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Journal of Pharmacy and Pharmacology 2017年第8期5卷 565-571页

作者： Daniel Amaral Alves Marliere Caio Bellini Lovisi Alan Robert Moreira Schmitt Bruno Salles Sotto-Maior Henrique Duque de Miranda Chaves Netto MSc in Clinical Dentistry- Juiz de Fora Dental School Federal University of Juiz de Fora Juiz de Fora 36036-300 Brazil MSc in Dentistry - Dental School University of the State of Rio de Janeiro Rio de Janeiro 20551-030 Brazil Lecturer in Dentistry- Juiz de Fora Dental School Federal University of Juiz de Fora Juiz de Fora 36036-300 Brazil

orthognathic surgery involves correction of functional and often esthetic disharmonies. The purpose of this case report is topresent the case of a 22 years-old female with class III dentofacial deformity that required orthognathic surgery to treat hermalocclusion and buccal fat pad excision for optimizing soft-tissue facial contour. Treatment planning involved a counterclockwiserotation of the maxilomandibular complex with genioplasty based on digital 3D surgical planning using the Dolphin Imaging 11.7 3DPremium software. Prototyping splints allowed surgical procedures （bilateral sagital mandibular osteotomy associated to a Le fort Iosteotomy） that corrected position of the gnathic bones. In the same surgical procedure, the buccal fat pad was partially removed for asharp cheek contour giving a slimmer appearance to her face. After 5 months, the patient was reassessed and reported no complaintsregarding esthetics or function. This case illustrates that a combination oforthognathic surgery and an esthetic procedure can result in astable and harmonious facial as well as occlusal outcomes.

关键词： orthognathic surgery, occlusal plane, malocclusion, buccal fat pad, aesthetic procedure.

Major Approaches on the Piezoelectric Device, Drills and Saws to orthognathic Surgery: A Systematic Review

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Health 2019年第6期11卷 783-791页

作者： Diego César Marques Vanessa Gabriela Gonzáles Pinto Rogério Luiz de Araújo Vian Regis Manzini Leandro Aparecido Irrazabal Priscilla Janaína de Lima Borelli Bovo Idiberto José Zotarelli Filho Elias Naim Kassis University Center North Paulista (Unorp) S&#227 o José do Rio Preto (SP) Brazil Post Graduate and Continuing Education (Unipos) S&#227 o José do Rio Preto (SP) Brazil Cristo Redentor Hospital Iporá Goáis Brazil Santa Casa de Misericórdia Hospital Servi&#231 o de Cirurgia e Traumatologia Bucomaxilofacial Ribeir&#227 o Preto (SP) Brazil Universida de Federal do Pampa (Unipampa) Campus Uruguaiana (RS) Brazil

Introduction: The incidence of lesions of sensory and motor nerves associated with oral and maxillofacial surgery is often underestimated, representing around 32.0% of all lesions, and orthognathic surgery contributes 12.3% to these lesions. Thus, the use of piezosurgery (PiZCi) has been indicated in several procedures within oral and maxillofacial surgery due to a number of advantages over conventional drill and saw techniques. Objective: to analyze the main literature on the use of the piezoelectric device in relation to the use of drills and to orthognathic surgery in dentistry. Methods: A total of 41 articles were found involving orthognathic Surgery, Piezoelectric Device, Drills Device, Saws Device, and Efficiency. Initially, it was held the exclusion existing title and duplications following the interest described this work. After this process, the summaries were evaluated, and a new exclusion was held. 29 articles were included and discussed in this study. Initially, the keywords were determined by searching the DeCS tool (Descriptors in Health Sciences, BIREME base) and later verified and validated by MeSh system (Medical Subject Headings, the US National Library of Medicine). Results and conclusion: It was concluded that the piezoelectric device has excelled with an effective surgical technique, being able to be indicated in the most diverse areas of the oral surgery, providing accurate, clean and minimally traumatic osteotomies for the soft tissues, intraoperative bleeding, when compared to conventional surgery using drills and/or saws.

