Objectives: One of the most common complications of bilateral sagittal split ramus osteotomy (BSSRO) is neurosensory impairment of the inferior alveolar nerve (IAN). Accurate preoperative determination of the position of the IAN canal within the mandible using cone-beam computed tomography (CBCT) is recommended to prevent IAN dysfunction during BSSRO and facilitate neurosensory improvement after BSSRO. Materials and Methods: This randomized clinical trial consisted of 86 surgical sites in 43 patients (30 females and 13 males), including 21 cases (42 sides) and 22 controls (44 sides). Panoramic and lateral cephalographs were obtained from all patients. In the experimental group, CBCT was also performed from both sides of the ramus and mandibular body. Neurosensory function of the IAN was subjectively assessed using a 5-point scale preoperatively and 7 days, 1 month, 3 months, 6 months, and 12 months post-surgery. Data were analyzed using Fisher's test, Spearman's test, t-test, linear mixed-model regression, and repeated-measures ANCOVA (α=0.05, 0.01).
Background: The primary aim of this study was to assess the esthetic profile and hard and soft tissue changes in patients with borderline class III malocclusion after maxillary advancement or mandibular setback surgery. The secondary aim was also to evaluate the patients’ face attractiveness after different surgical treatment.
Materials and Methods: This observational cross-sectional study evaluated 50 patients with borderline class III malocclusion with a mean age of 29 ± 4 years treated from 2014 to 2019. They were divided into two groups based on the type of surgical treatment underwent: 13 patients were treated with mandibular setback (4 males, 9 females), and 37 patients with maxillary advancement (16 males, 21 females). Hard and soft tissue parameters were measured pre and postoperative evaluation. Frontal and profile photographs of these patients were judged by 15 orthodontists, 15 oral and maxillofacial surgeons, and 15 laypeople before and after surgery. The most and the least attractive profiles were scored 10 and 0, respectively. T-test was used to analyze normally distributed data while Mann-Whitney test for non-normally distributed data. The
Kruskal-Wallis test was used to compare the esthetic judgement between the three groups of observers. Pairwise comparisons were carried out using the Mann-Whitney test.
Results: Nasolabial angle, SNA, U1/NA (°), U1/NA (mm), L1/NB (°) and L1/NB (mm) were significantly different between the two groups p<0.04, p<0.001, p<0.001, p<0.005, p<0.07, p<0.08, p<0.01 respectively Orthodontists, oral and maxillofacial surgeons, and laypeople all gave a lower score to mandibular setback and higher score to maxillary advancement in terms of facial profile esthetics (P<0.001).
Conclusion: Some cephalometric parameters were significantly different between the two groups. The maxillary advancement seemed to provide better results in facial profile esthetics than mandibular setback for patients with borderline class III malocclusion.
The mean age of the patients in our study was 39.54 ± 15 years. Thirty-five patients were male, and 25 were female. The serum blood glucose level was 111.6 ± 25.47 mg/dL before local anesthesia and 115.3 ± 24.39 mg/dL after tooth extraction (P = 0.418). Eleven female patients and four male patients had a reduction in the blood glucose levels after injection. There was a significant difference between these groups (P = 0.01). Conclusion: According to our findings and previous reports, using local anesthesia during tooth extraction does not induce hypoglycemia and could increase the serum blood glucose level in individuals.
Introduction:
Changes in the soft palate and velopharyngeal function are among the most important concerns for maxillofacial surgeons in patients with midface deficiency, especially in those with cleft palate who needed maxillary advancement. In this study, we evaluated cephalometric changes in soft palate after maxillary advancement.
Materials and Methods:
This study included 16 cleft patients (7 females and 9 males), with a mean age of 22 ± 3.47. The maxillary advancement alone was done in 10 patients and bimaxillary osteotomy in the other six patients. Cephalometric characteristics were assessed before and 6 months after the surgery, and the results were analyzed using paired t-test or Wilcoxon test.
Results:
The results showed a 6% increase (P < 0.05) for PNS-U (soft palate length) index. In addition, PTM-UPW (upper pharyngeal space) and U-MPW (middle pharyngeal space) increased by 5% (P < 0.05) and 5% (P < 0.08), respectively, after the surgery. V-LPW (lower pharyngeal space) also increased by 0.6% but was not statically significant.
Conclusions:
According to the results of this study, after surgical maxillary advancement, changes were observed in upper and middle pharyngeal spaces, soft palate length, and inclination, but lower pharyngeal space remained unchanged.
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