• Title/Summary/Keyword: Post-operative stability

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THE EFFECT OF PRE-OPERATIVE MAXILLARY OCCLUSAL PLANE ANGLE TO POST-OPERATIVE SKELETAL STABILITY AFTER TWO-JAW SURGERY (수술 전 상악 교합평면각이 상하악 동시 수술 후 골격 안정성에 미치는 영향)

  • Choi, Youn-Mo;Ryu, Dong-Mok;Oh, Jung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.2
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    • pp.141-147
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    • 2007
  • The purpose of this study was to evaluate the effects of maxillary occlusal plane angle to postoperative skeletal stability by comparative analysis after two-jaw surgery of patients with skeletal CIII malocclusion. This study was made with lateral cephalometric radiography of 52 patients with skeletal class III malocclusion that were performed to Le Fort I osteotomy and BSSRO. And 52 patients were divided to Group A(n=30) and B(n=22). Maxillary posterior impaction was not conducted in Group A, which the pre-operative maxillary occlusal plane angle was in a normal range, and for Group B, which the pre-operative maxillary occlusal plane was low, the maxillary posterior impaction was conducted. The results were obtained as follows : 1. The relapse rate of Group A, which the pre-operative maxillary occlusal plane angle was in a normal range, was relatively stable compared to Group B, which the pre-operative maxillary occlusal plane was low. 2. The relapse rate of each measurement of Group B, which had the maxillary occlusal plane altered during the operation, was somewhat high, and of those, the post-operative relapse rate of overjet, overbite, mandibular plane angle appeared to be significantly high in the statistics. The analyzed results above, was thought to be indicating that the pre-operative maxillary occlusal plane angle was closely related to the post-operative skeletal stability, and that obtaining post-operative skeletal stability only through operative normalization of occlusal plane angle may meet limitations.

CONSIDERABLE FACTORS FOR FINAL OCCLUSION IN PRE-ORTHODONTIC LOWER ANTERIOR SEGMENTAL SURGERY AND ITS AVAILABILITY (교정전 하악전치부 분절골절단술 시행시 고려사항 및 그 유용성)

  • Lee, Baek-Soo;Choi, Hyun-Jung;Nam, Kwang-Ho;Ryu, Dong-Mok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.1
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    • pp.43-47
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    • 2003
  • Anterior set back segmental surgery has been used for shortening the period of orthodontic treatment in case of bimaxillary or maxillary protrusion. In most cases, it requires pre-operative orthodontic treatment. Through properly performed leveling and tooth aligning, the operative porcedure can be easier and post-operative occlusal stability can be increased. But it takes time for orthodontic treatment. Recently, we have been using anterior segmental surgery before orthodontic treatment and have reliable results from that. Therefore, we have to consider arch shape, curve of Spee, tooth selection to be extracted for obtaining of post-operative occlusal stability without pre-operative orthodontic treatment.

POST-OPERATIVE SKELETAL STABILITY OF THE MAXILLA TREATED WITH LE FORT I AND U-SHAPED OSTEOTOMIES IN SIMULTANEOUS MAXILLOMANDIBULAR ORTHOGNATHIC SURGERY (양악 악교정 수술에서 르포트 I형과 U-자형 복합 골절단술 후 상악골의 안정성에 관한 임상적 연구)

  • Kim, Min-Keun;Park, Young-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.6
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    • pp.485-491
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    • 2009
  • Postoperative skeletal stability was evaluated in combination of Le Fort I and U-shaped osteotomies for superior repositioning of maxilla in bi-maxillary surgeries in 30 consecutive patients. The fifteen patients underwent Le Fort I osteotomy alone and the other fifteen patients underwent Le Fort I and U-shaped osteotomies. In all patients, the maxilla was first osteomized and fixed with absorbable plates system. A bilateral sagittal split ramus osteotomy (BSSRO) of the mandible was then carried out and fixation was performed using absorbable plates. Maxillo-mandibular fixation with rubber ring was used for two weeks post-operatively in all patients. Lateral cephalograms were obtained pre-operatively, 1 day post-operatively, 6 months after surgery. The changes in anterior nasal spine (ANS), point A, upper incisior (U1), and point of maxillary tuberosity (PMT) were examined. The maxillas in the fifteen patients of both examination group were repositioned nearly in their planned positions during surgery and no significant post-operative changes in the examined points of the maxilla were found. These results suggest that a combination of a Le Fort I and U-shaped osteotomy is a useful technique for reliable superior repositioning of the maxilla. The post-operative change in the maxilla using this combination osteotomy was comparatively stable.

