Yuho Kato, M. Fujimoto, Au Sasaki, K. Yamaguchi, Kouta Fujimoto, Takuya Sonokawa, T. Tatsuta, Jun Shimada, Nobuharu Yamamoto, Naoto Suda
{"title":"歯科矯正用アンカースクリューを用いた上顎臼歯遠心移動と上顎前歯部歯槽骨切り術によって良好な咬合と顔貌変化が得られた1例","authors":"Yuho Kato, M. Fujimoto, Au Sasaki, K. Yamaguchi, Kouta Fujimoto, Takuya Sonokawa, T. Tatsuta, Jun Shimada, Nobuharu Yamamoto, Naoto Suda","doi":"10.5927/jjjd.33.59","DOIUrl":"https://doi.org/10.5927/jjjd.33.59","url":null,"abstract":"","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":"114197908","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}
Masaki Donen, Yasuhito Moritani, K. Shimazaki, K. Matsushita, Yuki Miyakami, Mami Mutoh, Yuri Takakusagi, Yoshiaki Sato
{"title":"Two Cases of Skeletal Mandibular Protrusion Who Underwent Orthognathic Treatment after Middle Age","authors":"Masaki Donen, Yasuhito Moritani, K. Shimazaki, K. Matsushita, Yuki Miyakami, Mami Mutoh, Yuri Takakusagi, Yoshiaki Sato","doi":"10.5927/jjjd.32.250","DOIUrl":"https://doi.org/10.5927/jjjd.32.250","url":null,"abstract":"","PeriodicalId":102257,"journal":{"name":"The Japanese Journal of Jaw Deformities","volume":"477 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":"121008576","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 17th educational workshop of the Japanese Society for Jaw Deformities","authors":"","doi":"10.5927/jjjd.31.215","DOIUrl":"https://doi.org/10.5927/jjjd.31.215","url":null,"abstract":"","PeriodicalId":102257,"journal":{"name":"The Japanese Journal of Jaw Deformities","volume":"72 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":"134294302","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1：顎口腔機能のニューロリハビリテーション","authors":"","doi":"10.5927/jjjd.29.104","DOIUrl":"https://doi.org/10.5927/jjjd.29.104","url":null,"abstract":"","PeriodicalId":102257,"journal":{"name":"The Japanese Journal of Jaw Deformities","volume":"32 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":"130593180","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":"示説抄録","authors":"","doi":"10.5927/jjjd.30.144","DOIUrl":"https://doi.org/10.5927/jjjd.30.144","url":null,"abstract":"","PeriodicalId":102257,"journal":{"name":"The Japanese Journal of Jaw Deformities","volume":"241 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":"132404712","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}
Recently, the interest in surgery-first (SF) orthognathic treatment is increasing among the practitioners since patients appreciate immediate improvement in facial appearance. Orthodontic tooth movement is much easier and more physiologically favorable after surgical elimination of the skeletal disharmony. For a successful SF orthognathic treatment, a proper collaboration between surgeons and orthodontists is believed to be essential. It is because surgical occlusion is constructed based on orthodontic simulation. Present presentation will present rationale of SF orthognathic treatment and suggest a clinical protocol for the success of ortho-surgical treatment. In particular, the importance of interaction between surgeons and orthodontists will be emphasized by addressing following issues :
{"title":"シンポジウム2：顎変形症の未来Surgery First Approach","authors":"H. Hwang","doi":"10.5927/jjjd.31.52","DOIUrl":"https://doi.org/10.5927/jjjd.31.52","url":null,"abstract":"Recently, the interest in surgery-first (SF) orthognathic treatment is increasing among the practitioners since patients appreciate immediate improvement in facial appearance. Orthodontic tooth movement is much easier and more physiologically favorable after surgical elimination of the skeletal disharmony. For a successful SF orthognathic treatment, a proper collaboration between surgeons and orthodontists is believed to be essential. It is because surgical occlusion is constructed based on orthodontic simulation. Present presentation will present rationale of SF orthognathic treatment and suggest a clinical protocol for the success of ortho-surgical treatment. In particular, the importance of interaction between surgeons and orthodontists will be emphasized by addressing following issues :","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":"129369983","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":"口演抄録","authors":"","doi":"10.5927/jjjd.30.124","DOIUrl":"https://doi.org/10.5927/jjjd.30.124","url":null,"abstract":"","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":"127417454","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}
