جستجوی مقالات مرتبط با کلیدواژه "جراحی ارتوگناتیک" در نشریات گروه "پزشکی"

Porpose:

 The present study was conducted with the aim of investigating the effect of listening to the Quran on postoperative pain in orthognathic surgery candidates.

This clinical trial study was conducted on patients with ASA I classification who underwent orthognathic surgery. After general anesthesia, the anesthesiologist selected one of the Quran audio files (Q group) or white noise (W group) for the patient with the help of a random number table. After the patient entered recovery, vital signs were measured and the pain level of the patient was measured by visual analog pain index.

In this study, 40 patients were randomly divided into two groups: Quran (Q) and white noise (W). The average pain in group W was higher, and the two groups had statistically significant differences.

Listening to the sound of the Quran during unconsciousness can reduce pain reported in patients treated with orthognathic surgery after surgery.

  The primary aim of orthognathic surgery is to improve the aesthetic parameters of the face and dentition and to transform it into an acceptable clinical standard, which is often associated with the secondary aim of improving occlusal function. The most common treatment option for maxillofacial abnormalities in Class III malocclusion patients is bimaxillary surgery, treatment planning of which requires complete knowledge of soft tissue adaptation with the underlying hard tissue movements,so a complete treatment plan should be included both functional and esthetic results according to orthogenatic surgical prognosthic factors.

This review study was conducted by searching the keywords "orthognathic surgery", "maxilla", "soft tissue" and "nose" in Medline library and Google scholar databases among the studies published between the years 2012 and 2021. Finally, 14 studies were selected and reviewed.

Review of the previous studies have shown that changes in the soft tissue of maxilla and nose occurred after almost all maxillary osteotomies. Widening of alar width (AW) and alteration of nasolabial angle (NLA) have been reported frequently. Common preventative methods such as Alar Cinch suture have had little effect on preventing these changes. Conversely, the occurrence of these alterations may improve the beauty of the face, which depends on the race and ethnicity of patients and the perception of the aesthetic standards among them.

Functional and aesthetic evaluation of the nasal soft tissue should be considered as a part of the diagnosis and treatment planning for orthognathic surgeries and also the strategies considering the management of these changes should be shared with patients. The effect of Alar cinch suture on the control of alar base changes is challenging and requires further study.

The present study aimed to evaluate the incidence of obstructive sleep apnea (OSA) after monomax mandibular setback surgery using a combination of Berlin, STOP-BANG, and Epworth SleepScale questionnaires. This double-blind quasi-experimental before-after study was carried out on a total of healthy patients with class III deformity and eligible for orthognathic mandibular setback surgery. Age, gender, body mass index, neck circumference, and amount of mandibular setback were recorded in the study checklist. The incidence of OSA was assessed for allthe patients 1 week before the operation and 1 and 6 months following the surgery using the aforementioned questionnaires under the supervision of a pulmonary specialist. Descriptive and analytical statistics were analyzed by SPSS software (version 17). A p-value of less than 0.05 was considered statistically significant. A total of 30 patients, including 15 males and 15 females, with a mean age of 25.77±4.76 years participated in this study. The mean scores of OSA questionnaires increased a month after mandibular setback surgeryusing bilateral sagittal split osteotomy, compared to those reported before the operation; however, 6 months following the surgery, the results numerically reduced closer to the patient’s normal condition. The amount of mandibular setback was directly correlated with the incidence of OSA in patients 1 and 6 months after the surgery based on all the three questionnaires; nevertheless, it was significantly and directly correlated with STOP-BANG questionnaire (p < /em><0.05). The obtained results of the present study indicated that there was no evidence of severe OSA 6 months following mandibular setback surgery. Additionally, obese patients and those submitted to a large amount of mandibular setback presented a higher chance of developing OSA. The findings of the present study showed that the results of the numerical changes of the sleep questionnaires and incidence of OSA 1 and 6 months after the surgery and before the operation were significantly lower in patients with mandibular setback up to 5 mm, compared to those with equal or greater than 5 mm.

