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The Mandible is Further Retruded Under General Anesthesia: The Latent Concept for a Favorable Outcome in Sagittal Split Ramus Osteotomy

  • Kazuhiro MatsushitaEmail author
Short communication

Abstract

Introduction

In orthognathic surgery, we often experience that model mounting by the occlusal bite record taken at centric relation under the conscious condition in the sitting position does not always correctly replicate the actual maxilla–mandibular relationship under general anesthesia. Mandible often moves backward further in the latter condition. The present study was carried out to investigate the degree of extra retrusion of the mandible under general anesthesia and to determine the characteristics in each of the three original skeletal class patterns in a Japanese population.

Patients and methods

Fifty patients with jaw deformities (14 males and 36 females) were enrolled in this prospective study, their ages ranging from 16 to 49 years. The occlusal bite record at the incisor region obtained from a mounted articulator was compared with the records from the oral cavity of the patient under general anesthesia before surgery.

Results

Retrusion in the supine position under general anesthesia was observed in all skeletal classes, and it was significantly greater in skeletal Class II, compared to skeletal Class I and Class III.

Conclusion

This study clearly revealed the difference among three different skeletal classes, and the mandible in the skeletal Class II moved backward significantly compared to other classes.

Keywords

Mandibular retrusion Skeletal Class II General anesthesia 

Notes

References

  1. 1.
    Reyneke JP, Ferretti C (2002) Intraoperative diagnosis of condylar sag after bilateral sagittal split ramus osteotomy. Br J Oral Maxillofac Surg 40:285–292CrossRefPubMedGoogle Scholar
  2. 2.
    Bamber MA, Abang Z, Ng WF, Harris M, Linney A (1999) The effect of posture and anesthesia on the occlusal relationship in orthognathic surgery. J Oral Maxillofac Surg 57:1164–1172CrossRefPubMedGoogle Scholar
  3. 3.
    Yaghmaei M, Ejlali M, Nikzad S, Sayyedi A, Shafaeifard S, Pourdanesh F (2013) General anesthesia in orthognathic surgeries: does it affect horizontal jaw relations? J Oral Maxillofac Surg 71:1752–1756CrossRefPubMedGoogle Scholar
  4. 4.
    Jolivet C (2011) Variation in centric relation in the conscious and the anesthetized patient. J Dentofacial Anom Orthod 14:310–320CrossRefGoogle Scholar
  5. 5.
    The Academy of Prosthodontics (2017) Glossary of prosthodontic terms 9th edn. J Prosthet Dent 117:e1–e105CrossRefGoogle Scholar
  6. 6.
    The Academy of Prosthodontics (1994) Glossary of prosthodontic terms 6th edn. J Prosthet Dent 71:41–112CrossRefGoogle Scholar
  7. 7.
    Palaskar JN, Murali R, Bansal S (2013) Centric relation definition: a historical and contemporary prosthodontic perspective. J Indian Prosthodont Soc 13:149–154PubMedGoogle Scholar
  8. 8.
    Shafagh I, Yoder JL, Thayer KE (1975) Diurnal variance of centric relation position. J Prosthet Dent 34:574–582CrossRefPubMedGoogle Scholar
  9. 9.
    The Academy of Prosthodontics (2005) Glossary of prosthodontic terms 8th edn. J Prosthet Dent 94:10–92CrossRefGoogle Scholar
  10. 10.
    Matsushita K, Inoue N, Totsuka Y (2011) In vitro biomechanical evaluation of the effect of an additional L-shaped plate on straight or box plate fixation in sagittal split ramus osteotomy using a bioabsorbable plate system. Oral Maxillofac Surg 15:139–146CrossRefPubMedGoogle Scholar
  11. 11.
    Rotskoff KS, Herbosa EG, Villa P (1991) Maintenance of condyle-proximal segment position in orthognathic surgery. J Oral Maxillofac Surg 49:2–7CrossRefPubMedGoogle Scholar
  12. 12.
    Ooi K, Inoue N, Matsushita K, Yamaguchi H, Mikoya T, Minowa K, Kawashiri S, Nishikata S, Tei K (2018) Incidence of anterior disc displacement without reduction of the temporomandibular joint in patients with dentofacial deformity. Int J Oral Maxillofac Surg 47:505–510CrossRefPubMedGoogle Scholar
  13. 13.
    Gerressen M, Stockbrink G, Smeets R, Riediger D, Ghassemi A (2007) Skeletal stability following bilateral sagittal split osteotomy (BSSO) with and without condylar positioning device. J Oral Maxillofac Surg 65:1297–1302CrossRefPubMedGoogle Scholar

Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2019

Authors and Affiliations

  1. 1.Division of Oral Pathobiological Science, Department of Oral and Maxillofacial Surgery, Graduate School of Dental MedicineHokkaido UniversitySapporoJapan

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