Clinical and Histopathologic Study of Apocrine-Type Mixed Tumor of the Skin.

ABSTRACT: Mixed tumor of the skin (MTS) is a tumor characterized by folliculosebaceous-apocrine differentiation. Because of the wide range of histological variations, understanding the unique features of MTS can help improve diagnosis. This study describes the histopathological characteristics of MTS, mainly apocrine-type MTS (AMT), using 166 cases of AMT. We found that nodular aggregates of myoepithelial cells, mucinous changes in the stroma, and follicular differentiation were standard characteristic features of MTS. Among the cases studied, 67% showed prominent follicular germinative cells and 40% showed prominent lipomatous metaplasia in the stroma. These cases often pose difficulties for the diagnosis of AMT because of insufficient evidence of sweat glands or myoepithelial cell differentiation. This is the first study to examine how the histological features of AMT change as the tumor extends deeper into the dermis. We found that the proportion of AMT with folliculosebaceous differentiation and large lumina increased as it got deeper into the dermis. Histopathological diagnosis of MTS is vital because the clinical symptoms lack specificity. This study enhances our understanding of the histopathological characteristics of MTS.

Folliculosebaceous Cystic Hamartoma Arising in Miescher-Type Melanocytic Nevi.

ABSTRACT: Folliculosebaceous cystic hamartoma (FSCH) is a rare cutaneous hamartoma consisting of dilated folliculosebaceous units associated with mesenchymal elements. Ansai et al reported that distinctive features of Miescher-type melanocytic nevi (MMCNs) accompanied 4.6% of FSCH; however, there have been no data about how often FSCH features accompany MMCNs. In this study, we used 7829 cases that had been histopathologically diagnosed as MMCNs of the face, neck, and scalp at the Department of Dermatopathology, Nippon Medical School Musashi Kosugi Hospital and observed whether features of FSCH accompanied them. Of the resected MMCNs, 274 of 7829 (3%) were accompanied by features of FSCH. The nose was the most common resection site, followed by the eyebrow area, ear, and cheek. The coexistence rate for the nevi on the nose and features of FSCH was as high as 10%-20%, and its rate increased with age. We found that FSCH appears mostly in seborrheic areas, such as the nose and cheek, which are rich in normal sebaceous glands. This suggests that nevi, especially on and around the nose, may induce FSCH or similar lesions.

Prevalence and clinical characteristics of patients with biologically false-positive reactions with serological syphilis testing in contemporary practice: 10-year experience at a tertiary academic hospital.

OBJECTIVES: Biologically false positive (BFP) reactions are well described in early literature. However, only a few recent reports described the incidence and clinical characteristics of patients with BFP reactions. We reviewed the serological test results of patients tested for syphilis in our hospital in the past decade and described the clinical characteristics of patients with BFP reactions. METHODS: This is a retrospective study of patients tested for syphilis in a tertiary academic hospital. All serological results were retrieved from the clinical laboratory database. We calculated the incidence of BFP reactions. Clinical characteristics and laboratory data of patients with BFP reactions were reviewed manually. RESULTS: Among 94 462 subjects, 588 patients had BFP reactions (0.62%). Most BFP reactions were observed in patients aged over 60 years, with a history of malignancy and autoimmune diseases. Eighty-five per cent of patients had low rapid plasma reagin (RPR) titre (≤1:4), but two patients had extremely high RPR titre (≥1:256). BFP reactions were more likely to persist beyond 6 months among patients with RPR titre of ≥1:8. There was no statistically significant correlation between RPR titre and total protein albumin gap, surrogate of immunoglobulin levels among patients with BFP reactions. CONCLUSION: There was a low incidence of BFP reactions in the last decade. A minority of BFP reactions had high non-treponemal antibody titre and persisted longer than 6 months. In the era of re-emergence of syphilis, this information could help clinicians interpret the results of well-established diagnostic tests for syphilis.

Serving Temperatures of Best-Selling Coffees in Two Segments of the Brazilian Food Service Industry Are "Very Hot".

