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OBJECTIVE: This study aimed to assess mandibular morphologic changes to the condyle, ramus, mandibular body, and inferior mandibular border defect after sagittal split ramus osteotomy in class II and III patients. STUDY DESIGN: The relationships among the condyle, ramus, and mandibular body measured by computed tomography preoperatively and postoperatively were assessed and factors related to the reduction of the condylar square and mandibular inferior border defect were examined. RESULTS: Patients included 72 female patients with jaw deformity (36 skeletal class II cases, 36 skeletal class III cases). Postoperative reduction of the condylar square was significantly correlated with preoperative condylar height in patients with class II (P = .0297) vs preoperative condylar height and preoperative mandibular height in patients with class III (P < .0001). A mandibular inferior border defect was found in 18 of 72 class II sides (25.0%) and was significantly related to the position of the osteotomy line and attachment side of the inferior border cortex (P < .0001). CONCLUSIONS: This study's findings suggest that the postoperative reduction of the condyle could be associated with preoperative condylar height. However, the mandibular inferior border defect in class II advancement surgery could be independently associated with technical factors in sagittal split ramus osteotomy.
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Maloclusión de Angle Clase III , Osteotomía Sagital de Rama Mandibular , Femenino , Humanos , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Cóndilo Mandibular , Tomografía Computarizada por Rayos XRESUMEN
PURPOSE: The purpose of this study was to examine the relationship between occlusal force and condylar morphology in class II and III after sagittal split ramus osteotomy (SSRO) with Le Fort I osteotomy. MATERIALS AND METHODS: The subjects were 42 female patients who underwent bi-maxillary surgery, and were divided into 2 groups (21 class II and 21 class III cases). They were selected randomly from among patients that underwent surgery from 2012 to 2017. Condylar height, ramus height, ramus inclination and condylar square were assessed by computed tomography (CT), preoperatively and 1 year postoperatively. Occlusal contact area and occlusal force were measured pre- and 1, 3, 6 and 12 months post-operative. RESULTS: Condylar height and ramus height of the class II advancement cases decrease more significantly than those of class III. There were no significant differences in time-course changes of occlusal force and area between the class II and III. In the class II cases, occlusal force at 1 and 3 months was significantly lower than the preoperative value (P = 0.0009, P = 0.0002). On the other hand, in class III, occlusal force at 1, 3 and 6 months (P = 0.0038, P = 0.0031, P = 0.0283) was significantly lower than the preoperative value. CONCLUSION: This study suggested that occlusal force of the class II advancement cases reached the pre-operative level earlier than that of the class III setback cases, even though condylar height decreased after surgery in the class II cases. However, a correlation between occlusal force change and condylar height reduction after surgery could not be found.
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Fuerza de la Mordida , Maloclusión de Angle Clase III/cirugía , Maloclusión Clase II de Angle/cirugía , Cóndilo Mandibular/patología , Osteotomía Maxilar , Osteotomía Sagital de Rama Mandibular , Articulación Temporomandibular/patología , Adolescente , Adulto , Cefalometría , Femenino , Humanos , Imagen por Resonancia Magnética , Maloclusión Clase II de Angle/diagnóstico por imagen , Maloclusión de Angle Clase III/diagnóstico por imagen , Maloclusión de Angle Clase III/patología , Cóndilo Mandibular/diagnóstico por imagen , Persona de Mediana Edad , Osteotomía Le Fort , Estudios Retrospectivos , Articulación Temporomandibular/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
We report of a case of Graves' ophthalmopathy presented solely with symptoms of the eyes with normal thyroid function tests and negative immunoreactive TSH receptor autoantibody. 40-year-old male was referred to our hospital due to 2-month history of ocular focusing deficit without any signs or symptoms of hyper- or hypothyroidism. Serum thyroid function tests and 99mTc uptake were both within the normal range. Anti-thyroid autoantibodies were all negative except for the cell-based assay for serum TSH receptor stimulating activity. Since orbital CT scan and MRI gave typical results compatible with Graves' ophthalmopathy, we treated the patients with corticosteroid pulse therapy and orbital radiation therapy, leading to a partial improvement of the symptoms. This case gives insights into the potential pathophysiologic mechanism underlying Graves' ophthalmopathy and casts light upon the difficulties of establishing the diagnosis in a euthyroid case with minimal positive results for anti-thyroid autoantibodies.
