Document Detail


Three-dimensional assessment of mandibular advancement 1 year after surgery.
MedLine Citation:
PMID:  20381760     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: This prospective observational study evaluated changes in the 3-dimensional position and remodeling of the mandibular rami, condyles, and chin at splint removal and 1 year after mandibular advancement surgery.
METHODS: Presurgery, splint removal (4-6 weeks postsurgery), and 1-year postsurgery cone-beam computed tomography scans of 27 subjects were used. Superimposition on the cranial base was used to assess positional or remodeling changes in the anatomic regions of interest. Surface distance displacements were visually displayed and quantified by 3-dimensional color maps. A 1-sample t test was used to assess the average postsurgical changes of each region of interest. The level of significance was set at 0.05.
RESULTS: After antero-inferior chin displacement with surgery (mean, 6.81 +/- 3.2 mm at splint removal), the average 1-year postsurgery displacement was not statistically significant (P = 0.44). Postsurgical adaptations greater than 2 mm were observed in 48% of the patients: 16% with an additional anterior-inferior displacement of the chin of 2 to 4 mm, and 4% with >or= 4 mm; 20% had postero-superior movement of 2 to 4 mm, and 8% had postero-superior movement of >or= 4 mm. The condyles tended to move, on average, <or= 2 mm supero-posteriorly with surgery, and this small positional displacement was maintained 1 year postsurgery (right condyle, P = 0.58; left, P = 0.88). The rami exhibited outward (lateral) movements with surgery, with greater displacement of the inferior part of the rami (2 mm in 65% of the subjects). This torque of the ramus with surgery was stable 1 year postsurgery.
CONCLUSIONS: Three-dimensional assessment of skeletal changes with mandibular advancement surgery shows that nearly half of the patients have >2 mm change in chin position from splint removal to the 1-year follow-up, with approximately equal chances of anterior and posterior movement. Torque of the rami usually occurs with mandibular advancement surgery.
Authors:
Felipe de Assis Ribeiro Carvalho; Lucia Helena Soares Cevidanes; Alexandre Trindade Simões da Motta; Marco Antonio de Oliveira Almeida; Ceib Phillips
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics     Volume:  137     ISSN:  1097-6752     ISO Abbreviation:  Am J Orthod Dentofacial Orthop     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-12     Completed Date:  2010-05-03     Revised Date:  2014-07-04    
Medline Journal Info:
Nlm Unique ID:  8610224     Medline TA:  Am J Orthod Dentofacial Orthop     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S53.e1-12; discussion S53-5     Citation Subset:  D; IM    
Copyright Information:
Copyright 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cephalometry / methods
Chin / radiography
Computer Simulation
Cone-Beam Computed Tomography
Female
Humans
Imaging, Three-Dimensional / methods*
Male
Malocclusion, Angle Class II / surgery*
Mandible / radiography*
Mandibular Advancement*
Middle Aged
Outcome Assessment (Health Care)
Postoperative Period
Prospective Studies
Recurrence
Skull Base / radiography
Software
Subtraction Technique
Torsion, Mechanical
Young Adult
Grant Support
ID/Acronym/Agency:
DE005215/DE/NIDCR NIH HHS; DE017727/DE/NIDCR NIH HHS; DE018962/DE/NIDCR NIH HHS; K23 DE017727/DE/NIDCR NIH HHS; K23 DE017727-04/DE/NIDCR NIH HHS; R03 DE018962/DE/NIDCR NIH HHS; R03 DE018962-02/DE/NIDCR NIH HHS
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