Cleft lip and palate (CLP) is the most common congenital deformity of the orofacial. Team care is essential to meet the medical, surgical, dental, orthodontic, and psychological needs of individuals with cleft lip and palate. The currently accepted standards of care can only be met if the specialists work together in the diagnosis and treatment planning. Interdisciplinary team care provides the best overall outcomes for the individual and is also the most efficacious and cost-effective way of meeting the goals of treatment. In this review article, published 21 articles were reviewed between years (2000-2018), the electronic databases PubMed,Scopus and Google Scholar were searched. The following search terms were used: nasoalveolar molding, cleft lip and palate, team care, and multidisciplinary management, lip repair, orthognathic surgery.The goal of treatment is to restore esthetics and functional impairments associated with clefts. The nature and the extent of medical and dental problems among CLP patients dictate the need toward multidisciplinary approach where different medical and  dental specialists are involved in the treatment. The purpose of this article is to review  management of cleft lip and palate deformity from birth until adulthood. In this regard, feeding plates, nasoalveolar molding (NAM), lip and palate repair, palatal expansion, alveolar bone grafting, rhinoplasty, orthodontic treatment, and orthognathic surgery will be discussed.

The present study aimed to evaluate the rate ofminiplate and miniscrew removal and its etiology after orthognathic surgery during 2016-2018. Materials &

For the purposes of this cross-sectional study, all the patients who referred to the surgical department of Dental School of Mashhad University of Medical Sciences, for orthognathic surgery were included. All cases were assessed to determine whether the miniplate and miniscrew were removed after the surgery or not. Subsequently, the age, gender, cause of removal, and type of their orthognathic surgery were identified. Finally, the collected data were analyzed in SPSS software (version 21).

The present study was performed on 69 subjects with the average age of 24.9±4.09 who underwent orthognathic surgery during 2016-2018. The aim was to analyze the miniplate and miniscrew removal and related variables. Based on the results, the rate of miniplate and miniscrew removal was 10.14% (7 cases out of 69 patients). It was found that infection and plate exposure were the most common reasons for miniplate and miniscrew removal after orthognathic surgery. Moreover, miniplate and miniscrew removal was more frequent in the mandible, compared to the maxilla. Furthermore, the removal had a significant relationship with the type of jaw movement and usage of alcoholic drinks (P<0.05).

Regarding the low rate of miniplate removal after orthognathic surgery (10.14%), it can be concluded that there is no need to remove asymptomatic titanium miniplates. It is only necessary to do so when there are indications and clear symptoms for the removal.

Orthognathic surgery is one of the safe methods for treating dentofacial abnormalities that is effective in a patient’s quality of life and psychological aspects. The aim of this study was to compare the effect of orthognathic surgery on the quality of life of patients with class III deformity treated by orthognathic surgery with patients without dentofacial deformity and nontreated class III patients. Materials & In this descriptive-analytic study, 75 individuals aged 18 to 35 years from both genders who referred to Dental Faculty of Islamic Azad University, Isfahan branch, Isfahan, Iran, were chosen. Thirty subjects had undergone the surgery for class III malocclusion, and at least 6 months passed from their surgery. Thirty individuals with no dentofacial deformity and fifteen untreated patients with class III malocclusion were selected. Then the orthognathic quality of life questionnaires were provided for the patients, and the results were compared. The questionnaire included four aspects of social, dentofacial esthetics, oral function, and awareness of dentofacial aesthetics. The data were analyzed using the Chi-square test, one-way analysis of variance, least significant difference follow-up test, and Pearson correlation coefficient. The mean scores of total quality of life (P=0.02), dentofacial esthetics (P=0.003), oral function (P=0.04), and social domain were significantly different among the three groups; but there was no significant difference between the mean scores of quality of life in awareness of dentofacial aesthetics among the three groups (P=0.81). The mean score of quality of life in the awareness of dentofacial aesthetics domain was the same in the group of treated class III individuals and the group with no dentofacial deformity. Moreover, it was lower in nontreated class III cases.   The quality of life of the patients with class III malocclusion after orthognathic surgery improved, compared to the level of the control group (with no dentofacial deformities), and it was greater than that of the untreated class III group. This difference was greater in oral function and social domains and lower in the awareness of dentofacial aesthetics domain.

The aim of orthosurgery treatment is not only to improve the function and esthetic appearance of dentofacial deformities but also to pay attention to patients’ psychological functions. The aim of this study was to evaluate the psychosocial effects of orthognathic treatment and maxillofacial surgeries on candidates for maxillofacial surgeries. In this descriptive‒analytical study, 27 patients who were candidates for orthognathic surgery were selected and assessed by MMPI questionnaire one month before surgery and two months after surgery. Then, the results were compared with a control group consisting of 30 dental students with Angle class I occlusion, who were matched in terms of sex and age. Data were analyzed with t-test, paired t-test and chi-squared test (α = 0.05). Schizophrenia, psychasthenia, paranoia and depression scores in the test group were significantly higher than those in the control group before the surgery (p value < 0.05). However, there were no significant differences in other psychosocial profiles between the test and control groups before surgery. The mean depression score was significantly higher in the test group compared to the control group after surgery (p value < 0.04); however, other psychological profiles were not significant different between the two groups. The mean schizophrenia and psychasthenia scores decreased significantly after surgery (p value < 0.05), with no significant differences in other psychological aspects. Maxillofacial deformities might result in some psychological disorders in patients and orthognathic surgery might help decrease some of these disorders.