Yu Togane, Au Sasaki, Y. Otsuka, T. Uesato, Akemi Kawajiri, K. Yamaguchi, Takuya Sonokawa, Tomonori Ozawa, H. Abukawa, Nobutoshi Takahashi, S. Kito, J. Shimada, N. Suda
In mandibular protrusion cases who undergo short lingual osteotomy(SL), interference between the distal mandibular segment and medial pterygoid muscle (MPM)is occasionally seen at setback operation. The interference causes posterior deviation of the mesial mandibular segment and affects the postoperative stability. Thus, the relationship between the MPM and the mesial segment was examined three-dimensionally using preoperative CT images. In this study, 18 cases of mandibular protrusion(7 males and 11 females, average age at first visit : 22.4 years old)who visited Meikai University Hospital were examined. All cases were not affected by any congenital anomalies, and the lateral deviation of Me was within 3 mm. Lateral cephalograms were taken immediately before surgery(T1), less than 5 weeks after surgery (T2), and more than 1 year after surgery(T3). CTs were taken at T1. Seven of the 18 cases showed postoperative anterior relapse of more than 2.0mm at Me from T2 to T3(group U). The relapse of the other 11 cases(group S)was 2.0mm or less. Using DICOM data of CT, MTM was reconstructed three-dimensionally, and the relationship with the mesial mandibular segment was analyzed. There was no significant difference in the amount of mandibular setback and decrease in SNB angle between group S and group U from T1 to T2. Group U, but not group S, showed posterior deviation of the mesial mandibular segment from T1 to T2. MPM was significantly inclined less laterally in group U than group S at T1, indicating that cases in group U exhibited closer 1)明海大学歯学部形態機能成育学講座歯科矯正学分野(主任:須田直人教授) 2)明海大学歯学部病態診断治療学講座口腔顎顔面外科学分野 1(主任:嶋田 淳教授) 3)明海大学歯学部病態診断治療学講座歯科放射線学分野(主任:鬼頭慎司教授) 1)Division of Orthodontics, Department of Human and Development and Fostering, Meikai University School of Dentistry (Chief : Prof. Naoto SUDA) 2)First division of Oral and Maxillofacial Surgery, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry(Chief : Prof. Jun SHIMADA) 3)Division of Dental Radiology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry (Chief : Prof. Shinji KITO) 270 日顎変形誌 2019 年 東金 由莉,他 proximity of MPM to the mandibular ramus. These findings suggest that the proximity of MPM to the mandibular ramus at T1 is one of the risk factors causing interference, and affects the postoperative stability when performing SL. Simulation of MTM, together with the mandible, is informative in predicting postoperative stability at SSRO.
在下颌骨前突行短舌截骨术的病例中，下颌骨远端节段与内侧翼状肌(MPM)之间偶尔会出现干扰。这种干扰导致下颌中段后偏，影响术后稳定性。因此，使用术前CT图像三维检查MPM和中段之间的关系。本研究对18例下颌前突患者(男7例，女11例，平均初诊年龄22.4岁)进行了检查。所有病例均无先天性异常，Me侧偏在3mm以内。术前即刻(T1)、术后不到5周(T2)、术后1年以上(T3)均行侧位头颅造影。T1时进行ct检查。18例患者中有7例(U组)术后T2 ~ T3 Me前侧复发大于2.0mm, 11例(S组)术后复发小于2.0mm。利用CT DICOM数据对MTM进行三维重建，并分析其与下颌中段的关系。从T1到T2, S组和U组的下颌后退量和SNB角减小量无显著差异。U组出现下颌中段T1向T2的后偏，S组没有。MPM明显倾向于外侧U组低于组T1,表明病例组U展出近1)明海大学歯学部形態機能成育学講座歯科矯正学分野(主任:須田直人教授)2)明海大学歯学部病態診断治療学講座口腔顎顔面外科学分野1(主任:嶋田淳教授)3)明海大学歯学部病態診断治療学講座歯科放射線学分野(主任:鬼頭慎司教授)1)正畸分工,人类与发展和培养,Meikai大学牙科学院(负责人:须田直人教授)2)美开大学牙科学院诊疗科学部口腔颌面外科一科(主任:岛田俊教授)3)美开大学牙科学院诊疗科学部口腔放射学科(主任:木藤真司教授)270下颌支的邻近性。这些发现表明，在T1时，MPM与下颌分支的接近是造成干扰的危险因素之一，并影响手术后的稳定性。MTM和下颌骨的模拟可以预测SSRO术后的稳定性。
