Orthognathic Surgery For Correction Research Articles

Assessment of changes in muscle activity using electromyography in patients undergoing orthognathic surgery

The aim of the present clinical trial study is to evaluate the effect of double jaw orthognathic surgery (OGS) on electromyographic activity of the masseter, anterior temporal, digastric, and sternocleidomastoid muscles in skeletal Class III patients. This prospective study included 10 patients who underwent Lefort 1 osteotomy of the maxilla and genioplasty of the mandible to correct skeletal dental class III malocclusion and presurgical and postsurgical EMG data were analyzed and compared. The participants underwent bilateral surface electromyography activity evaluation with a focus on the masseter, anterior temporalis, digastric and sternocleidomastoid muscles. Recordings were made each during 3 jaw positions: clench, resting and swallowing positions. The pre-surgical EMG data were compared with the post-surgical EMG data taken after 1 month to evaluate any changes in muscle activity. A significant increase in the average EMG activity after an orthognathic corrective surgery was observed. There were no significant postoperative changes in the EMG potentials of the anterior temporalis and masseter bilateral balance in the pre-op and post-op clench positions. Significant muscle posturing was observed in the post-op resting position with bilateral masseter, sternocleidomastoid, and right temporalis values>2mcv with mandible and rest.

Customized Three-Dimensional Printing Spacers for Bone Positioning in Orthognathic Surgery for Correction and Prevention of Facial Asymmetry.

Orthognathic surgery is a powerful tool for correction of facial asymmetry and malocclusion. The goal is to achieve good dental function and facial aesthetics. Three-dimensional simulation is used for surgical planning, and bone gaps could be created to achieve facial balance. In this study, customized "spacers" were made using computer-aided design and three-dimensional printing for guides for use during surgery. With the final three-dimensional plan, the skull images were exported to 3-Matic software, where spacers were designed according to the bone gaps. Three-dimensionally-printed spacers were made and used to facilitate positioning and fixation. Consecutive patients with facial asymmetry were recruited in this prospective study. The postoperative outcome was assessed using a visual analogue scale and the three-dimensional facial surface area discrepancy index for subjective and objective evaluation. There were 12 patients and a total of 19 spacers for the Le Fort I and mandibular ramus segments. The spacers worked nicely during the bone fixation process. Mean preoperative and postoperative visual analogue scale scores were 4.83 and 7.14, with a statistically significant improvement for facial symmetry (p = 0.018). Mean preoperative and postoperative facial surface area discrepancy index was 0.95 and 0.98, and the correction of asymmetry was significant (p = 0.009). There were no related surgical complications. All patients were satisfied with the correction of facial asymmetry and malocclusion. The custom-made, three-dimensionally-printed spacers help to achieve surgical precision to correct and prevent facial asymmetry in orthognathic surgery. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, IV.

Cirurgia Ortognática em paciente portador de Fissura Labiopalatina

INTRODUÇÃO: As fissuras labiais e/ou palatinas (FL±P) são malformações congênitas comuns da face , ocorrem entre a quarta e nona semana do período embrionário. A etiologia ainda incerta aponta para fatores genéticos, ambientais ou mistos, ocorrendo devido à má junção dos processos maxilares e frontonasal. Classificam-se de acordo com o forame incisivo em fissura pré-forame incisivo, fissura pós-forame incisivo, fissura transforame incisivo e fissuras raras da face. Entretanto cirurgias em idade precoce do lábio e palato inibem o crescimento facial, posteriormente a realização de cirurgia ortognática para correção é necessária. OBJETIVO: O presente trabalho teve como objetivo, portanto, apresentar um relato de caso sobre cirurgia ortognática em um paciente fissurado, mostrando a importância do tratamento para a reabilitação do portador. RELATO DE CASO: O estudo se trata de um paciente leucoderma, sexo masculino, 21 anos, portador de fissura transforame unilateral lado esquerdo que procurou o Hospital Santo Antônio das Obras Sociais Irmã Dulce para reabilitação, ao qual o paciente foi submetido a tratamento cirúrgico de avanço de maxila e mentoplastia. CONSIDERAÇÕES FINAIS: É imperativa a necessidade que os pacientes portadores de fissura labiopalatina têm de serem avaliados e acompanhados em centros de referência por uma equipe multidisciplinar, composta principalmente por cirurgiões, ortodontistas e fonoaudiólogos. Neste presente caso paciente encontra-se em acompanhamento pós operatório e satisfeito com tratamento que lhe foi proposto.

