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Journal of Maxillofacial and Oral Surgery

, Volume 16, Issue 3, pp 365–373 | Cite as

Surgical Management of Laterognathia in Orthofacial Surgery

  • J. M. García y Sánchez
  • C. L. Gómez Rodríguez
  • J. Romero Flores
Case Report
  • 258 Downloads

Abstract

Introduction

Each year around the world, various surgical procedures are carried out with the goal of correcting laterognathia; both the intraoral vertical ramus osteotomy (IVRO) and bilateral sagittal split ramus osteotomy (OSB) have been the most used techniques in mandibular surgery. These techniques have advantages and disadvantages; for example the advantages of the OSB include: increased coefficient of friction between bony segments, for both the forward and the retroposition, as well as decrease in the time of intermaxillary fixation (IMF). Disadvantages include injury to the inferior alveolar nerve (IAN), hemorrhage, bad split, among others. The advantages of IVRO include decrease of possibility of injury to the IAN, ease of implementation of the technique, a lower incidence of hemorrhage and the short duration of the surgical procedure. Their disadvantages include: lower coefficient of friction between bony segments, requires a relatively long period of IMF. The combination between the techniques of mandibular osteotomy for the correction of minor 10 mm laterognathia is the ideal treatment, since it avoids potential recurrence.

Materials and methods

We describe two cases of patients with laterognathia greater than 6 mm associated with maxilla deformity, which were treated with combined osteotomies. At Maxillofacial Surgery Service, Specialty Hospital, National Medical Center XXI Century, we describe the advantages and disadvantages, pre and postoperative nosocomial, by comparing them with the reports of the literature.

Conclusion

The combination of techniques in the correction of laterognathias greater than 4 mm (smaller than 10 mm) is the ideal treatment, eliminating problems of articular compression, recurrence and damage to the alveolar nerve.