The International Agency for Research on Cancer has classified the consumption of "very hot" beverages (temperature >65 °C) as "probably carcinogenic to humans", but there is no information regarding the serving temperature of Brazil's most consumed hot beverage-coffee. The serving temperatures of best-selling coffee beverages in 50 low-cost food service establishments (LCFS) and 50 coffee shops (CS) were studied. The bestsellers in the LCFS were dominated by 50 mL shots of sweetened black coffee served in disposable polystyrene (PS) cups from thermos flasks. In the CS, 50 mL shots of freshly brewed espresso served in porcelain cups were the dominant beverage. The serving temperatures of all beverages were on average 90% and 68% above 65 °C in the LCFS and CS, respectively (P95 and median value of measurements: 77 and 70 °C, LCFS; 75 and 69 °C, CS). Furthermore, the cooling periods of hot water systems (50 mL at 75 °C and 69 °C in porcelain cups; 50 mL at 77 °C and 70 °C in PS cups) to 65 °C were investigated. When median temperatures of the best-selling coffees are considered, consumers should allow a minimum cooling time before drinking of about 2 min at both LCFS and CS.

Assessment of vascular autonomic function using peripheral arterial tonometry.

Peripheral autonomic function is impaired in diabetic polyneuropathy. However, it is difficult to evaluate it due to the lack of non-invasive quantitative assessment. We aimed to establish a novel index to evaluate vascular autonomic function using reactive hyperemia peripheral arterial tonometry (RH-PAT), a widely performed endothelial function test. Sixty-five subjects were enrolled, including healthy subjects, cases with sympathetic nerve blockers, and diabetic patients. RH-PAT was performed with 5-min blood flow occlusion in unilateral arm. We calculated the reduction ratio of the post-occlusion pulse amplitude to the baseline in the non-occluded arm (RPN), with 1-min sliding window. In healthy subjects, RPN gradually increased with time-dependent manner. However, this phenomenon was eliminated in cases with sympathetic nerve blockers. Plasma concentration of norepinephrine was measured before and after the blood flow occlusion, which showed a significant increase. We then compared RPNs with the change in heart rate variability (HRV) parameters. RPN calculated at 5 min after the reperfusion had the highest correlation with the change in sympathetic HRV parameter, and thus, we named sympathetic hypoemia index (SHI). Finally, we studied the relationship between SHI and diabetes. SHI was significantly lower in diabetic patients than matched controls. SHI, a novel index derived from RH-PAT, represented the peripheral sympathetic activity. SHI may be useful for assessing the vascular autonomic activity in diabetic patients.

Evaluation of bone formation after sagittal split ramus osteotomy using different fixation materials.

PURPOSE: The purpose of this study was to evaluate bony change between the proximal and distal segments after sagittal split ramus osteotomy (SSRO) using different fixation materials. SUBJECTS AND METHODS: The subjects consisted of 74 patients (21 male and 53 female; 148 sides) who underwent SSRO with and without Le Fort I osteotomy. They were divided into five groups: (1) an MT group, mono-cortical titanium plate fixation (26 sides); (2) an MA group, mono-cortical absorbable plate fixation (48 sides); (3) a BA group, bi-cortical absorbable plate fixation (22 sides); (4) an MAα group, mono-cortical plate absorbable fixation with α-tricalcium phosphate (36 sides); and (5) a BAα group, bi-cortical plate absorbable fixation with α-tricalcium phosphate (16 sides). Ramus square (RmS), ramus width (RmM-RmL) and ramus length (RmA-RmP) at the horizontal plane under the mandibular foramen were assessed pre-operatively, immediately after surgery, and at 1 year after surgery by computed tomography (CT). RESULTS: There were significant differences among the groups regarding change over time in RmS (p = 0.0126) and RmM-RmL (p = 0.0001). However, there was no significant difference among the groups regarding change over time in RmA-RmP. CONCLUSION: These results suggest that the use of different fixation materials leads to significant differences in the bone healing process after SSRO.

Comparison of lower lip hypoesthesia between hybrid fixation and conventional fixation following sagittal split ramus osteotomy.

