Panfacial fracture is often accompanied by soft tis-sue injuries and loss of bony structures. Because of the lack of normative anatomical structure, it is difficult to reduce and fix to the former state. Moreover, it could lead to post-traumatic deformities and dysfunctions. If appropriate primary treatment is not performed, it can cause abnormal bone healing and scarring of soft tissue. Therefore, orthognathic surgery is frequently performed for jaw deformity due to malunited panfacial fracture. The present case was a 24-year-old man who suffered panfacial fracture in a traffic accident. The maxilla and mandible were openly reduced and internally fixed at another hospital; other fractures in this region were conservatively managed. However, malocclusion and facial deformity caused by malunion were seen and nine months later he was referred to our hospital with a chief complaint of concave profile and occlusal reconstruction. We aimed to improve his concave profile and decided to perform orthognathic surgery. Intraoral findings showed Angle Class Ⅰ and Class Ⅲ molar relations on the right and left, respectively. Cephalometric analysis revealed SNA 72.0°, SNB 77.7°, ANB−5.7° and A-B plane 7.4°. He was diagnosed as maxillary retrusion associated with malunited panfacial fracture. In order to achieve func-tional occlusion, two surgical plans were proposed: 5 mm advance by Le Fort Ⅰ osteotomy or 5 mm setback by bi-lateral sagittal split ramus osteotomy. We performed 3D virtual planning using software, which showed that Le Fort Ⅰ osteotomy was appropriate compared with bilat-eral sagittal split ramus osteotomy. We informed him of this surgical plan with 3D simulation data, and he agreed to it. It was expected to be difficult to perform normal osteotomy because of bone defect and malunion, so we constructed a 3D stereolithographic model and carried out surgery on the model. Finally, we performed orthognathic surgery as planned and safely. The postoperative course has been uneventful since then. It is thought that these surgical procedures may be effective for patients with malunited panfacial fracture, and that preoperative management led to good results.
{"title":"A Case of Le Fort Ⅰ Osteotomy on a Patient with Malunited Panfacial Fracture","authors":"T. Karube, S. Kato, Yuki Okuhara, H. Shiba","doi":"10.5927/JJJD.31.24","DOIUrl":"https://doi.org/10.5927/JJJD.31.24","url":null,"abstract":"Panfacial fracture is often accompanied by soft tis-sue injuries and loss of bony structures. Because of the lack of normative anatomical structure, it is difficult to reduce and fix to the former state. Moreover, it could lead to post-traumatic deformities and dysfunctions. If appropriate primary treatment is not performed, it can cause abnormal bone healing and scarring of soft tissue. Therefore, orthognathic surgery is frequently performed for jaw deformity due to malunited panfacial fracture. The present case was a 24-year-old man who suffered panfacial fracture in a traffic accident. The maxilla and mandible were openly reduced and internally fixed at another hospital; other fractures in this region were conservatively managed. However, malocclusion and facial deformity caused by malunion were seen and nine months later he was referred to our hospital with a chief complaint of concave profile and occlusal reconstruction. We aimed to improve his concave profile and decided to perform orthognathic surgery. Intraoral findings showed Angle Class Ⅰ and Class Ⅲ molar relations on the right and left, respectively. Cephalometric analysis revealed SNA 72.0°, SNB 77.7°, ANB−5.7° and A-B plane 7.4°. He was diagnosed as maxillary retrusion associated with malunited panfacial fracture. In order to achieve func-tional occlusion, two surgical plans were proposed: 5 mm advance by Le Fort Ⅰ osteotomy or 5 mm setback by bi-lateral sagittal split ramus osteotomy. We performed 3D virtual planning using software, which showed that Le Fort Ⅰ osteotomy was appropriate compared with bilat-eral sagittal split ramus osteotomy. We informed him of this surgical plan with 3D simulation data, and he agreed to it. It was expected to be difficult to perform normal osteotomy because of bone defect and malunion, so we constructed a 3D stereolithographic model and carried out surgery on the model. Finally, we performed orthognathic surgery as planned and safely. The postoperative course has been uneventful since then. It is thought that these surgical procedures may be effective for patients with malunited panfacial fracture, and that preoperative management led to good results.","PeriodicalId":102257,"journal":{"name":"The Japanese Journal of Jaw Deformities","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116791492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Iwai, T. Takenobu, T. Kanno, K. Yamauchi, K. Ooi, Y. Kawase‐Koga, Takako Sato, N. Tomomatsu, M. Narita, Norie Yoshioka, Tadaharu Kobayashi
A questionnaire-based survey of the current status of treatment of jaw deformity was carried out before a consensus meeting for treatment in 2018. The survey consisted of questions concerning treatment planning, preoperative preparation, prophylactic antibiotics, anesthesia, transfusion, orthognathic surgery, posto perative management, and complications. All 36 institutions ans-wered the web-based questionnaire, and the results of the survey were discussed in the consensus meeting. This study revealed the current status of treatment of jaw deformity in Japan. Because the study included only a small number of institutions, a more extensive survey is required to clarify the actual status of treatment of jaw deformity in Japan.
