Surgical Accuracy of Positioning the Maxilla in Patients With Skeletal Class II Malocclusion Using Computer-Aided Design and Computer-Aided Manufacturing-Assisted Orthognathic Surgery

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ali Alqussair ◽  
Seung-Hak Baek ◽  
Tae-Seup Kim ◽  
Sugn-Ho Ha ◽  
Jin-Young Choi
Keyword(s):  
Computer Aided Design ◽  
Orthognathic Surgery ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Computer Aided Manufacturing ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Computer Aided ◽  
Aided Design

scholarly journals Evaluation of Postsurgical Stability And Condylar Morphology In Skeletal Class II Patients With Condylar Resorption Following Orthognathic Surgery

2021 ◽  
Author(s):  
Minjiao Wang ◽  
Hanjiang Zhao ◽  
Xiangyu Wang ◽  
Yifeng Qian ◽  
Hongbo Yu ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Class Ii ◽  
Mandibular Advancement ◽  
Class Ii Malocclusion ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Condylar Morphology ◽  
Ramus Height ◽  
Condylar Volume

Abstract Background: To retrospectively evaluate postsurgical stability and condylar morphology for skeletal class II malocclusion patients with condylar resorption (CR) treated with orthognathic surgery.Methods: Thirty-five patients treated with combined orthodontic and orthognathic surgery between 2014 and 2018 were enrolled in this retrospective study. CT scans were acquired preoperatively (T0), 2–7 days after surgery (T1), and 1 year postoperatively (T2). The amount of mandibular advancement, postsurgical relapse, condylar morphology and joint spaces were analysed respectively. Statistical analysis was performed using R, version 3.4.3 (R Development Core Team 2010).Results: The average mandibular advancement and counter-clockwise rotation were 5.51 mm and -2.82 degrees respectively. The average relapse was 1.08 mm (19.6% of the advancement) and 1.13 degrees. The condylar volume showed a postoperative reduction of 161.86 mm3(13.7% of initial condylar volume). AJS increased after surgery and gradually returned to its original state, while SJS and PJS decreased and remained stable. Surgical advancement of B point was significantly correlated with skeletal relapse. The optimal cut-off values were as follows: MP-FH (40.75°); ramus height (51.125 mm); SJS (1.63 mm); surgical displacement (4.72 mm); CCR (-4.3°); AJSC (1.07 mm).Conclusions: Skeletal class II patients with CR have a high risk of postsurgical condylar resorption, which was most related to nonsurgical risk factors such as gender(female) and condylar angle. Condylar had moved posteriorly to the concentric position after surgery and remained quite stable through the 1-year follow-up. Preoperative skeletal patterns such as lower ramus height and surgical procedures such as larger advancement of the mandible were closely associated with sagittal relapse of the mandible.

scholarly journals Differential Diagnosis of Skeletal Class II: Orthodontic-Surgical Approach with Surgery First

2021 ◽  
Vol 23 (4) ◽  
pp. 257-263
Author(s):  
Jessica Rico Bocato ◽  
Daiara Paula Pacheco ◽  
Mauro Toma ◽  
Ricardo Lima Navarro ◽  
Thais Maria Freire Fernandes ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Treatment Time ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Facial Profile ◽  
Skeletal Class ◽  
Angle Class Ii ◽  
Main Complaint ◽  
Skeletal Class Ii ◽  
Surgery First

AbstractOrthodontic-surgical treatment with the “Surgery First Approach” provides immediate facial aesthetic improvements and significantly reduces the patient's orthodontic treatment time, avoiding the transient worsening of the facial profile due to dental decompensation that occurs in surgical cases. Thus, this clinical case describes the retreatment of a 22-year-old female leukoderma patient, whose main complaint was related to the proclination of upper and lower incisors. The patient used a mio-relaxing plate for 30 days, which evidenced the skeletal mandibular deficiency and the ½ bilateral Class II malocclusion. Orthognathic surgery first approach associated with the extraction of the 4 premolars was chosen considering the patient’s aesthetic demand. The use of a mio-relaxing plate in the diagnostic stage was essential for the real diagnosis of mandibular deficiency and the technique employed made it possible to conclude the treatment avoiding aesthetic commitment, with excellent results. Keywords: Malocclusion, Angle Class II. Orthognathic Surgery. Orthodontics, Corrective. ResumoO tratamento ortodôntico-cirúrgico por meio do benefício antecipado proporciona melhorias estéticas faciais imediatas e reduz de maneira significativa o tempo de tratamento ortodôntico do paciente, evitando a piora transitória do perfil facial devido à descompensação dentária que ocorre em casos cirúrgicos. Assim, este caso clínico descreve o retratamento de uma paciente com 22 anos de idade, leucoderma, sexo feminino, que apresentava queixa principal relacionada à inclinação vestibular dos dentes anteriores. Após uso de placa miorrelaxante por 30 dias, verificou-se a presença de Classe II esquelética com deficiência mandibular e ½ Classe II dentária bilateral. Considerando a demanda estética da paciente, optou-se pela abordagem ortodôntico-cirúrgica com Benefício Antecipado associada à extração de 4 pré-molares para correção da inclinação dentária anterior. O uso da placa miorrelaxante foi fundamental para o diagnóstico real da deficiência mandibular e a técnica empregada possibilitou concluir o tratamento evitando o comprometimento estético pré-cirúrgico, com obtenção de excelentes resultados. Palavras-chave: Maloclusão Classe II de Angle. Cirurgia Ortognática. Ortodontia Corretiva.

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