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PURPOSE: The purpose of this study was to compare mandibular bone healing after advancement or setback surgery using sagittal split ramus osteotomy (SSRO). SUBJECTS: and Methods. The subjects were 50 patients (100 sides) who underwent bi-maxillary surgery, and were divided into 2 groups (25 class II advancement cases and 25 class III setback cases). They were selected randomly from the patients who underwent surgery between 2012 and 2017. Ramus square, ramus length and ramus width were measured in the horizontal plane image of computed tomography (CT), before and immediately after the operation, and at 1 year after the operation. RESULTS: Ramus square in the class III cases significantly increased in 1 year after the operation (P < 0.0001), meanwhile there was no change after 1 year in the class II cases. Before the operation, there were no significant differences in the all measurements between classes II and III. However, for ramus width, class III was significantly larger than class II immediately after (P = 0.0014) and at 1 year after the operation (P = 0.0003). CONCLUSION: This study suggested that post-operative change in ramus morphology was different between class II advancement surgery and class III setback surgery.
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Mandíbula/cirugía , Osteotomía Sagital de Rama Mandibular , Prognatismo/cirugía , Retrognatismo/cirugía , Cicatrización de Heridas/fisiología , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
Snail, also called Snai1, is a key regulator of EMT. Snail plays crucial roles in cancer progression, including resistance to anti-tumor drugs and invasion by various cancer cells. Slug, also known as Snai2, is also involved in the aggravation of certain tumors. In this study, we examined the roles of Slug in human oral squamous cell carcinoma (OSCC) cells. Slug is highly expressed in these cells, and Slug siRNA effectively represses anti-tumor drug resistance and invasive properties. In addition, transforming growth factor (TGF)-ß upregulates the expression of Snail and Slug and promotes resistance to anti-tumor drugs in OSCC cells. Surprisingly, Slug siRNA appears to upregulate Snail expression considerably in OSCC cells. Snail siRNA also appears to upregulate Slug expression. Thus, either Slug or Snail siRNA alone partially mitigates malignant phenotypes in the presence of TGF-ß, whereas both Slug and Snail siRNAs together dramatically suppress them. Therefore, Slug and Snail in tandem, but not alone, are potential therapeutic targets for nucleic acid medicines to treat oral cancer.
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Regulación Neoplásica de la Expresión Génica , Neoplasias de la Boca/genética , Factores de Transcripción de la Familia Snail/genética , Antineoplásicos/farmacología , Biomarcadores , Línea Celular Tumoral , Citocinas/genética , Citocinas/metabolismo , Resistencia a Antineoplásicos/efectos de los fármacos , Resistencia a Antineoplásicos/genética , Transición Epitelial-Mesenquimal/efectos de los fármacos , Transición Epitelial-Mesenquimal/genética , Regulación Neoplásica de la Expresión Génica/efectos de los fármacos , Humanos , Neoplasias de la Boca/metabolismo , Neoplasias de la Boca/patología , Factores de Transcripción de la Familia Snail/metabolismo , Factor de Crecimiento Transformador beta/metabolismo , Factor de Crecimiento Transformador beta/farmacologíaRESUMEN
We herein describe a case of pulmonary tumor thrombotic microangiopathy (PTTM) with rapidly progressing colon cancer. A 61-year-old man who had been receiving treatment for type 2 diabetes mellitus for 3 years was hospitalized due to critical hypoxemia. Computed tomography, which had not shown any abnormalities 3 months previously, revealed a tumor in the ascending colon, multiple nodules in the liver, and the absence of any lung abnormalities. On day 3 of hospitalization, a sudden onset of severe dyspnea and tachycardia occurred, followed by death. Autopsy revealed microscopic metastatic tumor emboli in multiple pulmonary vessels with fibrin thrombus and intimal proliferation, which led to a diagnosis of PTTM.
