a pair of 3-cm mucoperiosteal incision is made from the premolar area in a slightly posterosuperior direction. Any premolar teeth to be extracted are extracted carefully. The buccal cortical bone is removed by osteotomy using a saw-type tip attached to a piezoelectric device (PED) at the same width as the distance of posterior repositioning. The osteotomy line is elongated in an L-shape toward the piriform aperture from a position approximately 5 mm superior to the apex of the canine tooth, and then the palatine bone is removed from the side of the removed buccal bone. For Le Fort I type osteotomy, horizontal vestibular mucosal incisions from canine to molar area are made in both sides. Osteotomy to move total maxillary alveolar segment is made with PED only in the maxillary anterior and posterior bony wall portion. Down fracture is performed with a pair of separators without a pterygomaxillary suture and nasal septum osteotomy. The bone fragments can be repositioned without dissecting the nasal septum, and a alar base cinch suture is no need. Results and discussion: The use of bone burs and bone saws results frequently in heavy bleeding. A little bleeding is encountered with this method. Because the present surgical technique preserves blood supply to the bone fragments being repositioned from both the palatal and buccal mucosa, the method is safe and offers favourable outcomes. Furthermore, the soft tissue shape of upper lip and nose is preserved without the use of alar base cinch suture. http://dx.doi.org/10.1016/j.ijom.2013.07.583 T26.OR059 Comparison in the assessment of facial aesthetics and personality traits between patients with a dysgnathia and a naive control group K. Sinko 1,∗ , R. Jagsch 2 , J. Dmyterko 3 , G. Millesi 1 1 Department 2 3
of Cranio-, Maxillofacial and Oral Surgery, Medical University, Vienna, Austria Department of Clinical Psychology, University Vienna, Austria Department of Radiology, Medical University, Vienna, Austria
Background and objectives: Improvement of facial aesthetics is one of the main reasons for orthognathic surgery. In respect of aesthetics and also the assignment of personality traits skeletal dysgnathia patients benefit markedly from orthognathic surgery. Aim of this study was to find out how patients, affected by a skeletal dysgnathia, rate photographs of patients with a skeletal dysgnathia before and after orthognathic surgery in respect of aesthetics and some personality traits, and if there is a difference to a naive control group. Another question was if skeletal Class II and Class III patients differ in their rating. Methods: 108 patients (61 with a skeletal Class II and 47 with a skeletal Class III) rated 40 profile photographs of women (8 skeletal Class II, pre and post surgery, 8 skeletal Class III, pre and post surgery and 8 skeletal Class I) on a 7-point Likert scale in respect of aesthetics and five personality traits. 92 naive volunteers rating the same photographs served as a control group. Results: There was found a significant improvement of facial aesthetics and the assignment of personality traits post surgery. Patients with a skeletal dysgnathia rated all preoperative pictures less critical than naive people. In respect to personality traits the differences to naive people were found less pronounced. There was no significant difference between the Class II and Class III patients’ rating. Conclusions: Patients with a skeletal Class II or Class III seem to be less critical in the assessment of facial aesthetics. In respect of the assignment of personality traits the results were less pronounced and similar to those of a naive control group. Key words: facial aesthetics; personality traits; orthognathic surgery http://dx.doi.org/10.1016/j.ijom.2013.07.584