关键词： orthognathic Surgery Piezoelectric Device Drills Device Saws Device Efficiency

Comparison of skeletal, dental and soft tissue changes in young adults with Class II malocclusion, treated either by camouflage, fixed functional appliance or orthognathic surgery—A prospective study on Indian subjects

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Open Journal of Stomatology 2012年第4期2卷 373-382页

作者： Anjana Shetty Anand Patil Sanjay Ganeshkar Department of Orthodontics and Dentofacial Orthopaedics AECS Maaruthi Dental College Banglore India Department of Orthodontics and Dentofacial Orthopaedics SDM College of Dental Sciences Dharwad India

Introduction: Borderline Class II malocclusion due to deficient mandible can be treated either by orthodontic camouflage, fixed functional appliances or by orthodontics followed by surgical mandibular advancement. Methodology: A prospective study was designed on young adults with Class II malocclusion on account of a deficient mandible. A total of 45 subjects were divided into three groups of 15 individuals each. The patients were treated either by camouflage, fixed functional appliances or by orthognathic surgery. Pre and post treatment cephalograms were used to assess the skeletal, dental and soft tissue changes. Pre and post treatment profile photographs were assessed on a Visual Analogue Scale (VAS) by orthodontists, oral surgeons and laypersons. Results: Each group achieved a reduction in facial convexity, but the results obtained from the surgical group were more pronounced than the camouflage and the fixed functional group. Conclusion: The reduction in convexity in the camouflage group was by retracting the upper anteriors, which increases the nasolabial angle. In the fixed functional appliance a combination of skeletal and dentoalveolar changes can be observed. However the most appropriate reduction in profile convexity can be obtained by combined orthodontic and surgical treatment of malocclusion.

关键词： Class II Malocclulsion Camouflage Fixed Function Appliance orthognathic Surgery

Parathyroid Hormone: Is It Really the Cause for Increased Tooth Mobility after orthognathic Surgery?

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Open Journal of Stomatology 2014年第8期4卷 424-433页

作者： Nezar Watted Emad Hussein Muhamad Abu-Mowais Azzaldeen Abdulgani Peter Proff Abu-Hussein Muhamad Department of Conservative Dentistry Al-Quds University Jerusalem Palestine Department of Orthodontics Arab American University Jenin Palestine Department of Orthodontics University of Regensburg Regensburg Germany Department of Pediatric Dentistry University of Athens Athens Greece

Introduction: Following orthognathic surgery, increased tooth mobility is observed clinically and is utilized for postsurgical orthodontic tooth movement. It was suggested that the increase may result from a surgery-associated alteration of parathyroid hormone (PTH) and calcium metabolism. Materials and Methods: 30 young adult patients were divided into a mandibular osteotomy group (Group A, n = 20) and an untreated control group (Group B, n = 10). Tooth mobility was evaluated using the Periotest device. Tooth mobility, serum PTH and calcium levels were determined repeatedly for both groups. Results: The tooth mobility was increased significantly in the Group A patients in the first 10 days post-surgery. All serum PTH and calcium mean levels were within normal ranges. No significant differences were found between the measurements of both groups. The serum calcium levels recorded at the 1st post-surgery day were slightly lower in the operated patients compared to the control group. Conclusion: It can be concluded that the increased facility of orthodontic tooth movement immediately post-surgery was confirmed by Periotest measurements, while no association was found with surgery-related altered levels of PTH and calcium. Since dietary effects can be ruled out, the increase of clinical tooth mobility may rather result from preoperative orthodontic forces and/or the post-surgical elimination of masticatory muscular influences.