{"title":"Postoperative Stability and Three-dimensional Evaluation of Medial Pterygoid Muscle in Skeletal Mandibular Protrusion Cases Undergone Short Lingual Osteotomy","authors":"Yu Togane, Au Sasaki, Y. Otsuka, T. Uesato, Akemi Kawajiri, K. Yamaguchi, Takuya Sonokawa, Tomonori Ozawa, H. Abukawa, Nobutoshi Takahashi, S. Kito, J. Shimada, N. Suda","doi":"10.5927/jjjd.29.269","DOIUrl":"https://doi.org/10.5927/jjjd.29.269","url":null,"abstract":"In mandibular protrusion cases who undergo short lingual osteotomy(SL), interference between the distal mandibular segment and medial pterygoid muscle (MPM)is occasionally seen at setback operation. The interference causes posterior deviation of the mesial mandibular segment and affects the postoperative stability. Thus, the relationship between the MPM and the mesial segment was examined three-dimensionally using preoperative CT images. In this study, 18 cases of mandibular protrusion(7 males and 11 females, average age at first visit : 22.4 years old)who visited Meikai University Hospital were examined. All cases were not affected by any congenital anomalies, and the lateral deviation of Me was within 3 mm. Lateral cephalograms were taken immediately before surgery(T1), less than 5 weeks after surgery (T2), and more than 1 year after surgery(T3). CTs were taken at T1. Seven of the 18 cases showed postoperative anterior relapse of more than 2.0mm at Me from T2 to T3(group U). The relapse of the other 11 cases(group S)was 2.0mm or less. Using DICOM data of CT, MTM was reconstructed three-dimensionally, and the relationship with the mesial mandibular segment was analyzed. There was no significant difference in the amount of mandibular setback and decrease in SNB angle between group S and group U from T1 to T2. Group U, but not group S, showed posterior deviation of the mesial mandibular segment from T1 to T2. MPM was significantly inclined less laterally in group U than group S at T1, indicating that cases in group U exhibited closer 1)明海大学歯学部形態機能成育学講座歯科矯正学分野(主任:須田直人教授) 2)明海大学歯学部病態診断治療学講座口腔顎顔面外科学分野 1(主任:嶋田 淳教授) 3)明海大学歯学部病態診断治療学講座歯科放射線学分野(主任:鬼頭慎司教授) 1)Division of Orthodontics, Department of Human and Development and Fostering, Meikai University School of Dentistry (Chief : Prof. Naoto SUDA) 2)First division of Oral and Maxillofacial Surgery, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry(Chief : Prof. Jun SHIMADA) 3)Division of Dental Radiology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry (Chief : Prof. Shinji KITO) 270 日顎変形誌 2019 年 東金 由莉,他 proximity of MPM to the mandibular ramus. These findings suggest that the proximity of MPM to the mandibular ramus at T1 is one of the risk factors causing interference, and affects the postoperative stability when performing SL. Simulation of MTM, together with the mandible, is informative in predicting postoperative stability at SSRO.","PeriodicalId":102257,"journal":{"name":"The Japanese Journal of Jaw Deformities","volume":"33 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":"122010041","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}
Shigehiro Ono, T. Nakagawa, M. Kaku, Taeko Yamamoto, K. Ohta, Kazumi Kubozono, Ryo Uetsuki, K. Mizuta, K. Tanimoto, M. Takechi
Surgical correction for skeletal maxillary protrusion is frequently associated with various risks, such as relapse and progressive condylar resorption (PCR). In addition, affected patients with a deformity of the condylar head have increased risk of these complications. We report a case of skeletal maxillary protrusion associated with hypoplasia of the bilateral mandibular condyles, in which a favorable outcome was attained by utilizing a combination of Le Fort I osteotomy and anterior segmental maxillary osteotomy procedures along with planned mandibular autorotation. A 26-year-old woman visited the Department of Orthodontic Dentistry at our hospital with complaints of maxillary protrusion and anterior open bite. The patient was diagnosed with hypoplasia of the bilateral mandibular condyles and maxillary protrusion associated with an open bite of the anterior teeth by several radiographic and orthodontic examinations, and was referred to our department for surgical correction. Preoperative orthodontic treatment was initially performed for 1 year 8 months, after which she underwent orthognathic surgery. The operation was two segmental Le Fort I osteotomy (a combination of Le Fort I and anterior segmental maxillary osteotomy), along with mandibular autorotation. At more than 2 years after surgery, the patient expressed satisfaction with changes in facial appearance and stable occlusion also remained. Accordingly, we consider that these surgical procedures may be effective for patients with maxillary protrusion associated with hypoplasia of the bilateral mandibular condyles.