Keywords

Laterognathia OSVI OSB 

References

  1. 1.
    González R, Zárate C (2014) Relación entre la proporción áurea facial y la maloclusión en pacientes mexicanos con criterios faciales estéticos evaluados con la máscara de Marquardt que acudieron a la Clínica de Ortodoncia de la Facultad de Odontología de la Universidad Tecnológica de México durante el 2009. Revista Mexicana de Ortodoncia 2(1): Enero-Marzo 9–17Google Scholar
  2. 2.
    Bolde Villarreal C, Pineda Cásarez F (2008) Evaluación de la funcionalidad de la máscara de Marquardt para la valoración preoperatoria de pacientes para rinoseptoplastia estética. AN ORL MEX 53(1):23–28. http://www.medigraphic.com/pdfs/anaotomex/aom-2008/aom081e.pdf
  3. 3.
    Zaytoun HS Jr, Phillips C, Terry BC (1966) Long-term neurosensory deficits following transoral vertical ramus and sagittal split osteotomies for mandibular prognathism. J Oral Maxillofac Surg 44:193–196CrossRefGoogle Scholar
  4. 4.
    Panossian AJ, Block MS (2010) Evaluation of the smile: facial and dental considerations. J Oral Maxillofac Surg 68:547–554CrossRefPubMedGoogle Scholar
  5. 5.
    Jung H-D, Jung Y-S, Kimb SY (2013) Postoperative stability following bilateral intraoral vertical ramus osteotomy based on amount of setback. Br J Oral Maxillofac Surg 51:822–826CrossRefPubMedGoogle Scholar
  6. 6.
    Ueki K, Marukawa K, Shimada M (2006) Maxillary stability following Le Fort I osteotomy in combination with sagittal split ramus osteotomy and intraoral vertical ramus osteotomy: a comparative study between titanium miniplate and poly-l-lactic acid plate. Am Assoc Oral Maxillofac Surg 0278-2391/06/6401-0012Google Scholar
  7. 7.
    Bayat M, Badri A, Momen-Heravi F (2011) Transverse displacement and angulation of the proximal segment after mandibular setback by means of bilateral intraoral vertico-sagittal ramus osteotomy. Am Assoc Oral Maxillofac Surg 0278-2391/11/6903-0039Google Scholar
  8. 8.
    Halvorsen T, Beddari Y, Eriksen S (2014) Relapse and stability after mandibular set-back surgery (IVSO) one year postoperatively. J Oral Maxillofac Surg. doi: 10.1016/J.Joms..02.033 PubMedGoogle Scholar
  9. 9.
    Takazakura D, Ueki K, Nakagawa K (2007) A comparison of postoperative hypoesthesia between two types of sagittal split ramus osteotomy and intraoral vertical ramus osteotomy, using the trigeminal somatosensory evoked potential method. Int J Oral Maxillofac Surg 36:11–14. doi: 10.1016/j.ijom.2006.09.016 CrossRefPubMedGoogle Scholar
  10. 10.
    Nihara J, Takeyama M, Takayama Y, Mutoh Y, Saito I (2013) Postoperative changes in mandibular prognathism surgically treated by intraoral vertical ramus osteotomy, postoperative changes in mandibular prognathism surgically treated by intraoral vertical ramus osteotomy. Int J Oral Maxillofac Surg 42:62–70. doi: 10.1016/j.ijom.2012.06.024 CrossRefPubMedGoogle Scholar
  11. 11.
    Kim Y, Jung HD, Jung Y-S (2014) A simple classification of facial asymmetry by TML system. J Craniomaxillofac Surg 42(4):313–320CrossRefPubMedGoogle Scholar
  12. 12.
    Papadaki ME, Kaban LB, Troulis MJ (2014) Endoscopic vertical ramus osteotomy: a long-term prospective study. Int J Oral Maxillofac Surg 43:305–310CrossRefPubMedGoogle Scholar
  13. 13.
    Worms FW, Isaacson RJ, Spiedel TM (1976) Surgical orthodontic treatment planning: profile analysis and mandibular surgery. Angle Orthod 46:1–25PubMedGoogle Scholar
  14. 14.
    McCollum AG, Evans WG (2009) Facial soft tissue: the alpha and omega of treatment planning in orthognathic surgery. Semin Orthod 15:196–216CrossRefGoogle Scholar
  15. 15.
    Choi YJ, Lim H, Chung CJ, Park KH, Kim KH (2014) Two-year follow-up of changes in bite force and occlusal contact area after intraoral vertical ramus osteotomy with and without Le Fort I osteotomy. Int J Oral Maxillofac Surg 43(6):742–747CrossRefPubMedGoogle Scholar
  16. 16.
    Van Merkesteyn JP, Groot RH, Van Leeuwaarden R, Kroon FH (1987) Intra-operative complications in sagittal and vertical ramus osteotomies. Int J Oral Maxillofac Surg 16(6):665–670CrossRefPubMedGoogle Scholar
  17. 17.
    Wohlwender I, Daake G, Weingart D (2011) Condylar resorption and functional outcome after unilateral sagittal split osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 112(3):315–321CrossRefPubMedGoogle Scholar
  18. 18.
    Yazdani J, Taheritalesh K, Ghavimi M (2009) Comparison of changes of the gonial angle in 2 methods: IVRO and BSSO. Res J Biol Sci 4(2):148–151Google Scholar
  19. 19.
    Fujimura K, Segami N, Sato J, Kaneyama K (2005) Comparison of the clinical outcomes of patients having sounds in the temporomandibular joint with skeletal mandibular deformities treated by vertico-sagittal ramus osteotomy or vertical ramus osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 99:24–29CrossRefPubMedGoogle Scholar
  20. 20.
    Abeltins A, Jakobsone G, Urtane I, Bigestans A (2011) The stability of bilateral sagittal ramus osteotomy and vertical ramus osteotomy after bimaxillary correction of class III malocclusion. J Craniomaxillofac Surg 39(8):583–587CrossRefPubMedGoogle Scholar
  21. 21.
    Yoshioka I, Khanal A, Tominaga K (2008) Vertical ramus versus sagittal split osteotomies: comparison of stability after mandibular setback. American Association of Oral and Maxillofacial Surgeons. J Oral Maxillofac Surg 66:1138–1144CrossRefPubMedGoogle Scholar
  22. 22.
    de Souza Fernandes AC, Cardoso PM, Fernandes IS (2013) Anatomic study for the horizontal cut of the sagittal split ramus osteotomy—2013 American Association of Oral and Maxillofacial Surgeons. J Oral Maxillofac Surg 71:1239–1244CrossRefGoogle Scholar
  23. 23.