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Neoplasias del Colon/complicaciones , Neoplasias del Colon/patología , Diabetes Mellitus Tipo 2/complicaciones , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/secundario , Microangiopatías Trombóticas/complicaciones , Autopsia , Humanos , Hipoxia , Hígado/patología , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Neoplasias Primarias Secundarias , Células Neoplásicas Circulantes/patología , Microangiopatías Trombóticas/patología , Tomografía Computarizada por Rayos XRESUMEN
PURPOSE: The purpose of this study was to compare time-course changes in temporomandibular joint (TMJ) space between mandibular advancement surgery and setback surgery after sagittal split ramus osteotomy (SSRO) and Le Fort I osteotomy. SUBJECTS AND METHODS: The subjects were 46 patients (92 joints) who underwent bi-maxillary surgery. The TMJ disc position was assessed by magnetic resonance imaging (MRI) and the anterior, superior, posterior, medial and lateral joint spaces were assessed by computed tomography (CT), preoperatively and at 1 week and 1 year postoperative. The 92 joints were divided into 2 groups, namely class II (n = 46 joints), and class III (n = 46 joints) (an advanced group vs a setback group). Next, the 92 joints were divided into 2 groups comprising 36 joints with anterior disc displacement joint (ADD group) and 56 joints without (non-ADD group). Time-course changes in the measurements were compared statistically between the advanced and setback groups, and between the ADD and non-ADD groups. RESULTS: There were no significant differences between the advance group and setback group regarding time-course change in all the joint spaces. However, there were significant differences between the ADD group and non-ADD group regarding time-course change in the medial, anterior, superior and posterior joint spaces (P < 0.05). CONCLUSION: This study suggested that ADD could affect the time-course change in TMJ space and condylar position after bi-maxillary osteotomy.
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Avance Mandibular/efectos adversos , Osteotomía Le Fort/efectos adversos , Articulación Temporomandibular/patología , Adolescente , Adulto , Cefalometría , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Maloclusión Clase II de Angle/patología , Maloclusión Clase II de Angle/cirugía , Maloclusión de Angle Clase III/patología , Maloclusión de Angle Clase III/cirugía , Persona de Mediana Edad , Articulación Temporomandibular/diagnóstico por imagen , Factores de Tiempo , Tomografía Computarizada por Rayos X , Adulto JovenRESUMEN
PURPOSE: The purpose of this study was to compare changes in temporomandibular joint (TMJ) and ramus morphology between class II and III cases before and after sagittal split ramus osteotomy (SSRO) and Le Fort I osteotomy. MATERIALS AND METHODS: The subjects were 39 patients (78 sides) who underwent bi-maxillary surgery. They consisted of 2 groups (18 class II cases and 21 class III cases), and were selected randomly from among patients who underwent surgery between 2012 and 2016. The TMJ disc tissue and joint effusion were assessed by magnetic resonance imaging (MRI) and the TMJ space, condylar height, ramus height, ramus inclination and condylar square were assessed by computed tomography (CT), pre- and post-operatively. RESULTS: The number of joints with anterior disc displacement in class II was significantly higher than that in class III (p < 0.0001). However, there were no significant differences between the two classes regarding ratio of joint symptoms and ratio of joint effusion pre- and post-operatively. Class II was significantly better than class III regarding reduction ratio of condylar height (p < 0.0001) and square (p = 0.0005). CONCLUSION: The study findings suggest that condylar morphology could change in both class II and III after bi-maxillary surgery. The findings of the numerical analysis also demonstrated that reduction of condylar volume occurred frequently in class II, although TMJ disc position classification did not change significantly, as previously reported.
