THE DETERMINATION OF SAFE ZONE FOR HORIZONTAL RAMUS CUT IN SAGITTAL SPLIT RAMUS OSTEOTOMY WITH CONE BEAM COMPUTED TOMOGRAPHY: A RETROSPECTIVE PILOT STUDY
Öz
ABSTRACT Aim: Material Results: Conclusion: Keywords: Horizontal Ramus Osteotomy, CBCT, Sagittal Split SAGİTTAL SPLİT RAMUS OSTEOTOMİSİNDE RAMUS KESİSİ Amaç: Bilateral sagittal split ramus osteotomisi, Gereç Aksiyel düzlem, sigmoid çentikten geçecek Bulgular: Sonuç: Bu çalışmada elde edilen bulgular genç Türk Anahtar
Bilateral sagittal split ramus
osteotomy (BSSRO) is commonly used to correct mandibular deformities. The first
cut for this osteotomy is performed on the medial aspect above the lingula.
During this procedure; The most feared intraoperative complication, the
undesired fracture. Most of the BSSRO complications consist of condyle fracture
or buccal/lingual plate fracture. The aim of this study was to determined the
distance between the lingula and the sigmoid notch which is a surgical
importance for BSSRO.
and Methods: This retrospective study
composed of the cone beam computed tomography images that were obtained at the
our clinic. The sample compromised 70 patients (32 males and 38 females, with
an age range of 12 to 28 years). The perpendicular distance between the fixed
plane and upper limit of lingula was measured. The sample comprised 70 subjects
(32 males and 38 females, with an age range of 12 to 28 years). The obtained
data were statistically evaluated.
The minimum distance of the between
fixed plane passing from sigmoid notch with lingula was found as a minimum of
4.80mm and a maximum of 19.20mm (mean±std. dev.= 11.99mm±2.40, n=140). The
right and left side measurement ranged from 4.80mm to 16.4mm (mean±std.
dev=11.34mm±2.26, n=70) and 7.72mm to 19.20mm (mean±std. dev.= 12.64mm±2.39,
n=70), respectively.
The findings obtained in this study
provide a guideline for surgeons performing BSSRO on young populations in
Turkey. Pre-procedural three-dimensional evaluation provides valuable
information to prevent undesirable fractures.
Osteotomy
İÇİN GÜVENİLİR SINIRLARIN KONİK IŞINLI BİLGİSAYARLI TOMOGRAFİ İLE BELİRLENMESİ:
RETROSPEKTİF PİLOT ÇALIŞMA
ÖZ
mandibular deformiteleri düzeltmek için sıklıkla kullanılan cerrahi bir
yöntemdir. Bu osteotomi için ilk kesi lingula üzerinden geçen bir hat üzerinde
gerçekleştirilir. Bu cerrahi sırasında en korkulan intraoperatif komplikasyon
istenmeyen kırık oluşumudur. Operasyon esnasında hem proksimal hem de distal
segmentlerde kırık oluşabilir. Bu çalışmanın amacı, güvenli bir bilateral
sagittal split ramus osteotomisi için cerrahi önemi olan lingula ve sigmoid
çentik arasındaki mesafeyi belirlemektir.
ve Yöntem: Bu retrospektif çalışma,
kliniğimizde çeşitli dental sebeplerle elde edilen konik ışınlı bilgisayarlı
tomografi görüntüleri üzerinde gerçekleştirildi.
şekilde konumlandırılarak, oluşturulan sabit düzlem ile lingula üst sınırı
arasındaki dikey mesafe ölçüldü. Örneklem 70 kişinin (12-28 yaş aralığında, 32
erkek, 38 kadın) verilerini içermekteydi. Veriler istatistiksel olarak
değerlendirildi.
Minimum mesafe 4.8 mm maksimum mesafe
19 mm olarak bulundu (ort±std sapma=11,99 mm±2.40, n=140). Sağ ve sol taraf
ölçümleri sırasıyla 4.80 mm’den16.4mm’ye (ort±std. sapma= 11.34mm± 2.26, n=70),
7.72mm’den 19.20mm’ye (std. dev.= 12.64mm±2.39, n=70) değişmekteydi.
popülasyonuna bilateral sagittal split ramus osteotomisi için cerrahlara bir
rehber olabilir. Prosedür öncesi üç boyutlu değerlendirme, istenmeyen
fraktürlerin önlenmesinde değerli bilgiler sağlar.
Kelimeler: Horizontal Ramus Kesisi,
KIBT, Sagittal Split Osteotomisi
Anahtar Kelimeler
Kaynakça
- 1. Baek SM, Kim SS, Bindiger A. The prominent mandibular angle: preoperative management, operative technique, and results in 42 patients. Plast Reconstr Surg 1989;83:272-80.