    Yang HJ, Lee WJ, Yi WJ, Hwang SJ (2010) Interferences between mandibular proximal and distal segments in orthognathic surgery for patients with asymmetric mandibular prognathism depending on different osteotomy techniques. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 110:18–24CrossRefPubMedGoogle Scholar
  24. 24.
    American Association of Oral and Maxillofacial Surgeons, parameters of care: clinical practice guidelines for oral and maxillofacial surgery (2012) Surgical correction of maxillofacial. J Oral Maxillofac Surg 70(suppl 3):e107–e136Google Scholar
  25. 25.
    Puricelli E (2007) A new technique for mandibular osteotomy. Head Face Med 3:15CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Naples RJ, Van sickel JE, Jones DL (1994) Long-term neurosensory deficits associated with bilateral sagittal split osteotomy versus inverted “L” osteotomy. Oral Surg Oral Med Oral Pathol 77(4):318–321CrossRefPubMedGoogle Scholar
  27. 27.
    Park K-R, Kim S-Y, Kim G-J, Park H-S, Jung Y-S (2014) Anatomic study to determine a safe surgical reference point for mandibular ramus osteotomy. J Cranio Maxillofac Surg 42:22e27Google Scholar
  28. 28.
    Ohba S, Tasaki H, Tobita T (2013) Assessment of skeletal stability of intraoral vertical ramus osteotomy with one-day maxillaryemandibular fixation followed by early jaw exercise. J Cranio Maxillofac Surg 41:586e592CrossRefGoogle Scholar
  29. 29.
    Blinder D, Peleg O, Yoffe T, Taicher S (2010) Intraoral vertical ramus osteotomy: a simple method to prevent medial trapping of the proximal fragment. Int J Oral Maxillofac Surg. doi: 10.1016/j.ijom.2009.12.015 PubMedGoogle Scholar
  30. 30.
    Böckmann R, Schön P, Frotscher M (2011) Pilot study of modification of the bilateral sagittal split osteotomy (BSSO) in pig mandibles. J Cranio Maxillofac Surg 39:169–172CrossRefGoogle Scholar
  31. 31.
    Page JR, McLennana AS (2013) Vertical subsigmoid osteotomy fixation with miniplates: a case report. Br J Oral Maxillofac Surg 51:e11–e12CrossRefPubMedGoogle Scholar
  32. 32.
    Bloomquist DS, Lee JJ (2004) Principles of mandibular orthognathic surgery. In: Miloro M, Ghali GE, Larsen PE, Waite PD (eds) Peterson’s principles of oral and maxillofacial surgery, Second Edition, chap 56. BC Decker Inc, Hamilton, p 1135Google Scholar
  33. 33.
    Bell WH (1992) Modern practice in ortognathic and reconstructive surgery, vol 3. chap 24. WB Saunders, Philadelphia, p 647Google Scholar
  34. 34.
    Epker BN, Stella JP, Fish LC (1995) Dentofacial deformities: integrated orthodontic and surgical correction, vol IV. sect 9. Louis, Mosby, p 1855Google Scholar
  35. 35.
    García y Sánchez JM, García Pumarino MT (1988) Intraoral vertical subsigmoidal osteotomy (report of 110 cases). Rev ADM 45(3):159–162PubMedGoogle Scholar
  36. 36.
    Proffit WR, Phillips C, Dann C, Turvey TA (1991) Stability after surgical-orthodontic correction of skeletal class III malocclusion. I. Mandibular setback. Int J Adult Orthodon Orthognath Surg 6(1):7–18PubMedGoogle Scholar
  37. 37.
    Nystrom E, Rosenquist J, Astrand P, Nordin T (1984) Intraoral or extraoral approach in oblique sliding osteotomy of the mandibular ramus. A cephalometric study. J Maxillofac Surg 12:277–282CrossRefPubMedGoogle Scholar
  38. 38.
    Ayoub AF, Millett DT, Hasan S (2000) Evaluation of skeletal stability following surgical correction of mandibular prognathism. Brit J Oral Maxillofac Surg 38:305–311. doi: 10.1054/bjom.2000.0303 CrossRefGoogle Scholar
  39. 39.
    Chen C-M, Lai SST (2011) The stability of intraoral vertical ramus osteotomy and factors related to skeletal relapse. Aesthet Plast Surg 35:192–197. doi: 10.1007/s00266-010-9582-y CrossRefGoogle Scholar
  40. 40.
    Fabio C, Massimo R, Massimo P (2001) Stability of sagittal split ramus osteotomy used to correct class III malocclusion: review of the literature. Int J Adult Orthodon Orthognath Surg 16(2):121–129Google Scholar
  41. 41.
    Greebe RB, Tuinzing DB (1982) Overcorrection and relapse after the intraoral vertical ramus osteotomy. Oral Surg 54(4):382CrossRefPubMedGoogle Scholar
  42. 42.
    Meneses L, Ventura H, Arrascue M (1998) Cirugia ortognatica: una Revisión. Rev Estomatol Herediana 7–8(1–2):30–35Google Scholar
  43. 43.
    Hoppenreijs TJ, Freihofer HPM, Stoelinga PJ, Tuinzing DB (1998) Condylar remodelling and resorption after Le Fort I and bimaxillary osteotomies in patients with anterior open bite. A clinical and radiological study. Int J Oral Maxillofac Surg 27:81–91CrossRefPubMedGoogle Scholar
  44. 44.
    Kobayashi T, Watanabe I, Ueda K (1966) Stability of the mandible after sagittal ramus osteotomy for correction of prognathism. J Oral Maxillofac Surg 44:693–697Google Scholar
  45. 45.
    Mommaerts MY (2010) Endoscopically assisted sagittal split osteotomy for mandibular lengthening: technical note and initial experience. J Craniomaxillofac Surg 38(2):108–112. doi: 10.1016/j.jcms.2009.04.007 CrossRefPubMedGoogle Scholar
  46. 46.
    Proffit WR, Phillip C, Turvey TA (2012) Stability after mandibular setback: mandible-only versus 2-jaw surgery. J Oral Maxillofac Surg 70(7):e408–e414. doi: 10.1016/j.joms.2012.01.006 CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Hsu SS-P, Huang C-S, Chen PK-T, Ko EW-C, Chen Y-R (2012) The stability of mandibular prognathism corrected by bilateral sagittal split osteotomies: a comparison of bi-cortical osteosynthesis and mono-cortical osteosynthesis. Int J Oral Maxillofac Surg 41:142–149CrossRefPubMedGoogle Scholar

Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2016

Authors and Affiliations

  • J. M. García y Sánchez
    • 1
  • C. L. Gómez Rodríguez
    • 1
  • J. Romero Flores
    • 1
  1. 1.Maxillofacial Surgery Service, Specialty HospitalNational Medical Center XXI Century, Instituto Mexicano del seguro Social (IMSS)MexicoMexico

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