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Poster 069: Restoration of Bony Deformities of Maxillofacial Bone With Plastic and Esthetic Technique
Scientific Poster Session Materials and methods: The study group consisted of 12 patients with mandibular prognathism (5 males and 7 females) who underwent mandibular setback surgery (BBSRO) in the Department of Oral and Maxillofacial Surgery, Samsung Medical Center. Bite force was measured at pre op, post op 3, 6, and 12 months by occlusal force meter (GM10, Nagano Keiki, Japan). The preoperative CT examination of subjects was performed between one month prior to operation and one year after operation. And muscle volume was measured. Result: As compared to preoperative measurements at 1 year postoperatively the masseter & medial pterygoid muscle volume were diminished (paired t-test p⬍ 0.05). The bite force steadily recovered, so at postoperatively 6 months it nreached the preoperative level. And at 1 year after operation, the maximum bite force was significantly greater than preoperative levels. No significant correlation was presented between masseter muscle volume and bite force (Spearman correlation analysis p⬎0.05), Medial pterygoid muscle volume and bite force (Spearman correlation analysis p⬎0.05). Conclusion: In this study, the results showed that volume and bite force of the masticatory muscles decreased significantly after orthognathic surgery for mandibular setback. But any temporary reduction in maximum bite force disappears less than 6 months after surgery. References Katsumata A, Fujishita M, Ariji Y, Ariji E, Langlais RP: 3D CT evaluation of masseter muscle morphology after setback osteotomy for mandibular prognathism. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98:461-470 Ellis E, 3rd, Throckmorton GS, Sinn DP: Bite forces before and after surgical correction of mandibular prognathism. J Oral Maxillofac Surg 1996;54:176-181
POSTER 069 Restoration of Bony Deformities of Maxillofacial Bone With Plastic and Esthetic Technique Yuxin Wang, MD, Affiliated Stomatological Hospital China Medical University, 177 Nanjing Street Heping District, Shenyang, Liaoning, 110002, China (Yang ML; Luli) Objective: In order to improve the aesthetic results of restoration of bony deformities in maxillofacial region. To introduce the technique about restoration of bony deformities of maxillofacial bone based on orthodontic, plastic, and traumatic surgery. Methods: There are 2175 cases with various bony deformities that had been treated from January 1988 to January 2008 in our hospital. Among them 398 cases suffered from congenital development bony deformities including maxillary and mandible protrusion, upper and 108
lower jaw retrusion, laterognathism, and long face syndrome etc; another 1,777 cases of bony malformation caused by trauma including naso-orbito-ethmoidal complex, zygomatic maxillary complex, upper maxillofacial fractures, and mandible fractures. All patients had undertaken CT examination. It is necessary to take cephalometric – radiography, panography and cast model surgery to evaluate the conditions of maxillofacial bones, nose, orbit and eyes. Surgical technique of Le Fort I, Le Fort I1/2, Le Fort II and SSRO, genioplasy, reduction of mandible angles and mallar bone or augmentation malarplasty have been used for congenital deformities. For the traumatic bone malformation it underwent surgical replacement, internal fixation using several cosmetics favorable incisions. At the same time, nasal deformities were corrected with reduction and rhinoplasty technique. Correction of posttraumatic deformities is conceptualized in three steps: 1. Mobilization of soft tissue from the bone throughout and to just beyond the entire area of fracture. 2. Repositioning (with repair) of anterior and middle sections of bony orbital rim and walls into their proper position. 3. Reattachment of the soft tissue to the bone at the proper location. Results: After one month to eighteen years follow-up study, the outcomes of these patients were satisfactory functionally and esthetically, except that three cases suffered postoperative infection, twenty percent patients had temporary numbness of lower lip, after SSRO operation and recovery in the 1 to 6 months. Among 1,777 traumatic cases 19 cases suffered complication such as residual enophthalmos 5 cases; diplopia 4 cases and insufficient prominence of mid face 10 cases, which underwent secondary correction with good results. Conclusion: Comprehensive pre-operative evaluation of the patient and careful examinations should be taken to work out an appropriate operative plan. Joined and correct use of orthodontic, plastic, esthetic, and traumatic surgery technique is critical to obtain good results.
