著者

島峯 隆浩 米満 郁男 渋谷 直樹 纐纈 美沙子 今井 治樹 藤田 紘一 大村 進 小野 卓史

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.28, no.3, pp.226-234, 2018 (Released:2018-09-28)

参考文献数

38

被引用文献数

2

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This study aimed to compare cephalometric changes in the upper airway morphology, including the hyoid bone position, after the conventional Le Fort I (LF) osteotomy, and an LF and horse-shoe osteotomies. Twenty-two patients diagnosed as having skeletal maxillary protrusion at the Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Medical Center, were included. They were divided into two groups as follows: 13 patients underwent LF and sagittal split ramus osteotomies (LF group); and 9 patients underwent LF, horse-shoe and sagittal split ramus osteotomies (HS group). The following linear variables were measured on lateral cephalometric radiographs taken before (T0), immediately after (T1), and 1 year after (T2) surgery: palatal pharyngeal space (PPS), the length from the posterior pharyngeal wall to the posterior nasal spine (PNS); superior posterior palatal space (SPPS), the length from the posterior pharyngeal wall to the middle point between the PNS and the lowest point of the soft palate; middle posterior palatal space (MPS), the length from the posterior pharyngeal wall to the lowest point of the soft palate; inferior posterior palatal space (IPS), the length from the posterior pharyngeal wall to the tongue passing the lowest point of the second cervical vertebra; epiglottic pharyngeal space (EPS), the length from the posterior pharyngeal wall to the tongue passing the front end of the epiglottis; S-H, the length from the lowest point of the hyoid bone to the Sella; and C3-H, the length from the lowest point of the hyoid bone to the lowest front point of the second cervical vertebra. Statistical analyses were performed using the Mann-Whitney U test. P values of <0.05 indicated statistical significance. SPPS and MPS decreased at T2 in the HS group. IPS and EPS increased at T1 in both groups but decreased at T2 in the HS group. S-H decreased at T1 in both groups and at T2 in the LF group. C3-H increased at T1 in both groups but decreased at T2 in the HS group. The anteroposterior diameter of the oropharynx was unchanged in the LF group because the tongue moved upward after the palate moved upward but changed in the HS group because the tongue moved backward and the oral volume decreased due to the absence of palatal segment movement. In conclusion, the anteroposterior diameter of the oropharynx decreased after backward and upward movements of the maxilla by LF and HS in the patients with skeletal maxillary protrusions.

著者

上杉 俊輔 米満 郁男 小海 暁 大村 進 小野 卓史

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.24, no.1, pp.27-36, 2014-04-15 (Released:2014-04-23)

参考文献数

23

被引用文献数

2 3

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In subjects with facial asymmetry, it is generally accepted that the maxillary frontal occlusal plane inclines toward the deviated side of the mandible. However, a few patients with facial asymmetry have their frontal occlusal planes inclined toward the contralateral side of the mandibular deviation. The aim of this study was to elucidate the morphological features of the subjects with mandibular deviation with the frontal occlusal planes inclined toward the contralateral side.The sample consisted of 40 patients whose Menton was deviated at least 2.0 mm from the facial midline. They were divided into two groups based on the relationship between the side of inclination of the frontal occlusal plane and the side of the mandibular deviation. Group IL consisted of 20 patients whose frontal occlusal plane inclined to the ipsilateral side of the mandibular deviation, while Group CL consisted of 20 patients whose frontal occlusal plane inclined to the contralateral side of the mandibular deviation. Then, we compared the two groups using 1) lateral cephalometric analysis, 2) P-A cephalometric analysis, 3) frontal soft tissue analysis and 4) dental casts analysis. The following findings were obtained:1. In Group CL patients, not only the frontal occlusal plane defined by bilateral molar positions, but also the maxilla itself significantly inclined toward the contralateral side of the mandibular deviation.2. In Group CL patients, the maxillary dental midline was significantly deviated toward the contralateral side of the mandibular deviation.3. The difference in bilateral mandibular ramus lengths was significantly smaller in Group CL patients.4. In Group CL patients, the mandibular molar compensation for the mandibular lateral deviation was significantly less than that in Group IL patients.5. In Group CL patients, both the midline and cant of the upper lip were significantly deviated toward the contralateral side of the mandibular deviation.6. The incidence of missing or buccolingual version of maxillary premolar teeth was significantly higher in Group CL patients.