Dentofacial deformities have been described as changes that affect the jaws and dentition. Such deformities can be found in one jaw or in both jaws. Orthognathic surgery is a process in which dentofacial deformities and malocclusions are corrected with orthodontic and surgical operations of the facial skeleton. The aim of this study was to investigate epidemiological indices and some characteristics related to orthognathic surgery and compare data collected from patients requiring surgery with those from other communities and countries. This cross-sectional study was carried out on patients referring to an oral and maxillofacial surgery center in Isfahan. The subjects had undergone orthognathic surgery in 2011‒2015. Data were analyzed with SPSS 22, with t-test, one-way ANOVA and chi-squared test (α = 0.05). The mean patient age was 25.9 (range, 16‒45 years) with 67.7% (n = 203) and 32.3% (n = 97) female and male subjects, respectively. The most common facial pattern was class III (62%), followed by class II (32.7%) and class I (5.3%). The most common surgery was bimaxillary (57.3%), followed by BSSO (bilateral sagittal split osteotomy, 21.3%), Lefort I (16.3%) and SARPE (5%). Data showed 5.7% of patients had undergone genioplasty. Bimaxillary surgery was more often performed on patients with class III occlusal relationship. Orthognathic surgery was more common among women and young people. Class III deformity was the most common profile among patients seeking surgery in this region.

With the advancement of the instruments for oral surgeries, use of alternative methods instead of traditional scalpels has been evaluated, The present study aimed to compare the complications associated with electrosurgery techniques and use of scalpel during and after orthognathic surgery.
In this split-mouth designed study, 20 patient who were candidate for orthognathic surgery were enrolled. Symmetrical incisions were made using electrosurgical methods on one side of the jaw and routine techniques with a scalpel number 15 on the other side. Evaluation of the techniques was performed during the surgery and six weeks postoperatively based on specific parameters, including the cutting time, and rate of scar tissue formation. Finally, the collected data from the implications of the two methods were compared using Man-Whitney U- test.
Mean cutting time was 6.63±1.22 and 10.19±1.95 minutes in the electrical cautery and scalpel groups, respectively, which denoted a significant difference between the groups (P According to the results, cautery could lead to a more significant reduction in the cutting time compared to use of scalpel. Furthermore, the scar tissue produced in the electrocautery technique was significantly higher compared to scalpel, which could be due to the induced heat damage to the adjacent tissues.

Accurate estimation of the amount of blood loss for predicting the need for transfusion during bimaxillary orthognathic surgery is important for maxillofacial surgeons and anesthesiologists. The aim of this study was to determine the amount of blood loss during various types of orthognathic surgery.
A total of 92 patients were selected and were separated into two groups of monomaxillary & bimaxillary. All the surgeries were performed in Ghaem Hospital of Mashhad University of Medical Sciences under anesthesia with deliberate hypotension.Blood pressure during surgery was maintained under 100 mm/hg. Surgical blood losses was measured by the amount of blood in the surgical suction unit and counting the number of gauze pads saturated with blood by the anesthesiologiste and at the end of surgery was recorded. In the end, the amount of blood loss was determined separately according to the type of surgery & was statistically analyzed.
The study sample consisted of 92 subjects with a mean age of 23.6±3.64 years and all of the subjects completed the study. The average surgical blood loss was 351.63 ml. Mann-Whitney Test showed that the amount of blood loss in class II was significientlya higher than class III (monomaxillary P=0.040 and bimaxillary P=0.008). Blood loss in monoaxillary surgery was significiently less than bimaxillary surgery (P According to the present study, the amount of bleeding among different types of orthognathic surgeries is different depending on type & number of surgery and these factors are important in estimating the amount of blood loss and peredicting the necessary actions in order to replace the lost blood volume.