POSTER 070 Accuracy of a New Technique for Recording Natural Head Position in 3 Dimensions James J. Xia, MD, PhD, MS, Department of Oral and Maxillofacial Surgery, The Methodist Hospital Research Institute, 6560 Fannin, Suite 1228, Houston, TX 77030 (Gateno J; Schatz EC; Weiskircher MN; English JD, Teichgraeber JF) Purpose: Natural head position (NHP) is a vital piece of information in the diagnosis and treatment of patients with cranio-maxillofacial deformities. This is especially true in patients with complex asymmetric deformities. In these patients, three-dimensional (3D) computed toAAOMS • 2008
POSTER 069 Restoration of Bony Deformities of Maxillofacial Bone With Plastic and Esthetic Technique Yuxin Wang, MD, Affiliated Stomatological Hospital China Medical University, 177 Nanjing Street Heping District, Shenyang, Liaoning, 110002, China (Yang ML; Luli) Objective: In order to improve the aesthetic results of restoration of bony deformities in maxillofacial region. To introduce the technique about restoration of bony deformities of maxillofacial bone based on orthodontic, plastic, and traumatic surgery. Methods: There are 2175 cases with various bony deformities that had been treated from January 1988 to January 2008 in our hospital. Among them 398 cases suffered from congenital development bony deformities including maxillary and mandible protrusion, upper and 108
lower jaw retrusion, laterognathism, and long face syndrome etc; another 1,777 cases of bony malformation caused by trauma including naso-orbito-ethmoidal complex, zygomatic maxillary complex, upper maxillofacial fractures, and mandible fractures. All patients had undertaken CT examination. It is necessary to take cephalometric – radiography, panography and cast model surgery to evaluate the conditions of maxillofacial bones, nose, orbit and eyes. Surgical technique of Le Fort I, Le Fort I1/2, Le Fort II and SSRO, genioplasy, reduction of mandible angles and mallar bone or augmentation malarplasty have been used for congenital deformities. For the traumatic bone malformation it underwent surgical replacement, internal fixation using several cosmetics favorable incisions. At the same time, nasal deformities were corrected with reduction and rhinoplasty technique. Correction of posttraumatic deformities is conceptualized in three steps: 1. Mobilization of soft tissue from the bone throughout and to just beyond the entire area of fracture. 2. Repositioning (with repair) of anterior and middle sections of bony orbital rim and walls into their proper position. 3. Reattachment of the soft tissue to the bone at the proper location. Results: After one month to eighteen years follow-up study, the outcomes of these patients were satisfactory functionally and esthetically, except that three cases suffered postoperative infection, twenty percent patients had temporary numbness of lower lip, after SSRO operation and recovery in the 1 to 6 months. Among 1,777 traumatic cases 19 cases suffered complication such as residual enophthalmos 5 cases; diplopia 4 cases and insufficient prominence of mid face 10 cases, which underwent secondary correction with good results. Conclusion: Comprehensive pre-operative evaluation of the patient and careful examinations should be taken to work out an appropriate operative plan. Joined and correct use of orthodontic, plastic, esthetic, and traumatic surgery technique is critical to obtain good results.
POSTER 070 Accuracy of a New Technique for Recording Natural Head Position in 3 Dimensions James J. Xia, MD, PhD, MS, Department of Oral and Maxillofacial Surgery, The Methodist Hospital Research Institute, 6560 Fannin, Suite 1228, Houston, TX 77030 (Gateno J; Schatz EC; Weiskircher MN; English JD, Teichgraeber JF) Purpose: Natural head position (NHP) is a vital piece of information in the diagnosis and treatment of patients with cranio-maxillofacial deformities. This is especially true in patients with complex asymmetric deformities. In these patients, three-dimensional (3D) computed toAAOMS • 2008