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Maloclusión de Angle Clase III/cirugía , Maloclusión Clase II de Angle/cirugía , Osteotomía Sagital de Rama Mandibular , Articulación Temporomandibular/patología , Adolescente , Adulto , Femenino , Humanos , Masculino , Mandíbula , Persona de Mediana Edad , Periodo Posoperatorio , Periodo Preoperatorio , Estudios Retrospectivos , Adulto JovenRESUMEN
PURPOSE: The purpose of this study was to examine the skeletal stability of mandibular advancement after sagittal split ramus osteotomy (SSRO) with modified hybrid fixation using absorbable plates and screws. MATERIALS AND METHODS: A total of 54 Japanese patients were enrolled in this study. Of them, 23 who were diagnosed with mandibular prognathism underwent setback surgery with bi-cortical plate fixation using absorbable plates and screws (setback group). Another 23 who were diagnosed with mandibular retrognathism underwent advancement surgery with modified hybrid fixation using absorbable plates (advance group), and 8 who were diagnosed with mandibular retrognathism underwent advancement surgery with titanium plates (titanium group). Skeletal stability and horizontal condylar angle were analyzed by axial, frontal, and lateral cephalograms preoperatively and at 1 month, 3 months and 1 year post-operatively. The findings were compared statistically. RESULTS: The advance group showed no significant difference compared with the titanium group. There were significant differences between the setback and advance groups regarding SNB, ANB, gonial angle, ramus inclination, occlusal plane, convexity and Me-Ag right in T1 naturally (P < 0.05). However, in T2, there were no significant differences between the groups for the other measurements, although there were significant differences in ANB, interincisal angle, occlusal plane and Me-Ag right (P < 0.05). In T3, a significant difference was seen only in Me-Ag right (P = 0.0145). CONCLUSION: This study suggested that the use of an absorbable plate and screw was useful and reliable for mandibular advancement surgery as well as mandibular setback surgery, when the fixation method was devised successfully.
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Implantes Absorbibles , Placas Óseas , Tornillos Óseos , Avance Mandibular/instrumentación , Avance Mandibular/métodos , Prognatismo/cirugía , Adolescente , Adulto , Cefalometría , Durapatita , Femenino , Humanos , Imagenología Tridimensional , Masculino , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Persona de Mediana Edad , Osteotomía Sagital de Rama Mandibular , Poliésteres , Prognatismo/diagnóstico por imagen , Estudios Prospectivos , Tomografía Computarizada por Rayos X , Adulto JovenRESUMEN
PURPOSE: The purpose of this study was to examine lip closing force in Class II and III patients before and after orthognathic surgery. SUBJECT AND METHODS: The subjects were 45 patients (15 Class II women, 15 Class III men and 15 Class III women) diagnosed with jaw deformity who underwent sagittal split ramus osteotomy with Le Fort I osteotomy and 30 controls with normal skeleton and occlusion (15 men, 15 women). Maximum and minimum lip closing forces were measured using Lip De Cum® before and after surgery, and compared statistically. RESULTS: In the Class II women, maximum and minimum lip closing forces did not change after surgery. However, maximum and minimum lip pressure increased significantly in the Class III men (P = 0.0116, P = 0.0295) and maximum lip closing force increased significantly in the Class III women (P = 0.0082). After 6 months, maximum lip closing force was significantly lower in both Classes II and III women than in the control women (P = 0.0002, P = 0.0045). CONCLUSIONS: This study suggested that maximum postoperative lip pressure did not improve in the Class II women, although maximum lip closing force increased in the Class III men and women after sagittal split ramus osteotomy with Le Fort I osteotomy.