Pain control after orthognathic surgeries due to severity of pain and limitations of opioids use in these patients are particular importance. The aim of this study was to evaluate the effect of oral gabapentin and intramuscular ketorolac in combination with intravenous acetaminophen for pain control after this surgery.
This study was a randomized clinical trial (RCT) on 75 patients (18-60 years old American Society of Anesthesiologists (ASA) physical status classification system, I, II) that undergo orthognathic surgery in Sina University Hospital, Tehran University of Medical Sciences, Tehran, Iran from June 2013 to August 2014. The patients were randomly divided in 3 groups. All of groups received 1 gr (intravenous acetaminophen) 30 minutes before the end of surgery. The control group (n= 25) received placebo. The second group (n= 25) received 30 mg ketorolac intramuscular after induction of anesthesia and the third group (n= 25) received 600 mg Gabapentin orally 30 minute before the induction of anesthesia. The pain severity score assessed by visual analogue scale (VAS), the level of sedation assessed by Ramsey scale, opioid requirement, nausea and vomiting was recorded in the post-anesthesia care unit (PACU) at 1, 3, 6, 12 and 24 hours after surgery. For rescue pain management intravenous morphine was administered.
Seventy-five patients were enrolled in this study. Use of Ketorolac and gabapentin declines the pain intensity, level of agitation and morphine requirement in the recovery room and early hours in the ward (P= 0.011). The 24-hour opioid consumption, nausea and vomiting was significantly higher in control group compared with the both intervention groups (15±1.4 vs. 5±0.5 mg) (P The result of this study suggest that ketorolac as well as gabapentin can decline the pain intensity and opioid requirement with less nausea and vomiting and good hemodynamic control after orthognathic surgery.

In orthodontic treatment,the various alloys are widely used. These materials are placed in contact with the oral tissues for months or even years. Microbiological and enzymatic properties of the oral cavity provide appropriate conditions for metals corrosion, causing the release of elements such as nickel, chromium, copper and silver from wires, bands and orthodontic brackets. The purpose of this study is to measure the amount of nickel ions released from the simulated appliance in orthognathic patients and compare the amount of releasing nickel with its safe level. In this semi-experimental study, 60 stimulated appliances in three different types (groups of 20) were studied. Theses three groups examined by spectophotometer to measure free nickel in artificial saliva using atomic absorption after 3, 6 and 2 months respectively and then calculated the rates of three groups, after that compared to safe nickel’s level. Statistical analysis was done by one sample t-test The mean and standard deviation rates of the released nickel in four quadrants of the oral cavity were 1198±533.45 in first group and 825.5±390.40 and 1290.5±455.47 microgram per picoliter in second and third groups, respectively. The mean amount of released nickel in all groups were less than the safe threshold (2500) and statistical analysis showed a significant difference (p<0.001). The amount of released nickel in the whole oral cavity (four quadrants) in each group was less than the toxic dose so this appliance may be safe.

High attention of modern society to beauty and beauty surgery specially orthognathic surgery shows the importance of assessment of the ability of this surgery in changing parameters and soft tissue proportion and finally changing in attraction and beauty. Because of the ability of soft tissue in beauty and masking the defects of hard tissue, assessment of the changes during the orthognathic surgery seems important. In Ghaedi clinic (that is for Isfahan university) the patients are among the candidates of maxillary osteotomy (only lefortⅠosteotomy or Bimax surgery). With coordination of surgeon, the standard cephalometrices are prepared before and six months after the surgery and then soft tissue selected analysis are done. The cephalometrices, that are prepared before and after the surgery, are compared and according to paired T-test are analysed. The changes in parameters between two groups of surgery (one group with ANS-cut and another without ANS-cut) are compared, too. The data of two groups according to independent T-test are analysed. The total samples were sixteen (eight samples in each group). A sincere statistics adviser helped me in this way. According to the results, after the surgery, we see some changes in all of the parameters and proportions. We have statistical significant difference between the means of upper lip length before and after the surgery in uncut group (p value < 0.05). We didnt have statistical significant differences in other parameters in different situations (before and after the surgery or the difference between two groups). The differences might be so little that these are not significant with the samples. Also the nasolabial angle with the most differences, isnt significant. It's because of the high standard deviation. As a result, we can assert that the maxillary osteotomy has the most changes on nasolabial angle. During of the follow (6 months), we observed a decrease in upper lip vermilion and increase of upper lip length & also nasolabial angle. Despite of the numerical differences that almost were not statistically significant, clinical changes of soft tissue following the maxillary lefort Ⅰosteotomy are noticable. Also we can nearly predict the changes.

