Journal of Prevention and Treatment for Stomatological Diseases ›› 2017, Vol. 25 ›› Issue (8): 501-505.doi: 10.12016/j.issn.2096-1456.2017.08.006

• Cinical Study • Previous Articles     Next Articles

Surgical treatment of mandibular hypoplasia using inverted-L osteotomy of ramus and iliac creat bone grafting

Xianwen LIU1,2(), Yunfeng LI2, Yao LIU2, Songsong ZHU2()   

  1. 1. Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, China 510280
    2. State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2017-01-18 Revised:2017-05-03 Online:2017-08-20 Published:2018-09-03

Abstract:

Objective The present study was designed to evaluate the use of inverted-L osteotomy of ramus combined with iliac bone graft for the treatment of mandibular hypoplasia inadult patients. Methods Intraoral or extraoralinverted-L osteotomy of ramus and iliac crest bone grafting were used for the treatment of mandibular hypoplasia in 11 adult patients (aged 19 to 29 years) from 2010 to 2016. Data were collected from the patients’ records, photographs andradiographs. Results The height and width of the mandibular ramus were significantly augmented by inverted-L osteotomy and iliac crest bone grafting with minimal complications in all patients, resulting in remarkable improvements both in facial appearance and occlusion. Conclusions Our preliminary results showed that the inverted-L osteotomy of ramus and iliac crest bone grafting is safe and effective, and should be considered as a good alternative for the patients with mandibular hypoplasia.

Key words: Inverted-L osteotomy, Mandibular hypoplasia, Orthognathic surgery, Iliac crest bone grafting, Mandibular ramus

CLC Number: 

  • R782.2

Table 1

Patient details"

病例 年龄/
性别
手术方案 术后 随访
∆H
(mm)
∆W
(mm)
∆H
(mm)
∆W
(mm)
时间
(月)
1 21/F ILO1 + SSRO + Lef + G 9.6 7.3 9.5 7.1 12
2 29/M ILO2 + SSRO + Lef + G 14.2 8.2 14.0 8.2 9
3 23/M ILO1 + SSRO + Lef + G 11.3 8.5 11.3 8.5 7
4 25/F ILO2 + SSRO + Lef + G 12.7 5.4 12.5 5.4 8
5 24/F ILO1 + SSRO + Lef + G 15.5 7.6 15.3 7.6 12
6 28/M ILO2 + SSRO + Lef + G 14.3 5.8 14.3 5.8 13
7 24/F ILO2 + G 8.7 12.3 8.6 12.3 7
8 19/F ILO1 + SSRO + Lef + G 9.3 7.5 9.3 7.4 8
9 23/M ILO2 + SSRO + Lef + G 12.7 7.6 12.5 7.6 14
10 18/F ILO1 + SSRO + Lef + G 8.6 10.5 8.5 10.3 8
11 29/F ILO2 + G 10.4 12.5 10.2 12.4 9
平均 11.6 8.5 11.5 8.4 9.7

Figure 1

Inverted-L osteotomy of ramus and rigid fixation of bony segments"

Figure 2

The “W” line and “H” line of the mandible on the panoramicfilm"

Figure 3

Photographs of a representative case and panoramic radiography"