PURPOSE: The purpose of this study was to compare the recovery period of lower lip hypoesthesia between hybrid fixation and conventional fixation using absorbable plates and screw systems following sagittal split ramus osteotomy (SSRO). SUBJECTS AND METHODS: The subjects were 66 patients (132 sides) who underwent bilateral SSRO setback surgery. They were divided into a hybrid fixation group (66 sides, 1 u-HA/PLLA plate and 4 mono-cortical screws and a bi-cortical screw in each side) and a conventional fixation group (66 sides, 1 u-HA/PLLA plate and 4 mono-cortical screws in each side). Trigeminal nerve hypoesthesia at the region of the lower lip was assessed bilaterally by the trigeminal somatosensory-evoked potential (TSEP) method. RESULTS: The mean measurable periods were 8.1 ± 10.4 weeks in the hybrid fixation group, 5.1 ± 11.5 weeks in the conventional group with no significant difference. However, the maximum in the hybrid fixation group was 27 sides at 4 weeks postoperative and in the conventional fixation group was 37 sides at 1 week postoperative, and there was significant difference in the distribution of the measurable period (P < 0.0001). CONCLUSION: This study suggested that additional bi-cortical screws could affect the recovery of lower lip hypoesthesia after SSRO with bent absorbable plate fixation.

Evaluation of factors affecting recovery period in lower lip hypoesthesia after sagittal split ramus osteotomy in mandibular prognathism patients.

PURPOSE: The purpose of this study was to evaluate the factors affecting the recovery period of lower lip hypoesthesia after sagittal split ramus osteotomy (SSRO) in mandibular prognathism patients using multivariate analysis, retrospectively. SUBJECTS AND METHODS: The subjects were 222 patients (444 sides) who underwent bilateral SSRO setback surgery with and without Le Fort I osteotomy. Trigeminal nerve hypoesthesia at the region of the lower lip was assessed bilaterally by the trigeminal somatosensory-evoked potential (TSEP) method pre- and post-operatively. Recovery period was determined as the time when TSEP was first measurable post-operatively. Age, sex, presence or absence of third molars, setback amount and osteotomy type and fixation method were selected as covariates in the multivariate analysis. The factor affecting the recovery period in lower lip hypoesthesia was examined with Cox's proportional hazard regression. RESULTS: Sex and osteotomy fixation method affected the recovery period in lower lip hypoesthesia significantly (P = 0.0132 and P = 0.0394). However, the other factors did not affect the recovery period. CONCLUSION: This study suggested that sex and osteotomy type and fixation method may affect the recovery period in lower lip hypoesthesia after SSRO setback surgery.

Bone regeneration by periosteal elevation using conventional orthodontic wire and uHA/PLLA mesh.

This study evaluated bone regeneration by periosteal elevation using conventional orthodontic wire and an unsintered hydroxyapatite (u-HA)/poly-L-lactic acid (PLLA) mesh in rabbit frontal bone. Thirty two rabbits (12-16 weeks: 2.5-3.0 kg) were used in this study. In the experimental group, 1 week after the mesh was inserted under the periosteal membrane, it was elevated by traction using the mesh connected with wire and two anchor screws. In the control group, the mesh was kept inserted under the periosteal membrane. Four animals were killed in each period in both groups, at 2, 3, 5 and 9 weeks postoperatively. Operated parts in the frontal bone were removed and prepared for radiological and histological assessment. The distance between the mesh and pristine bone (elevation length), the bone area and the expression of BMP-2 were evaluated. The value in the experimental group was significantly higher when compared to the control group (length P < 0.0001, bone area P < 0.0010, BMP-2 P = 0.0015). The BMP-2 labelling index after 3 weeks tended to be the largest in both groups. This study suggests that bone regeneration can be induced by periosteal elevation using a conventional orthodontic wire and an uHA/PLLA mesh.

Evaluation of recovery in lip closing pressure and occlusal force and contact area after orthognathic surgery.

PURPOSE: The purpose of this study was to evaluate the relationship between lip closing force, occlusal contact area and occlusal force after orthognathic surgery in skeletal Class III patients. SUBJECTS AND METHODS: The subjects consisted of 54 patients (28 female and 26 male) diagnosed with mandibular prognathism who underwent sagittal split ramus osteotomy with and without Le Fort I osteotomy. Maximum and minimum lip closing forces, occlusal contact area and occlusal force were measured pre-operatively, 6 months and 1 year post-operative. RESULTS: Maximum and minimum lip closing forces, occlusal contact area and occlusal force increased with time after surgery, however a significant increase was not found in the occlusal contact area in women. In increased ratio (6 months/pre-operative and 1 year/pre-operative), the maximum lip closing force was significantly correlated with the occlusal contact area (P < 0.0001). CONCLUSIONS: This study suggested that orthognathic surgery could improve the occlusal force, contact area and lip closing force, and an increase ratio in maximum lip closing force was associated with an increased ratio in occlusal contact area.

