ABSTRACT
OBJECTIVE: The aim of the present study was to identify the risk factors for aggressive condylar resorption (ACR) after orthognathic surgery. METHODS: A total of 25 female patients with osteoarthritis (OA) scheduled for orthognathic surgery were divided into two groups: those who exhibited ACR (ACR (+), n = 8) and those who did not exhibit ACR (ACR (-), n = 17) after surgery. Clinical indices were used to determine the extent of mandibular advancement, the presence of temporomandibular disorder (TMD), and relevant medical treatment histories (including the use of oral contraceptive (OC) medication. TMJ dysfunction was clinically evaluated in terms of pain, the presence of sounds (clicks or crepitus), and disc displacement, joint effusion (JE), and synovial hyperplasia (SH); these were further investigated with the aid of magnetic resonance imaging (MRI). The cephalographic findings were compared with the normal profiles of Japanese subjects. RESULTS: The mean (with SD) extent of mandibular advancement was 11.4 mm (2.4) in ACR (+) and 4.1 mm (1.8) in ACR (-). The TMD medical history of ACR (+) was much more extensive than that of ACR (-); all patients in ACR (+) had a history of OC use. More patients in ACR (+) than in ACR (-) had TMJ dysfunction and disc displacement, JE, and SH on MRI. Preoperative cephalograms showed that ACR (+) patients exhibited counterclockwise rotation of the mandible and retrognathism that was attributable to a small sella-nasion-B (SNB) angle, a wide mandibular plane angle, and a negative inclination of the ramus. CONCLUSIONS: The present findings suggest that the development of ACR after orthognathic surgery to treat mandibular retrognathism may be associated with coexisting TMJ pathologic abnormality.
Subject(s)
Mandibular Condyle/pathology , Orthognathic Surgery , Adolescent , Adult , Cephalometry , Female , Humans , Magnetic Resonance Imaging , Male , Malocclusion/complications , Mandible/diagnostic imaging , Mandible/physiology , Mandibular Advancement/adverse effects , Mandibular Condyle/anatomy & histology , Mandibular Condyle/diagnostic imaging , Osteoarthritis/complications , Radiography, Panoramic , Retrognathia/diagnostic imaging , Retrognathia/surgery , Retrognathia/therapy , Retrospective Studies , Risk Factors , Temporomandibular Joint Disorders/diagnostic imaging , Temporomandibular Joint Disorders/physiopathology , Young AdultABSTRACT
The CryoSeal® FS System has been recently introduced as an automated device for the production of complete fibrin glue from autologous plasma, rather than from pool allogenic or cattle blood, to prevent viral infection and allergic reaction. We evaluated the effectiveness of complete autologous fibrin glue and polyglycolic acid (PGA) sheet wound coverings in mucosa defect oral surgery. Postoperative pain, scar contracture, ingestion, tongue dyskinesia, and postoperative bleeding were evaluated in 12 patients who underwent oral (including the tongue) mucosa excision, and received a PGA sheet and an autologous fibrin glue covering. They were compared with 12 patients who received a PGA sheet and commercial allogenic fibrin glue. All cases in the complete autologous fibrin glue group demonstrated good wound healing without complications such as local infection or incomplete cure. All evaluated clinical measures in this group were similar or superior to the commercial allogenic fibrin glue group. Coagulation and adhesion quality achieved with this method was comparable to that with a PGA sheet and commercial fibrin glue. Covering oral surgery wounds with complete autologous fibrin glue produced by an automated device was convenient, safe, and reduced the risk of viral infection and allergic reaction associated with conventional techniques.