上颌骨前突的手术矫正通常伴随着各种风险，如复发和进行性髁骨吸收(PCR)。此外，患有髁突头畸形的患者发生这些并发症的风险增加。我们报告一例伴有双侧下颌骨髁突发育不全的上颌骨突出，通过采用Le Fort I型截骨术和上颌前节段截骨术结合计划的下颌自旋，获得了良好的结果。一名26岁女性以上颌突出及前牙开咬就诊于我院口腔正畸科。患者经多次影像学和正畸检查，诊断为双侧下颌髁发育不全，上颌突出伴前牙开咬，转至我科进行手术矫正。术前进行了1年8个月的正畸治疗，之后进行了正颌手术。手术为两节段Le Fort I截骨术(联合Le Fort I和上颌前节段截骨术)，同时进行下颌自旋。术后2年多，患者对面部外观的改变表示满意，并且仍然保持稳定的咬合。因此，我们认为这些手术可能对伴有双侧下颌髁发育不全的上颌前突患者有效。
{"title":"A Case of Skeletal Maxillary Protrusion with Open Bite and Hypoplasia of the Condyle Treated Using Maxillary Surgery Alone","authors":"Shigehiro Ono, T. Nakagawa, M. Kaku, Taeko Yamamoto, K. Ohta, Kazumi Kubozono, Ryo Uetsuki, K. Mizuta, K. Tanimoto, M. Takechi","doi":"10.5927/JJJD.29.59","DOIUrl":"https://doi.org/10.5927/JJJD.29.59","url":null,"abstract":"Surgical correction for skeletal maxillary protrusion is frequently associated with various risks, such as relapse and progressive condylar resorption (PCR). In addition, affected patients with a deformity of the condylar head have increased risk of these complications. We report a case of skeletal maxillary protrusion associated with hypoplasia of the bilateral mandibular condyles, in which a favorable outcome was attained by utilizing a combination of Le Fort I osteotomy and anterior segmental maxillary osteotomy procedures along with planned mandibular autorotation. A 26-year-old woman visited the Department of Orthodontic Dentistry at our hospital with complaints of maxillary protrusion and anterior open bite. The patient was diagnosed with hypoplasia of the bilateral mandibular condyles and maxillary protrusion associated with an open bite of the anterior teeth by several radiographic and orthodontic examinations, and was referred to our department for surgical correction. Preoperative orthodontic treatment was initially performed for 1 year 8 months, after which she underwent orthognathic surgery. The operation was two segmental Le Fort I osteotomy (a combination of Le Fort I and anterior segmental maxillary osteotomy), along with mandibular autorotation. At more than 2 years after surgery, the patient expressed satisfaction with changes in facial appearance and stable occlusion also remained. Accordingly, we consider that these surgical procedures may be effective for patients with maxillary protrusion associated with hypoplasia of the bilateral mandibular condyles.","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":"123176549","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}
Noriaki Aoki, K. Ise, Arisa Onda, Yasufumi Kosugi, C. Koyama, H. Miyagishima, T. Iisaka, Keita Ishiguro, Shinsuke Ohta, J. Funaki
Orthognathic surgery is performed to establish func-tional occlusion and to make esthetic improvements. The most common surgical procedures are Le FortⅠosteotomy and sagittal split ramus osteotomy（SSRO）. Gen-erally, their postoperative course is uneventful. In many facilities in Japan, the plates are removed approximately one to two years after osteotomy. We report a case of refixed non-unioned maxilla caused by a fractured plate, 15 months after a Le FortⅠosteotomy, which has not been reported previously. A 43-year-old man visited our hospital with a chief complaint of concave profile and malocclusion. Subse-quently he underwent Le FortⅠosteotomy and SSRO. Facial findings were symmetric from the frontal view and a concave profile from the lateral view. Intraoral findings revealed an overjet of −8 mm and an overbite of ＋5 mm, showing Class Ⅲ molarization. Cephalometric analysis revealed ANB: −13.4°, U1 to SN: 108.1°, L1 to mandible: 69.0°, FMA: 19.0° and gonial angle: 121.3°. He was diagnosed as Skeletal Ⅲ and Dental Class Ⅲ with a low mandible and short face. Intraoperatively, the maxillary segments were rigidly fixed by 5 titanium plates in the piriformis margin and zygomatic buttress after the maxilla advanced 5 mm. They were not filled with an autogenous bone graft after the Le