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Labio/fisiología , Maloclusión de Angle Clase III/cirugía , Maloclusión Clase II de Angle/cirugía , Osteotomía Sagital de Rama Mandibular , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Maloclusión Clase II de Angle/fisiopatología , Maloclusión de Angle Clase III/fisiopatología , Periodo Posoperatorio , Estudios ProspectivosRESUMEN
PURPOSE: The purpose of this study was to evaluate the relationship between computed tomography (CT) values of the condylar surface and temporomandibular joint (TMJ) disc position in the sagittal plane before and after sagittal split ramus osteotomy (SSRO) setback surgery, retrospectively. MATERIALS AND METHODS: The subjects were 75 patients (150 condyles) who underwent bilateral SSRO setback surgery. They were divided into two groups (42 symmetric patients and 33 asymmetric patients). Maximum CT values (pixel values) of five points of the condylar surface and condylar height, length, fossa height, fossa length, and ramus angle in the sagittal plane were measured preoperatively and 1 year postoperatively. Disc position was classified as anterior disc displacement, anterior type, fully covered type, and posterior type, both pre- and postoperatively, using magnetic resonance imaging (MRI). RESULTS: Postoperative value was significantly higher than preoperative one in CT value of 135° (P = 0.0199) and 180° (0.0363), in the non-deviation side in the asymmetry group. The anterior disc displacement group was significantly larger than those of some other areas pre- and postoperatively in the CT value of 0° point (P < 0.05). CONCLUSIONS: This study suggested that CT value of the posterior site of the condylar surface could change in the non-deviation side in the asymmetry group after 1 year SSRO, and the condyle with anterior displacement showed high CT value at the anterior site of the condyle before and after surgery.
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Implantación Dental Endoósea , Cóndilo Mandibular/diagnóstico por imagen , Osteotomía Sagital de Rama Mandibular/métodos , Complicaciones Posoperatorias/diagnóstico por imagen , Prognatismo/cirugía , Disco de la Articulación Temporomandibular/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adolescente , Adulto , Cefalometría , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Extracción Dental , Adulto JovenRESUMEN
There is no established chemotherapy regimen in metastatic primary urethral cancer (mPUC). The efficacy of a cisplatin (CDDP)-based regimen has been reported, however, when the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) occurs, the chemotherapy regimen should be changed to another platinum compound. In this report, we describe a 66-year-old woman who was diagnosed as mPUC with, CDDP-induced SIADH. After switching her to CBDCA and careful managing her sodium balance, three courses of the chemotherapy regimen were completed.
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PURPOSE: The purpose of this study was to evaluate the effect of bone regeneration enhancement by ultra-violet (UV) treatment of an unsintered hydroxyapatite (u-HA)/poly-l-lactic acid (PLLA) mesh in rabbitnasal bone. MATERIALS AND METHODS: Thirty adult male Japanese white rabbits (12-16 weeks, 2.5-3.0 kg) were used in this study. After incising along the nasal bone, 6 × 6 × depth 1 mm two bone defects were made on both sides. In the UV group (n = 30), the defects were covered with uHA/PLLA mesh, treated by UV (wavelength 172 nm, tube wall illumination 13 mW/cm2, period 8 min, intensity 6.26 J/cm2) and screwed. In the control group (n = 30), untreated uHA/PLLA was applied in a similar manner. The rabbits were sacrificed at 1, 2, 3, 4 and 6 weeks postoperatively, and formalin-fixed specimens were frozen. The specimens were stained with haematoxylin and eosin. For immunohistochemical analysis, the specimens were treated with anti-alkaline phosphatase (ALP). Finally, bone ratio and ALP expression were evaluated microscopically. RESULTS: The UV group had a significantly higher number of ALP stained cells than the control group after 1, 2, and 3 weeks (P < 0.05). The bone ratio was also significantly higher in the UV group than in the control group after 1, 2, 3, and 4 weeks (P < 0.05). CONCLUSION: This study suggests that bone regeneration can be enhanced by UV treatment using an uHA/PLLA mesh.
