جستجوی مقالات مرتبط با کلیدواژه "sagittal split osteotomy" در نشریات گروه "پزشکی"

Bilateral Sagittal Split Osteotomy (BSSO) is one of the treatment options for Class III maxillary deficiency which may affect the condylar position and the patient's occlusion. We aimed to evaluate the clinical and radiographic changes of temporomandibular joint (TMJ) following mandibular set back surgery by BSSO.

In this retrospective study, All Class III patients, aged between 18-30 years old who underwent bimaxillary orthognathic surgery in the Oral and Maxillofacial Surgery Ward of Ghaem Hospital, Mashhad, Iran from January 2018- January 2020 were enrolled. Radiographic changes of joint space, condylar position and clinical changes for maximal mouth opening and joint sound were examined before and 6 months after surgery. Data were analyzed by SPSS16 software and the significance level of the data was set at P-value < 0.05.

Twenty-five patients were recruited. The axial angle of the left and right condyle and condylar inclination on both sides reduced but this reduction was not statistically significant. While the anterior joint space was reduced and posterior joint space was increased in both sides, the changes on the right side were only significant (P = 0.039). In clinical examinations maximum mouth opening, lateral and protrusive movements were also decreased but this reduction was not statistically significant.

The mandibular set back with BSSO surgery in class III skeletal patients had no significant effect on the position of the condyle in the glenoid fossa as well as clinical symptoms.

There are various alternative surgical approaches for removal of large benign lesions in the posterior part of the mandible. This study describes three cases of large mandibular mixed odontogenic lesions which were excised via sagittal split approach.
Report of Cases: All three cases were treated by surgical excision via unilateral sagittal split osteotomy under general anesthesia following a 2 weeks period of intermaxillary fixation.

The lesions were enucleated completely and all three osteotomy sites healed with no consequences with an intact neurosensory function.

This article suggests the sagittal split osteotomy approach for conservative treatment of large mandibular lesions based on excellent access, limited bone removal and reducing further complications.

Split sagittal osteotomy is a common operation that may induce inferior alveolar nerve (IAN) damage, potentially leading to sensory deficit, numbness, and pain. Investigations in Iran to evaluate the adverse effects of sagittal split osteotomy surgery are rare; so questions have been raised about the success rate of operation and the frequency of unwilling outcome. To address these concerns, we have conducted a prospective study evaluating the rate of IAN damage related to mandibular advancement by sagittal split osteotomy in Iranian population. In this prospective study, 66 patients including30 men (45.4%) and 36 women (54.5%) with Class II malocclusion and mandibular retrognathism who were undergoing mandibular advancement surgery (SSO) were recruited from 2013 to 2015. All patients were followed for 1 year after the surgery. Chi-square or Fisher’s exact was used test to compare categorical variables and the numerical variables were compared by t-test. P < 0.05 was considered significance level. The study sample included, with the mean age 32.3±12.04. The rate of nerve disturbance was 75.8%. Yet, 78.9% of patients were satisfied with the results of the surgery. Our study indicated that IAN disturbance after split sagittal surgery is frequent in Iran. The situation indicates the need for caution on considering split sagittal surgery as a safe medical technique.

Bilateral sagittal split osteotomy (BSSO) of mandible is vastly used in treatment of mandibular deficiencies and discrepancies. Since this method could affect esthetic as well as function, evaluating these effects from various aspects is crucial. This study assessed the effects of this technique on the function of masseter muscle, jaw movements, and sensory changes along with failures in screws used for fixation. 48 patients with mandibular prognathism participated. Electromyography (EMG) of the masseter muscle; limits of jaw movements including maximum opening (MIO), protrusive (PM), lateral movements (LLE and LRE); presences of sensory changes and two point discrimination test; and number of removed screws were recorded at the baseline, 3 months, and 6 months after surgery. EMG activity of masseter decreased significantly 3 months after the surgery. However, after 6 months the masseter activity revealed no statistically significant difference with baseline activity. There was a significant decrease in MIO and PM after 3 months. The 6 month measurement of MIO and PM was also lower than baseline. However, no difference was observed between LRE and LLE in both follow up sessions. Among 46 patients, 27 patients developed lip paresthesia 3 months after surgery. After 6 month, lip paresthesia remained in 11 patients. Among 276 screws used for fixation 3 screws removed due to exposure to oral cavity and 2 due to patient discomfort. As BSSO in patients with mandibular prognathism revealed temporary functional and sensory changes, it is a safe and appropriate method in orthognathic surgery.