著者

野上 晋之介 山内 健介 金氏 毅 山本 哲彰 宮本 郁也 山下 善弘 高橋 哲

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.21, no.3, pp.190-194, 2011-08-15 (Released:2012-01-24)

参考文献数

11

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The amount of postoperative bone resorption after genioplasty was studied in 13 patients. The subjects of this study were 4 patients who underwent genioplasty alone, and 5 who underwent genioplasty combined with other techniques for correcting skeletal Class II and Class III deformities.Large advancement genioplasties were performed on 13 patients by horizontal osteotomy of the inferior border of the mandible, with preservation of a musculoperiosteal pedicle to the advanced genial segment. Preoperative, immediate postoperative, and long-term follow-up lateral cephalometric radiographs were retrospectively analyzed to evaluate the osseous changes of the chin. We examined the correlation between bone resorption and the degree of advancement, the degree of mandible movement, the height of the genial segment, and the distance from the existing bone to the genial segment. The results showed a correlation between bone resorption and the distance from existing bone to the genial segment. This suggests that the supply of blood between existing bone and the genial segment has an influence on bone resorption.

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

TSUYOSHI SUZUKI TATSUO KAWAMOTO DAISUKE YAMADA RYOUHEI KITAMURA NAOKO TOMINAGA HIROKI FUKUOKA KEIJI MORIYAMA

出版者

THE JAPANESE SOCIETY FOR JAW DEFORMITIES

雑誌

The Japanese Journal of Jaw Deformities (ISSN:09167048)

巻号頁・発行日

vol.20, no.3, pp.220-227, 2010-08-15 (Released:2012-03-16)

参考文献数

28

被引用文献数

5

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The present study conducted a statistical survey of 1118 patients with jaw deformity who underwent surgical orthodontic treatment in the Section of Maxillofacial Orthognathics, Department of Orthodontics, Tokyo Medical and Dental University from 1980 to 2009.The results were as follows:1. There were 442 male and 676 female patients (ratio 1:1.5).2. The mean age at operation of all patients was 24.2 years old. The mean age has tended to increase in recent years.3. The most common condition was mandibular prognathism without other deformities of the jaw, accounting for 47.3% of the patients. Next was mandibular prognathism with asymmetry, accounting for 20.4%, and then mandibular prognathism with open bite, accounting for 14.1%.4. The most frequently used surgical procedure was sagittal split ramus osteotomy (SSRO), accounting for 64.0%. The combination of Le Fort I osteotomy and SSRO accounted for 21.0%.5. For bone fixation after SSRO, wire fixation, which used to be the most common method, has been almost completely replaced by screw or mini-plate fixation in recent years.

著者

大井 一浩 井上 農夫男 金子 真梨 道念 正樹 松下 和裕 山口 博雄 戸塚 靖則

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.20, no.1, pp.1-7, 2010-04-15 (Released:2012-03-02)

参考文献数

26

被引用文献数

1

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The purpose of this study is to evaluate the incidence, risk factors and postoperative nausea and vomiting (PONV) in patients who underwent orthognathic surgery.The subjects were 139 patients aged 17-52 years (47 males and 92 females) who underwent orthognathic surgery in the Hokkaido University Hospital from January 2001 to December 2003. Ninety-four Sagittal splitting ramus osteotomy (SSRO), 34 Le Fort I osteotomy and SSRO (Le Fort I+SSRO), and 11 surgically assisted rapid palatal expansion (SARPE) were performed. Anesthesia was maintained with sevoflurane and nitrous oxide in oxygen. There were no cases of maxillomandibular fixation. The factors investigated included age, gender, type of surgery, amount of bleeding, operation time, anesthesia time, anesthesia induction drugs, fentanyl dose and incidence of PONV. A statistical study was performed using logistic regression analysis to confirm the statistical significance among age, gender, amount of bleeding, operation time, anesthesia time, difference of anesthesia induction drugs, fentanyl dose, and incidence of PONV. A Chi-square test for independence was used to confirm the statistical significance between the type of surgery and incidence of PONV. Differences were considered significant for a P<.05.Nausea was observed in 44.6% females and 17.1% males. The incidence of nausea was significantly higher in females. A significantly higher amount of vomiting was observed in 23.5% of Le Fort I+SSRO compared with 7.4% of SSRO and 9.1% of SARPE. Statistically significant differences for vomiting were also noted in the operation time and anesthesia time.

著者

葭葉 清香 代田 達夫 山口 徹太郎 新 真紀子 栗原 祐史 槇 宏太郎 新谷 悟

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.23, no.1, pp.1-7, 2013-04-15 (Released:2013-05-13)

参考文献数

27

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In this study, we evaluated the usefulness of bioabsorbable poly-L-lactide (PLLA) mini-plates for bone fixation after Le Fort I osteotomy and bilateral sagittal split osteotomy (SSRO). The subjects were 19 patients, who received two-jaw surgery using titanium and PLLA mini-plates. Lateral cephalograms were taken before surgery (T1), immediately after surgery (T2), and more than six months after surgery (T3). Changes in the measurement points were statistically analyzed. There was no statistical difference in the postoperative skeletal difference between the two groups. The post-operative stability of PLLA mini-plates is comparable to that of titanium mini-plates. PLLA mini-plates are considered to be clinically useful.