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Regeneración Ósea/efectos de la radiación , Durapatita/uso terapéutico , Poliésteres/uso terapéutico , Mallas Quirúrgicas , Rayos Ultravioleta , Animales , Masculino , Hueso Nasal/fisiología , ConejosRESUMEN
PURPOSE: The purpose of this study was to evaluate maxillary sinus and predict the factors affecting the postoperative sinus condition after Le Fort I osteotomy using various fixation materials. MATERIALS AND METHODS: The study subjects consisted of 71 patients (21 male and 50 female, 142 sides) who underwent Le Fort I osteotomy with sagittal split ramus osteotomy. The maxillary sinus bony area and the inside air area were measured in the coronal plane across the mesial aspect of the first molar perpendicular to the Frankfurt horizontal plane of a computed tomography (CT) image preoperatively and at 1 week and 1 year after surgery. The rate of intact sinus area (the inside air area/the maxillary sinus bony area) was calculated. Subjects were divided into groups according to gender, preoperative diagnosis (Angle class II and III with and without asymmetry), plate fixation material (PLLA and uHA/PLLA), and use or non-use of bone alternative material (α-tricalcium phosphate). Statistic comparisons between groups were performed in each division. Furthermore, age, operation time, amount of blood loss, and direction and amount of movement were examined as the continuous variables to statistically predict the rate of intact sinus area after 1 week and 1 year. RESULTS: The rate of intact sinus area after 1 week was significantly correlated with age, amount of anterio-posterior movement, and preoperative rate of the intact sinus area (p < 0.0001). Rate of intact sinus area after 1 year was significantly low in the group that used the bone alternative material compared to the group that did not (p < 0.0282). CONCLUSION: The study suggests that the bone alternative material might be a cause of inflammation in the sinus after 1 year. Moreover, attention needs to be paid to older age, backward movement of the maxillary segment, and preoperative sinusitis including hypertrophy of sinus membrane in Le Fort I osteotomy.
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Cementos para Huesos , Maloclusión de Angle Clase III/cirugía , Maloclusión Clase II de Angle/cirugía , Maxilar/cirugía , Seno Maxilar , Osteotomía Le Fort/métodos , Adolescente , Adulto , Femenino , Humanos , Masculino , Seno Maxilar/diagnóstico por imagen , Persona de Mediana Edad , Adulto JovenRESUMEN
PURPOSE: The purpose of this study was to examine skeletal stability and plate breakage after sagittal split ramus osteotomy (SSRO) with the mono-cortical plate fixation, bi-cortical plate fixation, and hybrid fixation techniques using absorbable plates and screws. MATERIALS AND METHODS: A total of 76 Japanese patients diagnosed with mandibular prognathism with and without maxillary deformity were divided into 3 groups randomly. A total of 28 patients underwent SSRO with mono-cortical plate fixation, 23 underwent SSRO with bi-cortical plate fixation, and 25 underwent SSRO with hybrid fixation. Skeletal stability and horizontal condylar angle were analyzed by axial, frontal, and lateral cephalograms from before the operation to 1 year postoperatively. Breakage of the plate and screws was observed by 3-dimensional computed tomography (3DCT) immediately after surgery and after 1 year. RESULTS: Although there was a significant difference between the mono-cortical plate fixation group and hybrid fixation group regarding right MeAg in T1 (P = 0.0488) and occlusal plane in T1 (P = 0.0346), there were no significant differences between the groups for the other measurements in each time interval. In 2 cases, namely, 6 sides in the mono-cortical plate fixation group, breakage of the absorbable plate was found by 3DCT. However, there was no breakage in the bi-cortical plate fixation group and hybrid fixation group. CONCLUSION: This study results suggested that there were no significant differences in the postoperative skeletal stability among the 3 groups, and bi-cortical fixation as well as hybrid fixation was a reliable and useful method to prevent plate breakage even if an absorbable material was used.