Rotational Stability of AcrySof Toric Intraocular Lens Over Time: Influence of Capsulorhexis Contraction

  • Kim, Joong Hee;Cho, Kyong Jin
    • Medical Lasers
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    • v.9 no.1
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    • pp.44-50
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    • 2020
  • Background and Objectives To evaluate the rotational stability of AcrySof toric intraocular lenses (IOL) by considering lapse of postoperative time and influence of capsulorhexis contraction. Materials and Methods A prospective, masked, single center study was conducted on 19 patients who had undergone microcoaxial cataract surgery and AcrySof toric IOL implantation. Slit-lamp retroillumination photographs of anterior segments were obtained from all patients after 1 week, 1 month and 3 months post-surgery. The degree of alteration of the postoperative IOL axis alignment and the amount of anterior capsular shrinkage were analyzed using Adobe Photoshop software. Results The mean degree of toric IOL axis misalignment was 2.18 (±20.2) degrees at 3 months follow-up. Quadrant analysis of the capsulorhexis aperture area at 1 week and 1 month post-operative, showed counterclockwise IOL rotation when the capsule contraction was dominant in the haptic part as well as clockwise rotation when dominant in the non-haptic part (p = 0.015). Conclusion The direction and degree of AcrySof toric IOL rotation differed throughout the follow-up period. Since most misalignments were found on the first post-operative day, physicians should try to minimize peri-operative risk factors that influence IOL rotation. There was also a correlation between the part of anterior capsule contraction and the direction of IOL rotation.

A Modified Technique for the Correction of Funnel Chest (함몰흉 교정의 변형수기)

  • 이상호
    • Journal of Chest Surgery
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    • v.33 no.10
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    • pp.806-811
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    • 2000
  • Background : The authors have modified the method of Ravitch technique. Material and Method ; This technique was applied to 6 patients out of 18 patients who underwent corrective surgery from May 1987 to July 1999. The technique is quite different from that of Ravitch. We did not divide the intercostal muscle bundles from the laterals of sternum and the Akin's struts were placed retrosternally crossing the chest horizontally to prevent flail motion during immediate post-operative period and retraction of the sternum afterwards. Anterior sternal osteotomy instead of the posterior one was performed for the latest 3 cases which made operative procedure more simple and easy. The struts were removed one year later. Result : Compared to the hospital stay of the patients who received standard Ravitch method that of the six cases who received our modification was definitely shortened from 13.1 days to 8.3 days(p<0.0000). Flail motion was not noted in any patient and chest wall stability was obtained more easily with this technique. Conclusion : Our modification is recommendable for correction of funnel chest in regards to shorter operation time better chest wall stability shorter hospital stay and less complication.

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OBLIQUE TRANSCRANIAL RADIOGRAPHIC ANALYSIS OF CHANGES IN CONDYLE POSITION FOLLOWING SAGITTAL SPLIT RAMUS OSTEOTOMY IN MANDIBULAR PROGNATHISM (측사위경두개방사선사진(Oblique Transcranial Radiograph)을 이용한 하악전돌증환자의 하악지 시상골절단술후 하악과두위치변화 분석)