- 2. Deguchi M, Iio Y, Kobayashi K, Shirakabe T. Angle-splitting ostectomy for reducing the width of the lower face. Plast Reconstr Surg 1997;99:1831-9.
- 3. Ertas Ü, Saruhan N, Yalçin E. Surgical treatment of class iii malocclusion: monozygotic twin. J Craniofac Surg 2016;27:e471-e3.
- 4. Dal Pont G. Retromolar osteotomy for correction of prognathism. J Oral Surg 1961;19:42-7.
- 5. Hunsuck E. A modified intraoral sagittal splitting technique for correction of mandibular prognathism. J Oral Surg 1968;26:249-52.
- 6. Epker B. Modifications in the sagittal osteotomy of the mandible. J Oral Surg 1977;35:157-9.
- 7. Mehra P, Castro V, Freitas RZ, Wolford LM. Complications of the mandibular sagittal split ramus osteotomy associated with the presence or absence of third molars. J Oral Maxillofac Surg 2001;59:854-8.
- 8. Joseph P. McCain KK. Endoscopic oral and maxillofacial surgery. in: shahrakh c. bagheri rbb, husain ali khan., editor. curr theraphy oral maxillofac surg. United Kiingdom: Saunders; 2012. p. 45-7.
- 9. Wang T1, Han JJ, Oh HK, Park HJ, Jung S, Park YJ, Kook MS. Evaluation of mandibular anatomy associated with bad splits in sagittal split ramus osteotomy of mandible. J Craniofac Surg 2016; 27:e500-e4.
- 10. Blomqvist JE, Alberius P, Isaksson S. Sensibility following sagittal split osteotomy in the mandible: a prospective clinical study. Plast Reconstr Surg 1998;102:325-33.
- 11. Lee. JJ. Mandibular Asymmetry: diagnosis and treatment considerations. In: shahrakh c. bagheri rbb, husain ali khan., editor. curr Theraphy Oral Maxillofac Surg. United Kingdom: Saunders; 2012. p. 617-84.
- 12. Smith BR, Rajchel JL, Waite DE, Read L. Mandibular ramus anatomy as it relates to the medial osteotomy of the sagittal split ramus osteotomy. J Oral Maxillofac Surg 1991;49:112-6.
- 13. Aarabi M, Tabrizi R, Hekmat M, Shahidi S, Puzesh A. Relationship between mandibular anatomy and the occurrence of a bad split upon sagittal split osteotomy. J Oral Maxillofac Surg 2014; 72:2508-13.
- 14. Trost O, Kazemi A, Cheynel N, Benkhadra M, Soichot P, Malka G, Trouilloud P. Spatial relationships between lingual nerve and mandibular ramus: original study method, clinical and educational applications. Surg Radiol Anatomy 2009;31:447-52.
- 15. Fujimura K, Segami N, Kobayashi S. Anatomical study of the complications of intraoral vertico-sagittal ramus osteotomy. J Oral Maxillofac Surg 2006;64:384-9.
- 16. Yeh AY, Finn BP, Jones RH, Goss AN. The variable position of the inferior alveolar nerve (IAN) in the mandibular ramus: a computed tomography (CT) study. Surg Radiologic Anatomy 2018:1-13.
- 17. Shaeran TAT, Shaari R, Rahman SA, Alam MK, Husin AM. Morphometric analysis of prognathic and non-prognathic mandibles in relation to BSSO sites using CBCT. J Oral Biolog Craniofacial Res 2017;7:7-12.
- 18. Sahoo N, Kaur P, Roy I, Sharma R. Complications of sagittal split ramus osteotomy. J Oral Maxillofac Surg, Medicine Pathol 2017;29:100-4.
- 19. Agbaje JO, Sun Y, De Munter S, Schepers S, Vrielinck L, Lambrichts I, et al. CBCT-based predictability of attachment of the neurovascular bundle to the proximal segment of the mandible during sagittal split osteotomy. Int J oral maxillofac surg. 2013;42:308-15.
- 20. Motta ATSd, Carvalho FdAR, Cevidanes LHS, Almeida MAdO. Assessment of mandibular advancement surgery with 3D CBCT models superimposition. Dent Press J Orthod. 2010; 15: e1-12.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 15 Ocak 2019 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 29 Sayı: 1 |
Kaynak Göster
Bu eser Creative Commons Alıntı-GayriTicari-Türetilemez 4.0 Uluslararası Lisansı ile lisanslanmıştır. Tıklayınız.