{"title":"A Questionnaire-based Survey in Consensus Meeting of Jaw Deformity Treatment","authors":"T. Iwai, T. Takenobu, T. Kanno, K. Yamauchi, K. Ooi, Y. Kawase‐Koga, Takako Sato, N. Tomomatsu, M. Narita, Norie Yoshioka, Tadaharu Kobayashi","doi":"10.5927/JJJD.29.11","DOIUrl":"https://doi.org/10.5927/JJJD.29.11","url":null,"abstract":"A questionnaire-based survey of the current status of treatment of jaw deformity was carried out before a consensus meeting for treatment in 2018. The survey consisted of questions concerning treatment planning, preoperative preparation, prophylactic antibiotics, anesthesia, transfusion, orthognathic surgery, posto perative management, and complications. All 36 institutions ans-wered the web-based questionnaire, and the results of the survey were discussed in the consensus meeting. This study revealed the current status of treatment of jaw deformity in Japan. Because the study included only a small number of institutions, a more extensive survey is required to clarify the actual status of treatment of jaw deformity in Japan.","PeriodicalId":102257,"journal":{"name":"The Japanese Journal of Jaw Deformities","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128832062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: To perform a statistical analysis of orthognathic surgery performed at the Oral and Maxillofacial Surgery Department of Yamagata University Hospital between 1990 and 2017. Methods : Sex, age, clinical diagnosis, surgical method, operation time, bleeding volume, and postoperative management of 583 patients were analyzed. Results : There were 190 males and 393 females. The age at the time of surgery ranged from 5 to 73 years (average age 22.0 years). Mandibular protrusion alone was the most frequent clinical diagnosis, accounting for 278 cases (47.7%), followed by 99 cases of facial asymmetry with mandibular protrusion (17.0%), and 45 cases of open bite with mandibular protrusion (7.7%). A total of 384 cases (67.1%) of sagittal split ramus osteotomy (SSRO) and 140 cases (24.5%) of double-jaw surgery using SSRO and Le Fort I osteotomy (LF I) were performed. There were 20 cases (3.5%) of genioplasty (GEN) concomitant with SSRO. In recent years, double-jaw surgery has been the most frequent surgical procedure. The average surgical time and bleeding volume were 162.8min and 278.9ml in SSRO respectively, and 310.1min and 767.6ml in LF I+SSRO respectively, and both decreased over time. The number of days patients stayed in hospital was on a downward trend, with the shortest stay being 6 days, the longest 40 days, and the average 17.9 days. For occlusion management after surgery, no cases have been fixed with wire since 2010, and intermaxillary rubber traction was used in all cases. With regard to congenital diseases, 9 patients with cleft lip and palate, one with Apert syndrome, and one with Pfeiffer syndrome were treated. Discussion : In spite of the increase in complicated surgical procedures in recent years, operating time, hospitalization time and bleeding volume have decreased. These trends may signify improvements in surgical techniques and perioperative management. Because almost all of our cases are referrals from other dental clinics, the constant trend in the number of surgeries indicates smooth cooperation with regional medical facilities.
