Byoung Ho Kim | PubMed Health

PubMed2007

Sagittal split ramus osteotomy with mandible reduction.

BACKGROUND: The sagittal split ramus osteotomy is a well-established procedure, and many authors have attempted various modifications of the surgical technique. Nowadays, it is widely acknowledged that people in Korea, Japan, and China prefer an oval face, the lower part of which is slender. Therefore, among facial contouring procedures, the mandible reduction procedure is the most popular procedure in these countries. It is quite difficult for patients to undergo two different procedures on almost the same region separately. METHODS: For patients who underwent sagittal split ramus osteotomy on their mandible for various reasons, the authors performed mandible reduction at the same time if necessary. In the event that two procedures are performed simultaneously, the risk would be higher regarding postoperative stability, but there was no significant problem in achieving stable occlusion after surgery through a rigid fixation technique and 2 weeks of rigid intermaxillary fixation. RESULTS: The authors attained satisfactory aesthetic results and good postoperative stability by performing sagittal split ramus osteotomy and mandible reduction at the same time. CONCLUSION: This procedure is thought to be useful for patients who are to undergo sagittal split ramus osteotomy for various reasons and want to have a slender lower face.

Adult↗

PubMedDate not supplied

Three-dimensional mandible reduction: correction of occlusal class I in skeletal class III cases.

BACKGROUND: The human face is a three-dimensional structure. However, many studies on mandible reduction procedures are based on a two-dimensional concept, with a particular focus on one dimension: the width of the lower face. Many Korean individuals have class I occlusion with a skeletal class III pattern. When a conventional mandible reduction procedure is used on such individuals to reduce the width of the lower face, an unsatisfactory facial outcome may result because the changes in the other two dimensions of the lower face, vertical height and anteroposterior distance, are disregarded. This is true because the skeleton of the lower face is well developed in all three dimensions. METHODS: Bimaxillary surgery that reduces all three dimensions of the lower face was planned and conducted by the authors. This mandible reduction procedure reduced the protrusion of both the maxilla and the mandible and, at the same time, shortened the lower face height. The procedure consisted of a Le Fort I osteotomy for superior and/or posterior repositioning of the maxilla, followed by mandibular counterclockwise rotation and setback via a bilateral sagittal split osteotomy. Genioplasty was performed as necessary. RESULTS: With this procedure, the entire lower face volume is reduced, and the overall profile is improved. CONCLUSIONS: Three-dimensional mandible reduction greatly enhances the aesthetic outcome by improving the skeletal characteristics of the face common in the Korean population so that the facial measurements more closely approach normal values.

Adult↗