The time-course change in the lip closing force in Class III malocclusion after orthognathic surgery.

OBJECTIVES: The purpose of this study was to examine the changes with time in lip pressure after orthognathic surgery for skeletal Class III patients. STUDY DESIGN: The subjects consisted of 63 patients (32 female and 31 male) diagnosed with mandibular prognathism who underwent sagittal split ramus osteotomy with and without Le Fort I osteotomy. Maximum and minimum lip closing forces were measured with Lip De Cum(®). The changes with time were compared statistically. RESULTS: The maximum and minimum lip closing force increased time-dependently in men and women after surgery and there were significant differences between men and women with changes with time in the maximum lip closing force (p = 0.0086) and the minimum lip closing force (p = 0.0302). After 1 year, the Class III group maximum lip closing force was significantly smaller than the control group in both men (p < 0.0001) and women (p < 0.0001). CONCLUSIONS: This study suggests that there was significant difference in over time in the lip closing force between men and women in Class III patients. Although the maximum lip closing force increased with time, it did not reach the level of the control group after 1 year.

Evaluation of soft tissue morphologic changes after using the alar base cinch suture in Le Fort I osteotomy in mandibular prognathism with and without asymmetry.

PURPOSE: The purpose of this study was to investigate the effects of alar base cinch suture in Le Fort I osteotomy in mandibular prognathism with and without asymmetry. MATERIAL AND METHODS: Forty patients who underwent Le Fort I osteotomy were divided into an asymmetry group and a symmetry group (n = 20 each). Computed tomography (CT) was taken in all patients before and 1 year after surgery. The CT-3D volume rendering data with Aquarius Net (TeraRecon, Foster City, CA, USA) was reconstructed and the soft tissue was measured as follows, the distance between the bilateral alar base (Alar base width), the distance between the bilateral alar (Alar width), the angles between the FH plane and the line between the bilateral alar base (Alar base angle), the angle between the FH plane and the line between the bilateral alar (Alar angle), the angle between the FH plane and the line between the bilateral corners of the mouth (Lip angle), and the angle between the perpendicular line to the FH plane and the Philtrum (Philtrum angle). RESULTS: Significant differences were observed in the Alar width (P = 0.0448), the Alar angle (P = 0.0044), the Lip angle (P < 0.0001), and the Philtrum angle (P = 0.0057) between before and after surgery in the asymmetry group. CONCLUSIONS: This study suggested that the alar base cinch suture could prevent increases in the alar base width in both groups and help to improve the angle of soft tissue in the asymmetry group, although alar width significantly increases after surgery.

Evaluation of overlapped cortical bone area after modified plate fixation with bent plate in sagittal split ramus osteotomy.

PURPOSE: The purpose of this study was to evaluate bony change in an overlapped cortical bone area at the anterior site of the proximal segment after modified plate fixation with a bent plate in sagittal split ramus osteotomy (SSRO). SUBJECTS AND METHODS: The subjects were 66 patients (132 sides) who underwent bilateral SSRO setback surgery. After the surgery in SSRO, an overlapped area of cortical bone at the anterior site of the proximal segment was not removed to keep the contact area between the proximal and distal segments intact, and was fixed with a bent plate and 4 screws in each side of the mandible. At the posterior site, a 3-7 mm gap was maintained between the proximal and distal segments to prevent inward-rotation of the condylar long axis. Ramus width, lateral cortex width and lateral cortex step angle were assessed in a coronal image immediately after the surgery, and 1-year postoperative by computed tomography (CT). RESULTS: Ramus width after 1-year was significantly larger than that before surgery and smaller than that immediately after surgery in both sides (P < 0.0001). Lateral cortex width after 1-year was significantly larger than the preoperative value and smaller than that immediately after surgery in both sides (P < 0.0001). Lateral cortex angle after 1-year was significantly larger than the preoperative value in both sides (P < 0.0001). CONCLUSION: The above findings suggested that the overlapped cortical bone decreased thickness and the cortical bone step disappeared following favourable bone remodelling after 1-year, even though the cortical bone was not removed at the anterior site of the proximal segment.

Skeletal stability after mandibular setback surgery: comparison between the hybrid technique for fixation and the conventional plate fixation using an absorbable plate and screws.

