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Correlation between skeletal and dental changes after mandibular setback surgery-first orthodontic treatment: Cone-beam computed tomography-generated half-cephalograms

Korean Journal of Orthodontics 2015³â 45±Ç 2È£ p.59 ~ 65
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ÀÌâÈÆ ( Rhee Chang-Hoon ) - Private practice
ÃÖÀ±°æ ( Choi Youn-Kyung ) - Pusan National University Dental Hospital Department of Orthodontics
±è¿ëÀÏ ( Kim Yong-Il ) - Pusan National University Dental Hospital Department of Orthodontics
±è¼º½Ä ( Kim Seong-Sik ) - Pusan National University Dental Hospital Department of Orthodontics
¹Ú¼öº´ ( Park Soo-Byung ) - Pusan National University Dental Hospital Department of Orthodontics
¼Õ¿ì¼º ( Son Woo-Sung ) - Pusan National University Dental Hospital Department of Orthodontics

Abstract


Objective: To investigate skeletal and dental changes after application of a mandibular setback surgery-first orthodontic treatment approach in cases of skeletal Class III malocclusion.

Methods: A retrospective study of 34 patients (23 men, 11 women; mean age, 26.2 ¡¾ 6.6 years) with skeletal Class III deformities, who underwent surgery-first orthodontic treatment, was conducted. Skeletal landmarks in the maxilla and mandible at three time points, pre-treatment (T0), immediate-postoperative (T1), and post-treatment (T2), were analyzed using cone-beam computed tomography (CBCT)-generated half-cephalograms.

Results: The significant T0 to T1 mandibular changes occurred ?9.24 ¡¾ 3.97 mm horizontally. From T1 to T2, the mandible tended to move forward 1.22 ¡¾ 2.02 mm, while the condylar position (Cd to Po-perpendicular plane) shifted backward, and the coronoid process (Cp to FH plane) moved vertically. Between T1 and T2, the vertical dimension changed significantly (p < 0.05). Changes in the vertical dimension were significantly correlated to T1 to T2 changes in the Cd to Po-perpendicular plane (r = ?0.671, p = 0.034), and in the Cp to FH plane (r = 0.733, p = 0.016), as well as to T0 to T1 changes in the Cp to Po-perpendicular plane (r = 0.758, p = 0.011).

Conclusions: Greater alterations in the vertical dimension caused larger post-treatment (T2) stage skeletal changes. Studying the mandibular position in relation to the post-surgical vertical dimension emphasized the integral importance of vertical dimension control and proximal segment management to the success of surgery-first orthodontic treatment.[Korean

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Three-dimensional cephalometrics; Computed tomography; Class III orthognathic surgery

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