著者

金子 早知子 中野 洋子 高野 伸夫

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.20-27, 2012-04-15 (Released:2012-09-14)

参考文献数

25

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Objective: We measured the formant frequency of vowels in retrusion patients and normal healthy control patients, and made a comparative study of the purpose in phonology. We wanted to know how orthognathic surgery has influenced the articulation of vowels in patients. We investigated how the relationships between the position of the maxilla and mandible and incisor occlusion affected vowel sounds. And because resonance space is believed to affect sound frequencies, we investigated the effect of the width of the airway preoperatively and postoperatively on vowel sounds.Methods: Five vowel sounds in 10 Japanese patients with mandibular retrusion requiring surgery for jaw deformity and malocclusion preoperatively and at 3 and 6 months postoperatively were recorded and compared with those in normal healthy control patients. Also, the effect of the positional relationship between the maxilla and the mandible and incisor occlusion on these vowel sounds was investigated by correlating skeletal and denture patterns of cephalometric measurements taken preoperatively and at 3 months postoperatively with these vowel sounds. The width of the airway was measured preoperatively and 3 months after the operation, and the correlation with the frequency of the vowels was examined.Results: In /e/ F1, /o/ F2-F1, significant differences were observed between the preoperative patients and the control patients. However, these differences disappeared at 3 and 6 months postoperatively.A significant difference was admitted with F1 of /a/ and F1 of /e/ in comparing the preoperative with the postoperative patients 6 months by a rank test with a sign of Wilcoxon.Both preoperatively and postoperatively, positive correlations were observed between F2-F1 the narrow, open vowels /i/ with SNA and SNB. In the preoperative patients, some correlations were observed between F1 the semi-narrow, open vowel /e/ and denture patterns.Significant increases were observed between the preoperative and 3 months postoperative patients in the width of the hypopharyngeal cavity. Many correlations were observed between the change of width of the airway and the vowel frequency, particularly in the posterior tongue vowel /u/. But other vowels had few correlations.Conclusion: A change of occlusion of the front teeth and a change of frame by the mandible correction operation greatly influenced close vowels and half close vowels that were a front tongue vowel, especially the influence of /i/ and /e/ in retrusion patients. It was an interior tongue vowel that the change in the airway influenced the vowel frequency of only /u/.

著者

奥村 映仁 飛田 尚慶 大場 誠悟 中尾 紀子 朝比奈 泉

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.20, no.1, pp.25-29, 2010-04-15 (Released:2012-03-02)

参考文献数

12

被引用文献数

2 7

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In this case report, we present a surgical orthodontic treatment performed for an aged female. The patient was a 62-year-old female with chief complaints concerning occlusal disharmony, dyslalia, and aesthetic disturbance. As a result of various analysis, the patient was diagnosed with mandibular prognathism accompanied by deep bite and reversed occlusion. Due to the venerability of the patient, she presented numerous risks. The patient was treated with Le Fort I osteotomy, sagittal split ramus osteotomy and genioplasty. To acquire and to maintain a stable postoperative occlusion, close cooperation with the prothodontist was carried out. Postoperatively, the patient's chief complaints were improved and she demonstrated satisfactory progress after one year. The results of this case report indicate that treatment of a jaw deformity with surgical orthodontic procedures is effective for the improvement of occlusal disorders as well as aesthetic problems. If there are no general health problems, this treatment may be applied irrespective of the patient's age.

著者

山内 健介 金氏 毅 野上 晋ノ介 山下 善弘 高橋 哲 永山 純一郎 酒井 香織 酒井 昭行

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.20, no.3, pp.205-210, 2010-08-15 (Released:2012-03-16)

参考文献数

20

被引用文献数

1 4

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The most frequently used techniques for correcting skeletal Class III deformity are sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO). The purpose of this study was to compare the clinical outcome including skeletal stability after SSRO with semirigid fixation and IVRO. The subjects of this study were 23 patients who underwent SSRO for mandibular setback with semirigid fixation by titanium miniplate and 20 patients who underwent IVRO for mandibular setback without interosseous fixation. The mean period of maxillo-mandibular fixation was 5.1 days in the SSRO group and 7.3 days in the IVRO group. The evaluation items were skeletal changes, operation time, blood loss, sensory disturbance, temporomandibular joint (TMJ) sound and mandibular range of motion (ROM). Compared with the SSRO group, the B-point and pogonion moved significantly posteriorly in the IVRO at more than 6 months after surgery. Operation time, blood loss and occurrence of sensory disturbance were also less than those in the SSRO group. There were no significant differences in TMJ sound and ROM. The results of this study showed that both methods had minimal relapse and no significant difference in comparison by measurement of B-point and pogonion. In conclusion, both methods are effective for correcting skeletal Class III malocclusion, and the surgical method should be selected in consideration of each clinical distinction.