PURPOSE: The purpose of this study was to compare the temporal changes in condylar long axis and skeletal stability after sagittal split ramus osteotomy (SSRO) with the hybrid fixation technique and the conventional plate fixation. PATIENTS AND METHODS: Of 44 Japanese patients diagnosed with mandibular prognathism, 22 underwent SSRO with the conventional plate fixation (1 u-HA/PLLA plate and 4 monocortical screws in each side) and 22 underwent SSRO with a hybrid fixation technique (1 u-HA/PLLA plate and 4 monocortical screws and bicortical screw in each side). The temporal changes in condylar long axis and skeletal stability were assessed by axial, frontal, and lateral cephalograms. After surgery, breakage of the plate and screws was checked by 3-dimensional computed tomography (3DCT). RESULTS: Although there was a significant difference between the groups regarding Me-Ag in T1 (P = 0.0138), there were no significant differences between the groups for the other measurements in lateral, frontal and axial cephalometric analysis in each time interval. In two cases, 4 sides in the conventional plate fixation group, failure of the absorbable plate was found by 3DCT. However, there was no breakage in the hybrid fixation group. CONCLUSION: This study suggested that there were no significant differences in the postoperative temporal changes between the two groups in mandibular setback surgery.

Bone regeneration by statin and low-intensity pulsed ultrasound (LIPUS) in rabbit nasal bone.

OBJECTIVES: To compare bone regeneration between local implantation of statin and low-intensity pulsed ultrasound (LIPUS), and the combination of statin with LIPUS in rabbit nasal bone using histological and immunohistochemical methods. STUDY DESIGN: Thirty-two adult male Japanese white rabbits (age: 12-16 weeks, weight: 2.5-3.0 kg) were used in this study. Two bone circular defects (5 mm in diameter) per rabbit were created in the nasal bone while preserving the nasal membrane. The two defects in each rabbit were filled with 2.5 mg/ml simvastatin in 0.2 ml water with an atelocollagen sponge (ACS) and ACS alone respectively. Sixteen rabbits (32 sides) received the LIPUS application; the remaining 16 rabbits (32 sides) did not. Therefore, the subjects composed of 4 groups, namely, (1) LIPUS + ACS + simvastatin (the LAS group), (2) LIPUS + ACS (the LA group), (3) ACS + simvastatin (the AS group) and (4) ACS alone (the A group). Four animals were killed in each period, at 1, 2, 4 and 8 weeks postoperative. The parts that had been operated on were removed and prepared for histological assessment. The expression of BMP-2 and the bone area ratio were evaluated using histological and immunohistochemical methods. RESULTS: Bone square in the LAS group was significantly larger than that in the AS group after 1 (P < 0.0001) and 2 week (P = 0.0113). The bone square in the LA group was significantly larger than that in the A group after 1 (P < 0.0001) and 2 weeks (P = 0.0090). However, there was no significant difference between the LAS and LA groups. In the number of cells that stained positive for BMP-2, the LAS group was significantly larger than that in the AS group after 1 (P < 0.0001) and 2 weeks (P = 0.0113). CONCLUSION: This study suggests that bone regeneration can be promoted by LIPUS alone and statin alone, respectively. However the combination use of LIPUS with statin does not differ from LIPUS alone or statin alone.

Study of the Warner-Bratzler shear force, sensory analysis and sarcomere length as indicators of the tenderness of sun-dried beef.

Sun-dried beef is a frequently consumed and valued product in Brazil, however, there have been no scientific studies on its texture. To assess the tenderness of sun-dried beef, an instrumental analysis (Warner-Bratzler Shear Force; WBSF), a sensory analysis (Quantitative Descriptive Analysis; QDA) and the sarcomere length (SL) were used as indicators. Significant differences were observed among the sun-dried beef samples. Sample 3 (composed of sun-dried meat purchased at three fairs from Region 3 in the city of João Pessoa-PB) was considered the most tender by the assessors, with a score of 6.7, and its WBSF analysis revealed a maximum value of 2.70 kgf. Additionally, this sample exhibited the highest SL value (1.89 µm). Samples 1 and 2 (composed of sun-dried meat purchased at three fairs from Regions 1 and 2, respectively, in the city of João Pessoa) exhibited very similar tenderness values (WBSF and QDA) but differed in their SL values, which suggested that sample 2 was the least tender. In conclusion, these results demonstrate that the studied parameters are complementary and can be used as tenderness indicators for sun-dried beef. However, although the difference was beyond the detection limit of the assessors and the texturometer, the SL analysis appears to have been the most effective.