  • Kwon, Tae-Geon;Jang, Hyun-Jung;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.1
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    • pp.32-45
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    • 1995
  • This study was intended to evaluate condyle position and the relationship of condyle position change and post surgical relapse following the sagittal split ramus osteotomy for mandible setback in 25 patients by paired t-test and multiple regression analysis. We used oblique transcranial and cephalometric radiographs taken before operation, immediate after operation, and at least 6 months post operatively. 1. In oblique transcranial view, posterior joint space was decreased immediate after operation and increased 6 months after operation. To compare the measurement before and 6 months after operation, there was no statistically significant change in over all joint spaces(P>0.05). 2. The joint spaces changed under the 0.2mm were 30%, 0.2mm to 1.0mm were 60.7%, above 1.0mm were 9.3%. This result reveals that condyle position was relatively reproduced to pre-operative state. 3. Statistically, the amount of mandible set back didn't influence the post operative relapse(P>0.05). 4. Statistically, the amount of mandible set back didn't influence the condylar displacement(P>0.05), and the amount of joint space change didn't influence the post operative relapse.(P>0.05) The changes in joint space is in the standard tracing error or within the adaptive capacity of the individual, it was too small to influence the stability of surgery.

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Clinical evaluation of ridge augmentation using autogenous tooth bone graft material: case series study

  • Lee, Ji-Young;Kim, Young-Kyun;Yi, Yang-Jin;Choi, Joon-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.4
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    • pp.156-160
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    • 2013
  • Objectives: Interest in bone graft material has increased with regard to restoration in cases of bone defect around the implant. Autogenous tooth bone graft material was developed and commercialized in 2008. In this study, we evaluated the results of vertical and horizontal ridge augmentation with autogenous tooth bone graft material. Materials and Methods: This study targeted patients who had vertical or horizontal ridge augmentation using AutoBT from March 2009 to April 2010. We evaluated the age and gender of the subject patients, implant stability, adjunctive surgery, additional bone graft material and barrier membrane, post-operative complication, implant survival rate, and crestal bone loss. Results: We performed vertical and horizontal ridge augmentation using powder- or block-type autogenous tooth bone graft material, and implant placement was performed on nine patients (male: 7, female: 2). The average age of patients was $49.88{\pm}12.98$ years, and the post-operative follow-up period was $35{\pm}5.31$ months. Post-operative complications included wound dehiscence (one case), hematoma (one case), and implant osseointegration failure (one case; survival rate: 96%); however, there were no complications related to bone graft material, such as infection. Average marginal bone loss after one-year loading was $0.12{\pm}0.19$ mm. Therefore, excellent clinical results can be said to have been obtained. Conclusion: Excellent clinical results can be said to have been obtained with vertical and horizontal ridge augmentation using autogenous tooth bone graft material.

THE CEPHALOMETRIC ANALYSIS OF THE SOFT TISSUE CHANGES AT THE MIDDLE FACE IN THE SKELETAL CLASS III PATIENTS WITH THE ORTHOGNATHIC 2-JAW SURGERY (골격성 제3급 부정교합자의 양악 수술 후 중안면부 연조직 변화에 관한 두부 계측 방사선학적 연구)

  • Ahn, Je-Young;Kim, Ji-Yong;Joo, Bum-Ki;Kim, Min-Chul;Huh, Jong-Ki;Kim, Hyung-Gon;Park, Kwang-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.1
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    • pp.21-26
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    • 2006
  • Considering the skeletal class III malocclusion that complains of mandibular prognathism, there have been some studies of the mandibular change for comparing the changes of pre operative with post operative state. Nowadays it is common to do the orthognathic 2-jaw surgery for the correction of the maxillary deficiency, the post operative stability and the esthetics. We compare and analyze the changes of soft tissue around the nose and the lip with the changes in the direction and the amount of maxilla. Patients who were diagnosed as maxillofacial deformity and received orthognathic surgery of both jaws at Yongdong Severance hospital from 2001 through 2003 were included in this study. Their lateral cephalograms were analyzed, and the post operative change of hard tissue and soft tissue were studied. Upon analyzing the preoperative cephalograms and 6 month post operative cephalograms, there were significant in the vertical change of Labialis superius(Ls) and Stomion(Stm) in soft tissue in relation to the vertical change of skeletal landmarks (Anterior Nasal Spine, Subspinale, Prosthion, Incision Superious). In addition, there were no significance in horizontal movement of the skeletal landmarks among groups. In terms of hard tissue landmarks, group 3(maxillary posterior impaction and advancement surgery group) showed significantly greater change in the vertical movement of Anterior Nasal Spine(ANS), Subspinale(A), Prosthion(Pr), and Incision Superious(Is) compared with other groups. In terms of soft tissue change, group 3 showed more significant change in the vertical movement of Ls and Stm. This study calculated the changes of the skeletal and soft tissue landmarks in order to act as a guide in planning and performing the surgery and as a reference in predicting the postoperative change of facial appearance.