In contemporary orthognatic surgery, osteotomy and rigid internal fixation procedures are commonly used to restore stability and function of the jaws, and to obtain comfort for patients. Although there are many good reasons for utilization of this type of fixation, in some patients the need to remove plates and screws after surgery may arise due to related complications. The present study investigated plate removal after sagital split osteotomy and its reasons. In this prospective study, 67 patients in need of sagital spilt osteotomy or bimaxillary osteotomy were selected from two university departments during the period of 2005 to 2007. All patients were followed up for 14 month after surgery and number of plates removed was recorded. In addition, information regarding age, sex, duration of operation, medical condition, splitting during surgery, smoking habits, and need to extract wisdom teeth at the time of surgery were gathered. The data were analyzed using a linear logistic regression model with the SPSS software version 12. Infection was the sole reason for plate removal in this study. From 134 plates used in 67 patients 14 plates (10.5%) were removed in 10 patients. Age was the only statistically significant factor to affect plate removal and the effect of other factors were not statistically significant. According to the findings of this study only a few patients needed plate removal. Routine removal of plate does not appear to be clinically indicated.

The purpose of orthognathic surgery is to correct facial deformity and dental malocclusion and to obtain normal orofacial function. However, there are controversies of whether orthognathic surgery might have any negative influence on temporomandibular joint. The purpose of this study was to evaluate the influence of orthognathic surgery on articular disc position and temporomandibular joint symptoms of skeletal CI II patients by means of Magnetic Resonance Imaging. Fifteen patients (10 women and 5 men) with skeletal CI II malocclusion, aged 19-32 years (mean 23 years), from the Isfahan Department of Maxillofacial surgery were studied. All received lefort I & bilateral sagittal split osteotomy (BSSO) and all patients received pre- and post surgical orthodontic treatment, Magnetic Resonance Imaging was performed 1 day preoperatively and 3 month post operatively. Statistical analysis of the positional change of the disk was done by Wilcoxon rank sum test. The change of articular disc position after mandibular advancement surgery by means of sagittal split ramus osteotomy was not statistically significant, but it tended to be positioned anteriorly. It can be suggested that orthognathic surgery dose not significantly change the position of the articular disc.

Abnormal occlusion is one of the most important etiologic problems in patients with dento – facial and cranio – facial abnormalities. In orthognathic surgery this parameter (occlusion) would become normal. Probably it is acceptable to correct the skeletal and occlusal problems to improve speech and articulation. This study was designed to evaluate the effect of orthognathic surgery on articulation and speech on 1999 in Taleghani Hospital. Methods & Materials: This clinical trial study was performed cross – sectionally on 18 patients that consist of 5 male and 13 females. All patients had dentofacial deformities. BSSRO osteotomy and bimaxillary ostetomy were performed on each patient to correct their skeletal deformities. There was no palatal defect or dentocranial problem, mental retardation and hearing problem in the patients. Phonetic test was done before surgery. This test was repeated 6 months after surgery. Findings before and after surgery were evaluated and data were compared with paired t - test. Results showed significant changes after surgery which means these kind of surgery have a positive effect on speech and articulation. It seems an advantage to use orthognathic surgery with speech therapy to improving speech and articulation.

Today, in modern dental practice, one of the main reasons for orthodontics and orthognathic surgery, in addition to improvement in morphology and function, is prevention of periodontal problems. The purpose of this study was to evaluate. the effects of interdental osteotomies on periodontal tissues. In this prospective Cohort study, 18 patients with class II Malocclusions were selected and for them, interdental osteotomies was done. Using periodontial probes and periapical radiographies, the patient’s preoperative periodontal conditions at the site of osteotomy were evaluated as well as postoperative conditions (1,3,6 and 12 months). 1) 6 pathological periodontal lesions were found in 40 segmental osteotomy sites. 2) Among 6 pathological periodontal lesions, 4 areas were with osseous periodontal defects and 2 areas with missing teeth. 3) The prevalence of periodontal defects after segmental surgery in men was two times more than women. A low incidence of dental loss and periodontal defects occurs in the region of segmental osteotomies.

Dept. of Oral and Maxillofacial Surgery, Ghazvin University of Medical Sciences A lot of studies have discussed the reduction of mandibular movements range after orthognatic surgeries. The present study focuses on the conventional orthognatic surgery methods to determine the method with the least effects on mandibular movements. Sixty patients were investigated in a prospective study. They were divided, based on the surgical method, into three groups. In the first group (20 patients) sagital osteotomy, in the second group extra oral vertical osteotomy for mandibular retrusion, and in the third group simultanouse Bimax osteotomies of the upper and lower jaws, were performed. The surgical method applied for maxilla was Lefort 1 osteotmy to protrude the upper jaw and of the lower jaw was extraoral vertical osteotmy. The range of mouth opening, in centrals region, right and left lateral movements and protrusive movements, before and three months after surgery, were measured. Sagital osteotomy method (the first group) showed the most changes and reduction in movements, while the least changes were observed in extraoral vertical method (the second group).