[1] Ueki K, Marukawa K, Shimada M, et al.Condylar and disc positions after sagittal split ramus osteotomy with and without Le Fort I osteotomy[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2007, 103(3): 342-348.
[2] Hwang K, Nam YS, Han SH.Vulnerable structures during intraoral sagittal split ramus osteotomy[J]. J Craniofac Surg, 2009, 20(1): 229-232.
[3] Baek RM, Lee SW.A new condyle repositionable plate for sagittal split ramus osteotomy[J]. J Craniofac Surg, 2010, 21(2): 489-490.
[4] Kohn MW.Analysis of relapse after mandibular advancement surgery[J]. J Oral Surg, 1978, 36(9): 676-684.
[5] Poulton DR, Ware WH.Surgical-orthodontic treatment of severe mandibular retrusion. II[J]. Am J Orthod, 1973, 63(3): 237-255.
[6] Rubens BC, Stoelinga PJ, Blijdorp PA, et al.Skeletal stability following sagittal split osteotomy using monocortical miniplate internal fixation[J]. Int J Oral Maxillofac Surg, 1988, 17(6): 371-376.
[7] Leira JI, Gilhuus-Moe OT.Sensory impairment following sagittal split osteotomy for correction of mandibular retrognathism[J]. Int J Adult Orthodon Orthognath Surg, 1991, 6(3): 161-167.
[8] Coghlan KM, Irvine GH.Neurological damage after sagittal split osteotomy[J]. Int J Oral Maxillofac Surg, 1986, 15(4): 369-371.
[9] Hall HD, Chase DC, Payor LG.Evaluation and refinement of the intraoral vertical subcondylar osteotomy[J]. J Oral Surg, 1975, 33(5): 333-341.
[10] Hall HD, Mckenna SJ.Further refinement and evaluation of intraoral vertical ramus osteotomy[J]. J Oral Maxillofac Surg, 1987, 45(8): 684-688.
[11] Tuinzing DB, Greebe RB.Complications related to the intraoral vertical ramus osteotomy[J]. Int J Oral Surg, 1985, 14(4): 319-324.
[12] Dattilo DJ, Braun TW, Sotereanos GC.The inverted L osteotomy for treatment of skeletal open-bite deformities[J]. J Oral Maxillofac Surg, 1985, 43(6): 440-443.
[13] Mcmillan B, Jones R, Ward-Booth P, et al.Technique for intraoral inverted ‘L’ osteotomy[J]. Br J Oral Maxillofac Surg, 1999, 37(4): 324-326.
[14] Muto T, Akizuki K, Tsuchida N, et al.Modified intraoral inverted "L" osteotomy: a technique for good visibility, greater bony overlap, and rigid fixation[J]. J Oral Maxillofac Surg, 2008, 66(6): 1309-1315.
[15] Van Sickels JE, Tiner BD, Jeter TS.Rigid fixation of the intraoral inverted ‘L’ osteotomy[J]. J Oral Maxillofac Surg, 1990, 48(8): 894-898.
[16] Naples RJ, Van Sickels JE, Jones DL.Long-term neurosensory deficits associated with bilateral sagittal split osteotomy versus inverted ‘L’ osteotomy[J]. Oral Surg Oral Med Oral Pathol, 1994, 77(4): 318-321.
[17] Kobayashi A, Yoshimasu H, Kobayashi J, et al.Neurosensory alteration in the lower lip and chin area after orthognathic surgery: bilateral sagittal split osteotomy versus inverted L ramus osteotomy[J]. J Oral Maxillofac Surg, 2006, 64(5): 778-784.
[18] Zhu SS, Feng G, Li JH, et al.Correction of mandibular deficiency by inverted-L osteotomy of ramus and iliac crest bone grafting[J]. Int J Oral Sci, 2012, 4(4): 214-217.
[19] Qi MC, Zou SJ, Han LC, et al.Expression of bone-related genes in bone marrow MSCs after cyclic mechanical strain: implications for distraction osteogenesis[J]. Int J Oral Sci, 2009, 1(3): 143-150.
[20] Chopra S, Enepekides DJ.The role of distraction osteogenesis in mandibular Reconstruction[J]. Curr Opin Otolaryngol Head Neck Surg, 2007, 15(4): 197-201.
[21] Kanellopoulos AD, Soucacos PN.Management of nonunion with distraction osteogenesis[J]. Injury, 2006, 37(Suppl 1): S51-S55.
[22] Wijbenga JG, Verlinden CR, Jansma J, et al.Long-lasting neurosensory disturbance following advancement of the retrognathic mandible: distraction osteogenesis versus bilateral sagittal split osteotomy[J]. Int J Oral Maxillofac Surg, 2009, 38(7): 719-725.
[1] ZHAO Qiucheng,LIU Hanghang,HE Ze,ZHOU Yingxin,LUO En. Simultaneous distraction osteogenesis of the maxilla and mandible combined with second-stage orthognathic surgery for correction of hemifacial microsomia in adults [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2019, 27(9): 569-576.
[2] LI Yunfeng,ZHU Songsong. Application of digital technology in diagnosis and treatment of dentofacial deformities [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2019, 27(2): 74-82.
[3] Xianwen LIU,Weijian AI. Application of digital surgery for orthognathic surgical planning [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2018, 26(11): 681-687.
[4] Hui-xi ZHOU. Orthognathic surgical correction of bimaxillary deformities [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2016, 24(2): 69-73.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!
This work is licensed under a Creative Commons Attribution 3.0 License.