Initial Stability after Bilateral Sagittal Split Ramus Osteotomy Application in Patients with Mandibular Prognathism (하악골 전돌증 환자에서 하악지 시상분할골 절단술 적용술 후 초기 안정성 평가)

  • Kwon, Myung-Hee;Leem, Dae-Ho;Baek, Jin-A;Shin, Hyo-Keun;Ko, Seung-O
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.3
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    • pp.218-224
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    • 2011
  • Purpose: The purpose of this study is to evaluate the post-operative skeletal stability after surgical correction of patients with mandibular prognathism by bilateral sagittal split ramus osteotomy (BSSRO) and to evaluate the horizontal relapse tendency after the surgery. Methods: Twenty-six patients with Class III dental and skeletal malocclusion were selected for this retrospective study. Fifteen of them underwent BSSRO for mandibular setback and eleven of them underwent two-jaw surgery (Lefort I and BSSRO). In each patient, lateral cephalometric radiographs were taken pre-operatively, post-operatively within 1 week, and post-operatively after eight months. After tracing of the cephalometric radiographs, various parameters were measured. The analyses were done by linear measurement to evaluate the change in position of hard tissue B point, pogonion and mandibular plan angle by examination on lateral cephalograms. Results: The horizontal relapse rate was 27.1% at B point and 31.6% at pogonion in patients who underwent BSSRO. The horizontal relapse rate of the group where the amount of correction exceeded 10 mm was 25.69% at B point. Conclusion: There were no statistical differences on the magnitude of setback and direction of rotation of the mandible in mandibular stability. There were also no statistical differences between single mandibular surgery and two-jaw surgery for mandibular stability.

A Three-Dimensional Finite Element Study of Interface Micromotion in a Non-Cement Total Hip stem (FEM 3차원 모델을 이용한 인공관절 대퇴 Stem 경계면의 미세운동 분석)

  • Kim, Sung-Kon;Choi, Hyung-Yun;Chae, Soo-Won
    • Journal of Biomedical Engineering Research
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    • v.17 no.1
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    • pp.61-70
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    • 1996
  • In cementless total hip arthroplasty(THA), an initial stability of the femoral component is mandatory to achieve bony inyowth and secondary long term fixation. Primary stability of the femoral component can be obtained by minimizing the magnitude of relative micromotions at bone stem interface. An accurate evaluation of interf'ace micromotion and stress/strain fields in the bone-implant system may be relevant for better understanding of clinical situations and improving THA design. Recently finite element method(FEM) was introduced in'orthopaedic research field due to its unique capacity to evaluate stress in structure of complex shape, loading and material behavior. The authors developed the 3-dimensional finite element model of proximal femur with $Multilock^{TM}$ stem of 1179 blick elements to analyse the micromotions and mechanical behaviors at the bone-stem inteface in early post-operative period for the load simulating single leg stance. The results indicates that the values of relative motion for this well fit stem were $150{\mu}m$ in maximum $82{\mu}m$ in minimum and the largest relative motion was developed in medial region of Proximal femur and in anterior-posterior direction. The motion in the proximal bone was much greater than in the distal bone and the stress pattern showed high stress concentration on the cortex near the tip of the stem. These findings indicate that the loading on the hip joint in the early postoperative situation before achieving bony ingrowth could produce large micromotion of $150{\mu}m$ and clinicaly non-cemented THA patient should not be allowed weight bearing strictly early in the postoperative period.

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