目的:对1990年至2017年在山形大学医院口腔颌面外科进行的正颌手术进行统计分析。方法:对583例患者的性别、年龄、临床诊断、手术方式、手术时间、出血量及术后处理进行分析。结果:男性190例，女性393例。手术时年龄5 ~ 73岁，平均22.0岁。单纯下颌突出是临床最常见的诊断，占278例(47.7%)，其次是面部不对称合并下颌突出99例(17.0%)，开放咬合合并下颌突出45例(7.7%)。共行矢状裂支截骨术(SSRO) 384例(67.1%)和双颌手术(SSRO + Le Fort I型截骨术)140例(24.5%)。genioplasty合并SSRO 20例(3.5%)。近年来，双颌手术是最常见的外科手术。SSRO组平均手术时间162.8min、出血量278.9ml, LF I+SSRO组平均手术时间310.1min、出血量767.6ml，均随时间推移而减少。患者住院天数呈下降趋势，最短6天，最长40天，平均17.9天。对于术后的咬合处理，2010年以来没有病例用金属丝固定，所有病例均采用上颌间橡胶牵引。先天性疾病治疗唇腭裂9例，Apert综合征1例，Pfeiffer综合征1例。讨论:尽管近年来复杂的外科手术增多，但手术时间、住院时间和出血量却减少了。这些趋势可能意味着手术技术和围手术期管理的改进。由于我们几乎所有的病例都是从其他牙科诊所转诊过来的，手术数量的持续增长表明我们与地区医疗机构的合作很顺利。
{"title":"Statistical Analysis of Orthognathic Surgery Undertaken in the Oral and Maxillofacial Surgery Department of Yamagata University Hospital over the Past 28 Years","authors":"T. Kawaguchi, S. Ishikawa, K. Maehara, M. Iino","doi":"10.5927/JJJD.29.23","DOIUrl":"https://doi.org/10.5927/JJJD.29.23","url":null,"abstract":"Purpose: To perform a statistical analysis of orthognathic surgery performed at the Oral and Maxillofacial Surgery Department of Yamagata University Hospital between 1990 and 2017. Methods : Sex, age, clinical diagnosis, surgical method, operation time, bleeding volume, and postoperative management of 583 patients were analyzed. Results : There were 190 males and 393 females. The age at the time of surgery ranged from 5 to 73 years (average age 22.0 years). Mandibular protrusion alone was the most frequent clinical diagnosis, accounting for 278 cases (47.7%), followed by 99 cases of facial asymmetry with mandibular protrusion (17.0%), and 45 cases of open bite with mandibular protrusion (7.7%). A total of 384 cases (67.1%) of sagittal split ramus osteotomy (SSRO) and 140 cases (24.5%) of double-jaw surgery using SSRO and Le Fort I osteotomy (LF I) were performed. There were 20 cases (3.5%) of genioplasty (GEN) concomitant with SSRO. In recent years, double-jaw surgery has been the most frequent surgical procedure. The average surgical time and bleeding volume were 162.8min and 278.9ml in SSRO respectively, and 310.1min and 767.6ml in LF I+SSRO respectively, and both decreased over time. The number of days patients stayed in hospital was on a downward trend, with the shortest stay being 6 days, the longest 40 days, and the average 17.9 days. For occlusion management after surgery, no cases have been fixed with wire since 2010, and intermaxillary rubber traction was used in all cases. With regard to congenital diseases, 9 patients with cleft lip and palate, one with Apert syndrome, and one with Pfeiffer syndrome were treated. Discussion : In spite of the increase in complicated surgical procedures in recent years, operating time, hospitalization time and bleeding volume have decreased. These trends may signify improvements in surgical techniques and perioperative management. Because almost all of our cases are referrals from other dental clinics, the constant trend in the number of surgeries indicates smooth cooperation with regional medical facilities.","PeriodicalId":102257,"journal":{"name":"The Japanese Journal of Jaw Deformities","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133123880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"特別講演：Enhancing Satisfaction in Orthognathic Treatment","authors":"","doi":"10.5927/jjjd.32.72","DOIUrl":"https://doi.org/10.5927/jjjd.32.72","url":null,"abstract":"","PeriodicalId":102257,"journal":{"name":"The Japanese Journal of Jaw Deformities","volume":"245 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114370069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Orthognathic surgery involves a series of a procedure including diagnosis, surgical consultation, post-operative prediction and evaluation of intra-operative or post-operative modification. the efficacy limits of 3-dimensional images that can be used in surgery, planning, and splint device using 3D printing technology
{"title":"Do advances in examinations and diagnostic equipment improve treatment outcomes?","authors":"","doi":"10.5927/jjjd.30.75","DOIUrl":"https://doi.org/10.5927/jjjd.30.75","url":null,"abstract":"Orthognathic surgery involves a series of a procedure including diagnosis, surgical consultation, post-operative prediction and evaluation of intra-operative or post-operative modification. the efficacy limits of 3-dimensional images that can be used in surgery, planning, and splint device using 3D printing technology","PeriodicalId":102257,"journal":{"name":"The Japanese Journal of Jaw Deformities","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123119509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Egami, K. Fujita, K. Yokoyama, Hiroki Kobayashi, Y. Tsuchida, T. Shimo, K. Akizuki
Patients with a long face and open bite often undergo posterior-superior repositioning of the maxilla in orthognathic surgery. In this paper, we report an analysis of cases of posterior-superior repositioning of the maxilla at Matsuda Orthopedic Memorial Hospital from June 2004 to December 2018. The results were as follows : 1.There were 44 patients who had undergone orthognathic surgery for posterior-superior repositioning of the maxilla. The patients were 3 males (7%) and 41 females (93%). 2.The mean age at surgery was 27.3 at s years old (range : 16-60 years). 3.The most common clinical diagnosis was maxillary prognathism with maxillary excess (16 cases : 36.4%). 4.The most common surgical method was Le Fort I osteotomy (LF I+SSRO (23 cases : 52.3%)), followed by LF I+SSRO+Genioplasty (GEN) (11 cases : 25.0%). 5.The average time of operation for LF I+SSRO was 306.7±56.2 minutes and that for LF I+SSRO+GEN was 337.1±59.1 minutes. 6.The average amount of bleeding was 461.7± 188.0ml for LF I+SSRO and that for LF I+SSRO+GEN was 377.0±206.0ml. 7.The average distance of posterior and superior of the maxilla was 3.6±1.6mm and 4.3±2.1mm, respectively.