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Placas Óseas , Tornillos Óseos , Osteotomía Sagital de Rama Mandibular/métodos , Adolescente , Adulto , Femenino , Humanos , Masculino , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Persona de Mediana Edad , Osteotomía Sagital de Rama Mandibular/instrumentación , Prognatismo/cirugía , Falla de Prótesis , Radiografía , Tomografía Computarizada por Rayos X , Adulto JovenRESUMEN
The purpose of this study was to evaluate the effects of Le Fort I osteotomy on nasal septum deviation and differences in left and right airway sizes, and to determine whether the nasal septum was affected by differences in the direction of movement. Forty patients underwent conventional Le Fort I osteotomy, and computed tomography (CT) was performed preoperatively, and 1 week and 1 year postoperatively. The nasal septum angle and airway area were measured at the anterior, middle, and posterior positions on the CT images Patients were divided into 2 groups depending on each difference in movement (impaction ≥5 mm or other; anterior movement or other; and impaction asymmetry or other). There were no significant differences in the nasal septum angle and the airway of all patients. Among the patient groups, there were no significant differences in the nasal septum angle and airway. We concluded that conventional LI osteotomy did not influence the nasal septum deviation or the left and right airway asymmetry. Differences in the method of moving the maxilla have not been shown to affect changes in the nasal septum.
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Enfermedades Mandibulares/cirugía , Enfermedades Maxilares/cirugía , Tabique Nasal/diagnóstico por imagen , Tabique Nasal/cirugía , Osteotomía Le Fort , Tomografía Computarizada por Rayos X , Implantes Absorbibles , Adolescente , Adulto , Placas Óseas , Tornillos Óseos , Femenino , Humanos , Masculino , Enfermedades Mandibulares/diagnóstico por imagen , Enfermedades Maxilares/diagnóstico por imagen , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
PURPOSE: The purpose of this study was to compare bone regenerative capability following use of polytetrafluoroethylene (ePTFE) membrane against that when various densities of pore titanium meshes are used with and without low intensity pulsed ultrasound (LIPUS). MATERIALS AND METHODS: Adult male white rabbits were divided into 8 groups. In 4 groups, after incising along the nasal bone, four 3 × 8 mm bone defects were made in both sides and covered by an ePTFE membrane (group E: n = 15), a high density pore titanium mesh (group H: n = 15), a low density pore titanium mesh (group L: n = 15), and no mesh (control) (group C: n = 15). Furthermore, LIPUS was irradiated after surgery in 4 groups (groups EL, HL, LL and CL, in each n = 15). The rabbits were sacrificed at 1, 2 and 8 weeks postoperative, and formalin-fixed specimens were embedded in acrylic resin. The specimens were stained with hematoxylin and eosin. For immunohistochemical analysis, the specimens were treated with bone morphogenetic protein (BMP)-2 antibody. RESULTS: Group H had significantly higher values than groups L, E, and C regarding bone area ratio and labeling index of BMP-2 positive cells (P < 0.05). Furthermore, Group HL also had significantly higher values than the other groups regarding bone area ratio and labeling index of BMP-2 positive cells at 1, 2 and 8 weeks postoperative (P < 0.05). CONCLUSION: The results suggested that high density pore titanium mesh could induce new bone regeneration more than low density pore titanium mesh and ePTFE membrane. New bone formation may increase following LIPUS application.
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Regeneración Ósea/fisiología , Membranas Artificiales , Hueso Nasal/cirugía , Politetrafluoroetileno , Mallas Quirúrgicas , Titanio , Ondas Ultrasónicas , Animales , Inmunohistoquímica , Masculino , Porosidad , ConejosRESUMEN
PURPOSE: The purpose of this study was to evaluate changes in mandibular body height at the site of a fixation plate in the advance (lengthening) and setback (shortening) sides after sagittal split ramus osteotomy (SSRO). SUBJECTS AND METHODS: The subjects were 49 patients (98 sides) who underwent bilateral SSRO surgery. The subjects were divided into 4 groups as follows, setback (shortening) sides in mandibular prognathism (Prog S group; n = 42), advancement (lengthening) sides in mandibular retrognathism (Retro L group; n = 24), setback (shortening) sides in mandibular asymmetry (Asym S group; n = 16) and advancement (lengthening) sides in mandibular asymmetry (Asym L group; n = 16). Postoperative computed tomography (CT) was analyzed for all patients pre-operatively, and at 1 week and 1 year postoperative. Mandibular body height at the site of the fixation plate, mandibular upper height above the plate and mandibular lower height under the plate were measured by 3-dimensional (3D) CT. RESULTS: There were no significant differences in mandibular height between the lengthening and shortening sides in mandibular prognathism, retrognathism and asymmetry in the time-course change. Upper mandibular height at the mid-point of the fixation plate after 1 year was significantly smaller than that after 1 week in all sides (P < 0.05). CONCLUSION: This study suggested that slight bone resorption could occur at the upper site of a fixation plate after set back and advancement SSRO.
