下顎骨前方移動術を行った７症例の顎態変化

DOI 被引用文献1件 参考文献28件
  • 川元 龍夫
    東京医科歯科大学大学院医歯学総合研究科顎顔面矯正学分野
  • 本橋 信義
    東京医科歯科大学大学院医歯学総合研究科顎顔面矯正学分野
  • 濱田 俊
    東京医科歯科大学大学院医歯学総合研究科顎顔面矯正学分野
  • 今村 尚子
    東京大学医学部附属病院, 顎口腔外科・歯科矯正歯科
  • 深田 健二
    東京医科歯科大学大学院医歯学総合研究科顎顔面矯正学分野
  • 中川 史彦
    東京医科歯科大学大学院医歯学総合研究科顎顔面矯正学分野
  • 小野 卓史
    東京医科歯科大学大学院医歯学総合研究科顎顔面矯正学分野
  • 加藤 嘉之
    東京医科歯科大学大学院医歯学総合研究科顎顔面矯正学分野
  • 黒田 敬之
    東京医科歯科大学大学院医歯学総合研究科顎顔面矯正学分野

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  • Dentofacial Changes in Seven Patients Treated by Surgical Advancement of the Mandible

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The purpose of this study was to examine dentofacial changes treated by orthognathic surgery, and to clarify morphological factors affecting the stability of postoperative occlusion.<BR>Seven adult patients treated by surgical orthodontics using symmetrical mandibular advancement with the Obwegeser sagittal osteotomy, were selected for this study. Lateral cephalograms taken at five stages: pre-treatment, immediately before and after surgery, at the beginning of retention, and under retention (more than one year after retention began), were used for quantitative evaluation of dentofacial changes.<BR>Changes in dental and skeletal components, and anterior occlusion at each period, were analyzed in the anteroposterior and vertical dimensions, respectively.<BR>The following results were obtained:<BR>1. During the preoperative orthodontic treatment period, a remarkable correction of the malpositioned maxillary and mandibular incisors, associated with a little mandibular displacement, contributed to the change in the anterior occlusion.<BR>2. Before and after surgery, marked improvement in anterior occlusion was completed by the surgical mandibular advancement. In some cases, positional changes in the maxillary and mandibular incisors were found in both the anteroposterior and vertical dimensions, leading to a skeletal relapse of the mandible.<BR>3. During the postoperative orthodontic treatment period, a tendency of skeletal relapse was found. However, the anterior occlusion was generally stable because of compensatory changes in the dental components by the postoperative orthodontic treatment.<BR>4. During the retention period, a notable deterioration in the anterior occlusion was found in a case presenting condylar resorption. Except for this case, the overjet was stable due to the compensatory changes in the dental components for the skeletal relapse, while the overbite was unstable because of the dental relapse.<BR>The postsurgical stability of the anterior occlusion could be affected by the dentoskeletal relapse due to the amount of advancement, inadequate postoperative position of the condyle, fixation technique, and condylar resorption.

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