{"title":"Clinical Study of Posterior-superior Repositioning of Maxilla by Le Fort Ⅰ Osteotomy","authors":"K. Egami, K. Fujita, K. Yokoyama, Hiroki Kobayashi, Y. Tsuchida, T. Shimo, K. Akizuki","doi":"10.5927/jjjd.30.205","DOIUrl":"https://doi.org/10.5927/jjjd.30.205","url":null,"abstract":"Patients with a long face and open bite often undergo posterior-superior repositioning of the maxilla in orthognathic surgery. In this paper, we report an analysis of cases of posterior-superior repositioning of the maxilla at Matsuda Orthopedic Memorial Hospital from June 2004 to December 2018. The results were as follows : 1.There were 44 patients who had undergone orthognathic surgery for posterior-superior repositioning of the maxilla. The patients were 3 males (7%) and 41 females (93%). 2.The mean age at surgery was 27.3 at s years old (range : 16-60 years). 3.The most common clinical diagnosis was maxillary prognathism with maxillary excess (16 cases : 36.4%). 4.The most common surgical method was Le Fort I osteotomy (LF I+SSRO (23 cases : 52.3%)), followed by LF I+SSRO+Genioplasty (GEN) (11 cases : 25.0%). 5.The average time of operation for LF I+SSRO was 306.7±56.2 minutes and that for LF I+SSRO+GEN was 337.1±59.1 minutes. 6.The average amount of bleeding was 461.7± 188.0ml for LF I+SSRO and that for LF I+SSRO+GEN was 377.0±206.0ml. 7.The average distance of posterior and superior of the maxilla was 3.6±1.6mm and 4.3±2.1mm, respectively.","PeriodicalId":102257,"journal":{"name":"The Japanese Journal of Jaw Deformities","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123707075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"教育講演：顔と身体の認知科学","authors":"","doi":"10.5927/jjjd.32.80","DOIUrl":"https://doi.org/10.5927/jjjd.32.80","url":null,"abstract":"","PeriodicalId":102257,"journal":{"name":"The Japanese Journal of Jaw Deformities","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121889028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ayako Fujimoto, N. Tominaga, K. Tominaga, Chiaki Fukuda, Yoshimi Kawahara, Y. Yoshikawa
Clinical and statistical analyses were performed on 416 patients who underwent orthognathic surgery at Yoshikawa Orthodontic Clinic from January 2011 to December 2020. The results were as follows: In surgical orthodontic treatment, an interdisciplinary approach with oral surgery allows a more flexible response to various cases.
{"title":"A Statistical Analysis of Orthognathic Surgery for the Last 10 Years in Yoshikawa Orthodontic Clinic","authors":"Ayako Fujimoto, N. Tominaga, K. Tominaga, Chiaki Fukuda, Yoshimi Kawahara, Y. Yoshikawa","doi":"10.5927/jjjd.32.241","DOIUrl":"https://doi.org/10.5927/jjjd.32.241","url":null,"abstract":"Clinical and statistical analyses were performed on 416 patients who underwent orthognathic surgery at Yoshikawa Orthodontic Clinic from January 2011 to December 2020. The results were as follows: In surgical orthodontic treatment, an interdisciplinary approach with oral surgery allows a more flexible response to various cases.","PeriodicalId":102257,"journal":{"name":"The Japanese Journal of Jaw Deformities","volume":"138 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123743969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The 16th educational workshop of the Japanese Society for Jaw Deformities","authors":"","doi":"10.5927/jjjd.30.293","DOIUrl":"https://doi.org/10.5927/jjjd.30.293","url":null,"abstract":"","PeriodicalId":102257,"journal":{"name":"The Japanese Journal of Jaw Deformities","volume":"249 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115861418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"シンポジウム2：上下顎移動術における上顎骨位置決めの最新知見","authors":"","doi":"10.5927/jjjd.33.91","DOIUrl":"https://doi.org/10.5927/jjjd.33.91","url":null,"abstract":"","PeriodicalId":102257,"journal":{"name":"The Japanese Journal of Jaw Deformities","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124027142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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