Volatiles and water- and fat-soluble precursors of Saanen goat and cross Suffolk lamb flavour.

This paper evaluates the concentrations of water- and fat-soluble precursors of meat flavour, with the aim of characterising the effect of species on the volatile profile of grilled goat and lamb meat. Compared to goat, lamb meat had higher levels of saturated fatty acids--SFA, monounsaturated fatty acids--MUFA and polyunsaturated fatty acids--PUFA and similar levels of sugars and free amino acids, except for lysine and glycine, which were higher in goat. Major differences were detected in lipid-derived volatiles; only pyrazine, thiazole, and some Strecker aldehydes were at different concentrations in these species. Volatile compounds derived from the oxidation of linoleic acid were at higher levels in meat from lamb due to the higher concentration of the latter, while compounds formed from α-linolenic acid were at higher levels in goat. It can be concluded that lamb meat has a stronger flavour profile compared to goat meat because it has the highest concentrations of lipid-derived volatile compounds, primarily straight saturated alkanals, pyrazines and thiazole.

An odontoma found in the wake of maxillary sinusitis onset.

Sinusitis of dental origin is a relatively frequent entity, and odontomas are considered to be the most common odontogenic tumors of the oral cavity. Eruption and infection of odontomas are extremely rare. Here, we report an interesting case where odontoma was found in the wake of the maxillary sinusitis onset.

Assessment of bone healing and hypoesthesia in the upper lip after Le Fort I osteotomy with self-setting α-tricalcium phosphate and absorbable plates.

PURPOSE: The purpose of this study was to evaluate hypoesthesia of the upper lip and bone formation using self-setting α-tricalcium phosphate (Biopex(®)) between the segments following Le Fort I osteotomy with bent absorbable plate fixation. SUBJECTS AND METHODS: The subjects were 47 patients (94 sides) who underwent Le Fort I osteotomy with and without mandibular osteotomy. They were divided into a Biopex(®) group (48 sides) and a control group (46 sides). The Biopex(®) was inserted into the anterior part of the gap between the segments in the Biopex(®) group. Trigeminal nerve hypoesthesia at the region of the upper lip was assessed bilaterally by the trigeminal somatosensory-evoked potential (TSEP) method. The area of the Biopex(®) at the anterior part in the maxilla was assessed immediately after surgery and 1 year postoperatively by computed tomography (CT). RESULTS: The mean measurable period and standard deviation were 13.2 ± 18.5 weeks in the control group, 14.5 ± 17.9 weeks in the Biopex(®) group, and there was no significant difference in TSEP. The area of the Biopex(®) after 1 year was significantly smaller than that immediately after surgery (right side: P = 0.0024, left side: P = 0.0001) and bone defects between the segments could not be found in the Biopex(®) group. In the control group, although the areas of bone defect after 1 year were significantly smaller than that immediately after surgery on the right side (P = 0.0133) and left side (P = 0.0469) in the frontal view, complete healing of the bone defects could be seen in 12 of 46 sides after 1 year. CONCLUSION: This study suggested that inserting Biopex(®) in the gap between the maxillary segments was useful for new bone formation and it did not prevent the recovery of upper lip hypoesthesia after Le Fort I osteotomy with absorbable plate fixation.

A hypothesis on the desired postoperative position of the condyle in orthognathic surgery: a review.

It is very important to clarify the relationship between a dentofacial structure and a temporomandibular joint (TMJ) structure in orthognathic surgery. Recently, it was reported that the skeletal and occlusal patterns were associated with the TMJ morphology, including the disk position. In orthognathic surgery, some surgeons state that alterations in the condylar position from surgery can lead to malocclusion associated with the risk of early relapse, and also favor the development of temporomandibular disorders. For these reasons, several positioning devices have been proposed and applied, but now there is no scientific evidence to support the use of condylar positioning devices. There are some reasons why scientific evidence cannot be obtained; however, it also includes the question of whether the preoperative position of the condyle is the desired postoperative position. The purpose of this study was to verify the desired condylar position in orthognathic surgery, based on literature on the postoperative condylar position in orthognathic surgery. From the studies reviewed, it was suggested that the preoperative position of the condyle was not the desired postoperative position in orthognathic surgery.