FortⅠosteotomy because we confirmed immobilization of the maxilla. The patient was satisfied with the results of the opera-tion. The postoperative course has been uneventful since then. However, mobility of the maxilla was found 15 months after the Le FortⅠosteotomy. We diagnosed this as a non-unioned maxilla, and performed surgery to refix the non-unioned maxilla. One of the titanium plates in the piriformis margin on the right side had completely fractured, and the other titanium plates had become loose. Therefore, the fractured plate and another plate were replaced by new ones. In addition, a bone graft harvested from the mandibular ramus was placed with screws in the gap between the maxillary segments. At present, the postoperative course has been uneventful without complications to date. We need to take into ac-count the possibility of plate fractures for patients with short faces, due to the overload coming from the occlusal force and the necessity of a larger movement.
{"title":"A Case Report of Fractured Plate and Non-unioned Maxilla After Le FortⅠOsteotomy","authors":"Noriaki Aoki, K. Ise, Arisa Onda, Yasufumi Kosugi, C. Koyama, H. Miyagishima, T. Iisaka, Keita Ishiguro, Shinsuke Ohta, J. Funaki","doi":"10.5927/jjjd.29.83","DOIUrl":"https://doi.org/10.5927/jjjd.29.83","url":null,"abstract":"Orthognathic surgery is performed to establish func-tional occlusion and to make esthetic improvements. The most common surgical procedures are Le FortⅠosteotomy and sagittal split ramus osteotomy（SSRO）. Gen-erally, their postoperative course is uneventful. In many facilities in Japan, the plates are removed approximately one to two years after osteotomy. We report a case of refixed non-unioned maxilla caused by a fractured plate, 15 months after a Le FortⅠosteotomy, which has not been reported previously. A 43-year-old man visited our hospital with a chief complaint of concave profile and malocclusion. Subse-quently he underwent Le FortⅠosteotomy and SSRO. Facial findings were symmetric from the frontal view and a concave profile from the lateral view. Intraoral findings revealed an overjet of −8 mm and an overbite of ＋5 mm, showing Class Ⅲ molarization. Cephalometric analysis revealed ANB: −13.4°, U1 to SN: 108.1°, L1 to mandible: 69.0°, FMA: 19.0° and gonial angle: 121.3°. He was diagnosed as Skeletal Ⅲ and Dental Class Ⅲ with a low mandible and short face. Intraoperatively, the maxillary segments were rigidly fixed by 5 titanium plates in the piriformis margin and zygomatic buttress after the maxilla advanced 5 mm. They were not filled with an autogenous bone graft after the Le FortⅠosteotomy because we confirmed immobilization of the maxilla. The patient was satisfied with the results of the opera-tion. The postoperative course has been uneventful since then. However, mobility of the maxilla was found 15 months after the Le FortⅠosteotomy. We diagnosed this as a non-unioned maxilla, and performed surgery to refix the non-unioned maxilla. One of the titanium plates in the piriformis margin on the right side had completely fractured, and the other titanium plates had become loose. Therefore, the fractured plate and another plate were replaced by new ones. In addition, a bone graft harvested from the mandibular ramus was placed with screws in the gap between the maxillary segments. At present, the postoperative course has been uneventful without complications to date. We need to take into ac-count the possibility of plate fractures for patients with short faces, due to the overload coming from the occlusal force and the necessity of a larger movement.","PeriodicalId":102257,"journal":{"name":"The Japanese Journal of Jaw Deformities","volume":"25 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":"114600632","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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