Alloplastic TMJ Reconstruction and Orthognathic Surgery for Correction of Acquired Dentofacial Deformity Secondary to Idiopathic Condylar Resorption. a 2 Year Follow up

Alloplastic TMJ Reconstruction and Orthognathic Surgery for Correction of Acquired Dentofacial Deformity Secondary to Idiopathic Condylar Resorption. a 2 Year Follow up

Measuring effectiveness of orthognathic surgery by electromyography: a restrospective clinical study

This study investigates retrospectively if the initial electromyography (EMG) status of patients who underwent orthognathic surgery correlates with the extent of postsurgical EMG functional recovery. Clinical records concerning 20 patients who underwent Le Fort I and/or sagittal osteotomy of the mandibular ramus to correct skeletal dental class III malocclusions were retrieved and presurgical and postsurgical EMG data were analyzed and compared. Additionally, postsurgical EMG recovery was compared with that of a set of healthy, not surgically treated class I patients, with no sign of disorders affecting the temporomandibular joint (TMJ). Finally, the effect of six independent variables (age, sex, time from surgery, extent of segment re-positioning, malocclusion class, upper jaw repositioning) on muscular recovery was investigated by means of correlation analysis. A significant increase of the average EMG activity after orthognathic corrective surgery was observed (P=0.01). The postsurgical increase of EMG values showed a negative correlation trend with those collected before surgery (r=-0.38, clenching on teeth; r=-0.33, clenching on cotton rolls). None of the independent variables had any effect on the postsurgical outcome. Orthognathic surgery improves the muscular activity of patients who present skeletal dental class III malocclusions. This improvement can be objectively assessed with EMG measurements. Patients who benefit more from orthognathic surgery seem to be those displaying the lowest presurgical EMG activity.

Correlation of maxillo-mandibular skeletal changes and change of lip canting in two jaw orthognathic surgery for correction of facial asymmetry

Correlation of maxillo-mandibular skeletal changes and change of lip canting in two jaw orthognathic surgery for correction of facial asymmetry

Orthognathic surgery for correction of facial deformity in a patient with arthrogryposis multiplex congenita (AMC)

Orthognathic surgery for correction of facial deformity in a patient with arthrogryposis multiplex congenita (AMC)

Bone grafting and insertion of dental implants followed by Le Fort advancement for correction of severely atrophic maxilla in young patients

The atrophic maxilla often results in lateral, anteroposterior and vertical disproportion of the maxillary arches. This paper presents the case of a 40-year-old male with a severely atrophic maxilla who underwent oral rehabilitation. He was treated with onlay and inlay iliac bone grafts followed by vestibuloplasty and dental implant placement 170 days after initial bone grafting. The dental implants were uncovered after 4 months of healing. The patient also underwent orthognathic surgery for correction of the maxillary basal bone and to improve implant positioning. At the 48-month follow-up there were no complications.

A Cone-Beam CT-Based Technique to Augment the 3D Virtual Skull Model With a Detailed Dental Surface for Orthognathic Surgery Planning

and Class III elastics were used to protract the maxilla and to hold the maxillary advancement during the consolidation phase. The correction of 3-9 mm crossbites occured within four weeks after sutural loosening. Overcorrection of the malocclusion was followed by a 2-3 month period of consolidation with support from Class III elastics. Treatment outcomes were monitored using cephalometric analysis as well as intraoral and extraoral photographs. Method of Data Analysis: Treatment outcomes were monitored using cephalometric analysis as well as intraoral and extraoral photographs. Results: In our retrospective analysis of 30 maxillary protraction cases, there was significant relapse which necessitated overcorrection. Four cases failed due to poor cooperation. However, 26 patients were able to avoid orthognathic surgery for correction of skeletal underbites that ranged from 3-9 mm. Microscrews were added to eliminate headgear and to enhance skeletal movement in older patients. Conclusion: While preliminary, these results suggest that maxillary protraction is possible in the adolescent cleft lip and palate patient which contradicts previous studies on maxillary protraction. The difference between our patients and earlier studies is the loosening of sutures prior to protraction. The mobilization of the maxilla appears to be the critical part of a technique which resembles a distraction osteogenesis of the maxilla. This technique can be a useful alternative to orthognathic surgery in cooperative patients.

Simultaneous malaroplasty with porous polyethylene implants and orthognathic surgery for correction of malar deficiency

Simultaneous malaroplasty with porous polyethylene implants and orthognathic surgery for correction of malar deficiency