著者

砂川 紘子 大谷 淳二 佐野 良太 椿本 昇子 藤田 正 丹根 一夫

出版者

THE JAPANESE SOCIETY FOR JAW DEFORMITIES

雑誌

日本顎変形症学会雑誌 = The Japanese journal of jaw deformities (ISSN:09167048)

巻号頁・発行日

vol.20, no.1, pp.8-14, 2010-04-15

参考文献数

32

被引用文献数

2

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Idiopathic scoliosis is a well-known orthopedic disease in childhood and the onset and progress are observed during adolescence. It is speculated that the progress of idiopathic scoliosis affects the maxillofacial growth and the function of the temporomandibular joint because the craniofacial skeletal is located on the top of the spinal column. Another reason may be that asymmetric craniofacial growth changes the head posture and/or spinal column. In this study, we examined the association of scoliosis with jaw deformity and temporomandibular joint disorders.<br>The subjects were 44 patients who underwent orthognathic surgery for treatment of a jaw deformity at Hiroshima University Hospital. We measured the Cobb angle, an indicator of scoliosis, and the curve of the spinal column in vertebrae thoracicae on the chest radiograph. Moreover, the lateral shift of points A and B, cant of the occlusal plane and ANB angle were measured on the postero-anterior (PA) plane and lateral cephalograms. Association between the curve of the spinal column and maxillofacial morphology was examined by correlation analysis. The degree of scoliosis was examined in association with the pathological status of temporomandibular joint.<br>The prevalence of subjects diagnosed with scoliosis was 22.7%. Among the scoliosis patients, 70% were female. In all subjects with a jaw deformity, a significantly positive correlation was not found between the following variables and the Cobb angle: ANB angle, lateral shift of points A and B, cant of the occlusal plane. Moreover, no significant association between the curve of spinal column in the vertebrae thoracicae and previous variables was revealed. In addition, there was no relationship between the degree of the scoliosis and progress of the temporomandibular joint disorder.<br>These findings suggested that the progress of scoliosis exerts no substantial influence on the growth of the maxillofacial skeleton and the progress of temporomandibular joint disorders.

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.

著者

飯野 光喜 新津 恒太 堀内 俊克 松島 凛太郎 村上 夏帆 瀬戸 〓一 関谷 利子 中村 芳樹 桑原 洋助

出版者

THE JAPANESE SOCIETY FOR JAW DEFORMITIES

雑誌

日本顎変形症学会雑誌 = The Japanese journal of jaw deformities (ISSN:09167048)

巻号頁・発行日

vol.10, no.3, pp.273-280, 2000-12-15

参考文献数

22

被引用文献数

4 3

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The accuracy of positioning the osteotomized maxilla during orthognathic surgery was assessed in 26 patients, comparing the use of an external reference point placed on the forehead skin (SERP), and an external reference point consisting of a bone screw placed at the forehead bone (BERP). In all cases, the unoperated mandible was used to provide an anteroposterior and transverse maxillary position, through use of an intermediate splint. In 14 cases, the distance between the SERP and the maxillary central incisor was measured, to determine the maxillary vertical dimensions. In 12 cases, measurements between the BERP the and maxillary central incisor were made.<BR>All preoperative lateral cephalometric radiographs were traced by one investigator, and these tracings were superimposed on postoperative lateral chephalograms (3 to 6 days after surgery), respectively. The actual changes in the vertical and horizontal position of U1 were measured perpendicular and parallel to the Frankfort horizontal plane. The actual change of the palatal plane angle was also measured. These values of actual change were compared with the prediction tracings made by measurements obtained from model surgery, and the difference between planned and actual movements was calculated.<BR>The mean difference of U1 anteroposterior movement was 1.5±2.0mm in the SERP group, and 1.2±1.1 mm in the BERP group. The mean difference of U1 vertical movement was 1.8 ±2.8mm in the SERP group, and 0.5±0.3mm in the BERP group. And the mean difference of palatal plane angle rotation in the SERP group was 2.7±6.2°, and 1.6±1.8° in the BERP group. Statistical analysis showed a significant difference between the SERP group and the BERP group in the U1 vertical difference (t-test, p<0.05).<BR>The results of this investigation revealed less accuracy in the actual three-dimensional maxillary movements of the SERP group, compared with the BERP group. And this study also showed that use of the BERP will allow accurate three-dimensional control of the maxillary position, especially in the vertical dimension. However, the maxillary repositioning technique using BERP still remains subject to operator error, and other numerous possible sources of error were identified, which may lead to an incorrect result.