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Mandíbula/anatomía & histología , Osteotomía Sagital de Rama Mandibular , Prognatismo/cirugía , Adolescente , Adulto , Placas Óseas , Femenino , Humanos , Masculino , Mandíbula/cirugía , Persona de Mediana Edad , Adulto JovenRESUMEN
PURPOSE: The purpose of this study was to examine the influence between the magnitude of setback in sagittal split ramus osteotomy (SSRO) and occlusal contact area and bite force without relapse after surgery. PATIENTS AND METHODS: Sixty female patients with a diagnosis of mandibular prognathism were divided into 3 groups according to the magnitude of setback: group 1 (≤5 mm), group 2 (>5 mm but <10 mm), and group 3 (≥10 mm). All patients underwent skeletal analysis by lateral and frontal cephalogrammetry and measured the occlusal contact area and bite force by the pressure-sensitive system (Dental Prescale, Dental Occlusion Pressuregraph FDP-705; Fuji Photo Film Co., Tokyo, Japan) preoperatively and postoperatively at 1 month, 3 months, 6 months, and 1 year. RESULTS: There were no significant differences in occlusal contact area and bite force between the 3 groups. Only group 3 showed a significant difference in occlusal contact area and bite force between the preoperative and 1-year measurements. CONCLUSION: The results indicate that the magnitude of setback did not influence the bite force or occlusal contact area in SSRO.
Asunto(s)
Fuerza de la Mordida , Mandíbula/fisiología , Mandíbula/cirugía , Osteotomía Sagital de Rama Mandibular , Prognatismo/cirugía , Adolescente , Adulto , Cefalometría , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Osteotomía Sagital de Rama Mandibular/métodos , Prognatismo/fisiopatología , Estudios Retrospectivos , Adulto JovenRESUMEN
PURPOSE: The purpose of this study was to evaluate change in computed tomography (CT) value of condyle and temporomandibular joint (TMJ) disc position after sagittal split ramus osteotomy (SSRO) setback surgery, retrospectively. SUBJECTS AND METHODS: The subjects were 76 patients (152 condyles) who underwent bilateral SSRO setback surgery. They were divided into 2 groups (43 symmetric patients and 33 asymmetric patients). CT values (pixel values) of 5 sites of the condyle and condylar width, length, horizontal angle were measured pre-operatively and 1 year post-operatively. Disc position was classified as anterior disc displacement, anterior type, fully covered type and posterior type, preoperatively and postoperatively using magnetic resonance imaging (MRI). RESULTS: In maximum CT value at the center of the condyle, post-operative value was significantly lower than pre-operative value bilaterally (Deviation side: P = 0.0003, Non-deviation side: P = 0.0003) in asymmetry group. In minimum CT value at the center of the condyle, the post-operative value was significantly lower than the pre-operative value bilaterally (Deviation side: P = 0.0309, Non-deviation side: P = 0.0004) in the symmetry group. With regard to maximum CT value at the lateral site of the condyle in the deviation side, the value for the anterior disc displacement group was significantly larger than that of the posterior type pre-operatively (P = 0.0123). CT value of the anterior disc displacement group was significantly larger than those of some other areas pre- and post-operatively (P < 0.05). CONCLUSION: This study suggested that CT value of condylar bone changes after 1 year in SSRO and anterior disc displacement may partially affect the CT value of the condyle in the TMJ in mandibular prognathism patients.