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Long-term 3-dimensional Stability of Mandibular Advancement Surgery

Institution:
1Department of Orthodontics, School of Dentistry, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
2Department of Orthodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA.
3Department of Orthodontics, University of North Carolina, School of Dentistry, Chapel Hill, North Carolina, USA.
4Department of Oral and Maxillofacial Surgery, University of North Carolina, School of Dentistry, Chapel Hill, North Carolina, USA.
5Department of Orthodontics, Federal University of Rio de Janeiro, School of Dentistry, Rio de Janeiro, Brazil
Publisher:
Elsevier Science
Publication Date:
Sep-2013
Journal:
J Oral Maxillofac Surg
Volume Number:
71
Issue Number:
9
Pages:
1588-97
Citation:
J Oral Maxillofac Surg. 2013 Sep;71(9):1588-97.
PubMed ID:
23769460
PMCID:
PMC3909662
Appears in Collections:
NA-MIC
Sponsors:
R01 DE005215/DE/NIDCR NIH HHS/United States
R01 DE024450/DE/NIDCR NIH HHS/United States
U54 EB005149/EB/NIBIB NIH HHS/United States
Generated Citation:
Franco A.A., Cevidanes L.H., Phillips C., Rossouw P.E., Turvey T.A., Carvalho F., Paula L., Quintão C., Almeida M. Long-term 3-dimensional Stability of Mandibular Advancement Surgery. J Oral Maxillofac Surg. 2013 Sep;71(9):1588-97. PMID: 23769460. PMCID: PMC3909662.
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PURPOSE: To evaluate 3-dimensional changes in the position of the condyles, rami, and chin from 1 to 3 years after mandibular advancement surgery. MATERIALS AND METHODS: This prospective observational study used pre- and postoperative cone-beam computed tomograms of 27 subjects with skeletal Class II jaw relation and normal or deep overbite. An automatic technique of cranial base superimposition was used to assess positional and bone remodeling changes that were visually displayed and quantified using 3-dimensional color maps. Analysis of covariance with presence of genioplasty, age at time of surgery, and gender as explanatory variables was used to estimate and test adjusted mean changes for each region of interest. RESULTS: The chin rotated downward and backward 1 to 3 years after surgery. Changes of at least 2 mm were observed in 17% of cases. Mandibular condyles presented with displacements or bone remodeling of at least 2 mm on the anterior surface (21% of cases on the left side and 13% on the right), superior surface (8% on right and left sides), and lateral poles (17% on left side and 4% on right). Posterior borders of the rami exhibited symmetric lateral or rotational displacements in 4% of cases. CONCLUSION: In the hierarchy of surgical stability, mandibular advancement surgery is considered one of the most stable surgical procedures. However, 1 to 3 years after surgery, approximately 20% of patients had 2- to 4-mm changes in horizontal and vertical chin positions or changes in condylar position and adaptive bone remodeling.

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