关键词： orthognathic Surgery Parathyroid Hormone (PTH) Calcium Concentration Tooth Mobility

Pneumomediastinum after orthognathic Surgery: Case Report and Review of the Literature

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International Journal of Otolaryngology and Head & Neck Surgery 2013年第2期2卷 57-60页

作者： Susanne Jung Thomas Prien Claudia Rudack Johannes Kleinheinz Department of Anaesthesiology University Hospital Muenster Muenster Germany Department of Cranio-Maxillofacial Surgery University Hospital Muenster Muenster Germany Department of Otorhinolaryngology University Hospital Muenster Muenster Germany

orthognathic surgery in general addresses young patients and aims to improve their bite function and to harmonize their facial aesthetics. Secure surgical standards and a defined post-surgical protocol of after-care are indispensable to reduce surgical as well as anaesthesiological risks in this area of complex elective surgery. The development of pneumomediastinum is a rare incident but threatens the patients’ physical integrity. The case of a young healthy male who underwent Le Fort I osteotomy in combination with bilateral mandibular sagittal split osteotomy and postoperatively developed pneumomediastinum is presented, together with a discussion of the possible reasons for this rare complication of orthognathic surgery. The avoidance of life-threatening coincidences must be one main focus in the preparation and aftercare in elective orthognathic surgery.

关键词： Pneumomediastinum Pneumothorax Mediastinal Emphysema orthognathic Surgery Complication

Orthodontic camouflage versus orthognathic surgery: A comparative analysis of long-term stability and satisfaction in moderate skeletal Class III

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Open Journal of Stomatology 2013年第1期3卷 89-93页

作者： Xueyan Xiong Yaxin Yu Fengshan Chen Department of Emergency Medicine First Hospital Jilin University Changchun China Laboratory of Oral Biomedical Science and Translational medicine School & Hospital of Stomatology Tongji University Shanghai China

Objective: The purpose of this study was to compare long-term stability and satisfaction between orthodontic camouflage and orthognathic surgery in treatment of moderate skeletal Class III adults. Materials and Methods: A total of 25 adults females who had been treated with orthodontic camouflage for Class III malocclusions were recalled at least 3 years post-treatment to evaluate stability and satisfaction with treatment outcomes. The data were compared with similar data for long-term outcomes in 21 patients with the same Class III problems who had bimaxillary surgical correction. Results: In the camouflage patients, small mean changes in skeletal landmark positions occurred over the long term, although the changes were generally much smaller than in the surgery patients. Dental changes in the surgery group were more severe than those in the camouflage group. The camouflage patients reported fewer functional or temporomandibular joint problems than did the surgery patients. Both groups reported similar levels of overall satisfaction with treatment. Conclusion: The results suggest that both camouflage and surgical treatment in moderate skeletal Class III adults can achieve satisfactory outcomes and provide long-term stability. If patients do not readily accept surgery because of potential surgical complications or financial difficulties, camouflage treatment may be an effective alternative treatment.

关键词： Moderate Skeletal Class III Adults Orthodontic Camouflage orthognathic Surgery

Applications of stem cells in orthodontics and dentofacial orthopedics:Current trends and future perspectives

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World Journal of Stem Cells 2018年第6期10卷 66-77页

作者： Shiva Safari Arezoo Mahdian Saeed Reza Motamedian Department of Orthodontics School of Dentistry Shahid Beheshti University of Medical Sciences

A simple overview of daily orthodontic practice involves use of brackets, wires and elastomeric modules. However, investigating the underlying effect of orthodontic forces shows various molecular and cellular changes. Also, orthodontics is in close relation with dentofacial orthopedics which involves bone regeneration. In this review current and future applications of stem cells(SCs) in orthodontics and dentofacial orthopedics have been discussed. For craniofacial anomalies, SCs have been applied to regenerate hard tissue(such as treatment of alveolar cleft) and soft tissue(such as treatment of hemifacial macrosomia). Several attempts have been done to reconstruct impaired temporomandibular joint. Also, SCs with or without bone scaffolds and growth factors have been used to regenerate bone following distraction osteogenesis of mandibular bone or maxillary expansion. Current evidence shows that SCs also have potential to be used to regenerate infrabony alveolar defects and move the teeth into regenerated areas. Future application of SCs in orthodontics could involve accelerating tooth movement, regenerating resorbed roots and expanding tooth movement limitations. However, evidence supporting these roles is weak and further studies are required to evaluate the possibility of these ideas.

