著者

山田 大輔 東堀 紀尚 福岡 裕樹 鈴木 聖一 川元 龍夫 森山 啓司

出版者

THE JAPANESE SOCIETY FOR JAW DEFORMITIES

雑誌

日本顎変形症学会雑誌 (ISSN:09167048)

巻号頁・発行日

vol.22, no.1, pp.12-19, 2012-04-15 (Released:2012-09-14)

参考文献数

28

被引用文献数

1 1

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Facial morphology improvements are obtained following two-jaw surgery in mandibular protrusion patients. Changing external nasal morphology does not always lead to good results in all patients. In this study, using 3-dimentional computed tomography (3D-CT), we examined the changes of external nasal morphology of patients who had undergone two-jaw surgery to correct mandibular protrusion. Seven adult patients (5 male; 2 female) who had been treated by two-jaw surgery associated with upward transposition of the posterior maxilla were enrolled in this study. 3D analysis software superimposed 3D-CTs of the pre-operative and post-operative stages (at least 6 months after surgery) on the hard tissue surfaces. We employed the 3D coordinate system constructed by Frankfort horizontal (FH) plane, the frontal plane incorporating the orbitals on both sides and the sagittal plane intersecting at the midpoint between the orbitals. After superimposition, soft tissue images of 3D-CT were reconstructed and changes in external nasal morphology were three-dimensionally analyzed. 3D geographical analysis, linear and angular measurements were performed for the most inferior points on the nasal alar (LBi, RBi) on bilateral sides, the most anterior point on the nose (Prn), the most anterior point on the columella of the nose (Cm), the most posterior superior point on the nasolabial curvature (Sn) and the most anterior point on the convexity of the upper lip (Vu). Correlation of hard tissue and soft tissue changes were statistically analyzed by Spearman's rank correlation analysis.LBi and RBi moved anterior according to the anterior movement of point A. Increase in distance of both LBi and RBi and angle of LBi-Prn-RBi were observed. We found significant increase in the area of external nasal aperture. Positive correlation was seen between the anterior movement of point A and the distance of LBi and RBi.These results imply that our superimposition of CT images using the 3D coordinate system are useful to compare soft tissue changes before and after surgery. Further investigation for more information about the factors that influence facial morphology changes is necessary since the changes may not be uniform due to the individual variety of soft tissue characterization, and the direction and amount of maxillary movement by Le Fort I osteotomy.

著者

片桐 渉 小林 正治 佐々木 朗 須佐美 隆史 須田 直人 田中 栄二 近津 大地 冨永 和宏 森山 啓司 山城 隆 齋藤 功 高橋 哲

出版者

特定非営利活動法人 日本顎変形症学会

雑誌

日本顎変形症学会雑誌 (ISSN:09167048)

巻号頁・発行日

vol.30, no.3, pp.213-225, 2020 (Released:2020-09-11)

参考文献数

21

被引用文献数

2 2

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The Japanese Society for Jaw Deformities performed a nationwide survey from 2006 to 2007 and the results were reported in 2008. In the last 10 years, new surgical procedures and medical devices have been developed and brought major changes to surgical orthodontic treatment. Accordingly, we need to assess the current status of surgical orthodontic treatment.A nationwide survey of surgical orthodontic treatment between April 2017 and March 2018 was carried out and 99 surgical facilities and 64 orthodontic facilities were enrolled in the survey. The number of patients who received orthognathic surgery was 3,405, about 69% of whom were diagnosed with mandibular protrusion. Before the surgery, 3D-simulation was performed for about 40% of patients at both surgical and orthodontic facilities. Computer-aided design and computer-aided manufacturing (CAD/CAM) wafers were used at 12.1% of surgical facilities and at 17.7% of orthodontic facilities. Sagittal split ramus osteotomy (SSRO) was performed in 2,768 patients (85.5%) and Le FortⅠosteotomy in 1,829 patients (56.5%). Blood loss during the surgery was reduced compared with that in the previous survey. Autologous blood transfusion tended to be performed in cases as necessary such as surgery for maxilla and anemia of the patient. Duration of intermaxillary fixation and hospital stay were also shortened. This survey revealed the current status of surgical orthodontic treatment in Japan in comparison with the previous survey.