关键词： Alveolar bone grafting Dentofacial deformities Distraction osteogenesis Guided tissue regeneration Orthodontics Orthodontic tooth movement orthognathic surgery Periodontitis Root resorption Stem cells

A Finite Element Analysis Study Comparing 3 Internal Fixation Techniques in Mandibular Sagittal Split Osteotomy

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International Journal of Otolaryngology and Head & Neck Surgery 2018年第5期7卷 298-311页

作者： Muhammad Kamil Hassan Michael Ring Leo F. A. Stassen Dublin Dental School and Hospital Trinity College Dublin Dublin Ireland St. James’s Hospital Dublin Dublin Ireland Dublin Institute of Technology Dublin Ireland Dublin Dental School and Hospital Trinity College Dublin Dublin Ireland

Purpose: To analyse, and compare using finite element analysis, the biomechanical properties of the 1.7 mm miniplate fixation against 2 conventional fixation techniques (2.0 mm bi-cortical screws and 2.0 mm miniplate) used in the mandibular sagittal split osteotomy. Methods: A 3-D virtual mandible model was constructed using images from CT scan. Sagittal split osteotomy was carried out virtually, and the fixation techniques were applied onto the model. 9 virtual models consisted of the 3 fixation techniques with mandibular movements of 3 mm setback, 3 mm advancement and 7 mm advancement were developed. Bite forces of 50, 75 and 100 N were applied for incisor bite simulation and 100, 200 and 300 N for molar biting force. Finite element analysis was carried out in Solidworks, and readings of stresses and displacement were recorded. Wilcoxon rank sum test was applied and P-value of 0.05 was set for statistical analysis. Results: In this manuscript the authors have compared 3 internal fixation techniques in mandibular sagittal split osteotomy. There was a statistically significant difference for both stress and displacement readings between the 1.7 mm miniplate, the 2.0 mm bi-cortical screws and the 2.0 mm miniplate for all mandibular movements. For the 1.7 mm miniplate vs 2.0 mm bi-cortical screws, the stress reading was (P = 3.063e-08, W = 314), and for displacement was (P = 5.811e-05, W = 282). For the 1.7 mm miniplate vs 2.0 mm miniplate, the stress reading was (P = 9.862e-4, W = 263) and for displacement was (2.05e-2, W = 235). Conclusion: The 1.7 mm miniplate has adequate strength to be used in mandibular sagittal split osteotomy, although statistically less rigid when compared to the conventional 2.0 mm miniplate and 2.0 mm bi-cortical screws, especially in larger movements.

关键词： orthognathic BSSO Rigid Fixation Biomechanical Finite Element Analysis

Surgical Manipulation of the Occlusal Plane in Class III Deformities: 5 Features to Help Planning

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Open Journal of Stomatology 2014年第5期4卷 238-242页

作者： Eduardo Parente Guilherme Lacerda Marcelo Galindo Silvares Department of Oral and Maxillofacial Surgery Pontifical Catholic University of Minas Gerais PUC Belo Horizonte Brazil Department of Oral and Maxillofacial Surgery State University of Rio de Janeiro Rio de Janeiro Brazil

Class III malocclusion is one of the most common deformities that requires correction through orthodontic-surgical treatment. These patients present different facial patterns depending on the occlusal plane angulation. These patients may benefit from surgical manipulation of the occlusal plane, because only bite correction does not always lead to the improvement of the facial deformity. The purpose of this paper is to show the surgical manipulation of the occlusal plane in Class III patients based on five features: 1) facial type, 2) upper incisor display at rest, 3) dental exposure during smile, 4) soft tissue support, and 5) chin projection. The surgical manipulation of the occlusal plane can improve the esthetic outcome in the treatment of class III deformities, and careful evaluation of the five features described could be a helpful planning method.

关键词： orthognathic Surgery Occlusal Plane Alteration Class III Malocclusion