In order to clarify the trend of patients undergoing surgical orthodontic treatment over the past decade at the Clinic of Orthodontics of Meikai University Hospital, a statistical analysis was performed. The general information, skeletal pattern and occlusion were examined.
The results were as follows:
1. A total of 208 cases underwent surgical orthodontic treatment. There was a gradual annual increase in the number of patients. The numbers of male and female patients were 63 (30.6%) and 145 (69.4%), respectively. The average age at the initial visit and orthognathic surgery were 21.3 and 24.1 years old, respectively. 97.6% of patients lived in Saitama prefecture where Meikai University Hospital is located. The chief complaints were facial deformity (79.3%) and occlusion (17.8%).
2. Skeletal Class I, II and III cases accounted for 14.9%, 8.7% and 76.4%, respectively. Skeletal Class III cases were divided into two groups according to whether sagittal split ramus osteotomy (SSRO) and/or intraoral vertical ramus osteotomy (IVRO) was performed (one-jaw group), or two-jaw surgery was performed (two-jaw group). Comparing the one- and two-jaw surgery groups, ANB angle was significantly smaller in the latter than the former, but there was no significant difference in Frankfort mandibular plane angle (FMA) between the two groups.
3. Patients undergoing SSRO solely accounted for 56.7%, followed by SSRO and Le Fort I osteotomy (17.3%), IVRO solely (8.7%), SSRO and IVRO (8.2%), Wassmund osteotomy solely (3.9%), and Wassmund osteotomy and SSRO (1.4%).
4. Female skeletal Class III patients tended to seek orthognathic treatment even if their intermaxillary discrepancy was mild.
5. 74.1% and 76.7% of the one- and two-jaw surgery groups, respectively, underwent first premolar extraction.

View full abstract

A statistical survey, by the Orthodontic Science, Department of Orofacial Development and Function at Tokyo Medical and Dental University, was performed on 626 subjects with jaw deformities who underwent orthodontic treatment in association with orthognathic surgery from 1997 to 2011. The results were as follows:
1. There were 266 males and 360 females (ratio: 1:1.35).
2. 50.2% of subjects lived in Tokyo.
3. The mean age at surgery was 25.8 years old. The number of subjects who are 31 years or older has tended to increase in recent years.
4. The most common condition was mandibular prognathism without anterior open bite, which accounted for 68.1% of the subjects. The second common condition was mandibular prognathism with anterior open bite, which accounted for 16.8%.
5. The most frequently used surgical technique was sagittal split ramus osteotomy (SSRO), which accounted for 55.4%. The combination of Le Fort I osteotomy and SSRO accounted for 36.3%.
6. The most common bone fixation technique after SSRO was screw- or miniplate-fixation.

View full abstract

This paper verified the stability of poly-L-Lactic/polyglycolic acid bone fixation devices in Le Fort I osteotomy. The subjects of the study were 40 patients (33 females and 7 males) who underwent Le Fort I osteotomy with fixation by poly-L-Lactic/polyglycolic acid bone fixation devices (plates and screws). The subjects were divided into two groups according to their skeletal deformity pattern: skeletal Class II and Class III. Lateral cephalometric radiographs were measured and compared for the absolute magnitude of skeletal relapse from pretreatment to immediately postoperative to 6 months and 1 year after surgery. The X-axis applied the Sella-Nasion line, and the Y-axis passed through Sella perpendicular to the X-axis. The evaluation factors were A-point, Prosthion, and posterior nasal spine (PNS). In both groups, statistical analysis showed no significant differences in postoperative skeletal stability. In conclusion, poly-L-Lactic/polyglycolic acid bone fixation devices can provide postoperative stability for Le Fort I osteotomy.

View full abstract

Bartter syndrome is a rare disorder characterized by severe hypokalemia, metabolic alkalosis, marked elevation of plasma rennin activity, pressor insensitivity to angiotensin II, and normal or low values for plasma sodium, plasma chloride, and blood pressure. We report a patient undergoing sagittal splitting ramus osteotomy who demonstrated Bartter syndrome with retrognathia. A 21-year-old woman was referred to our department because of malocclusion and maxillary protrusion. We diagnosed her as having micrognathia and skeletal open bite. We scheduled sagittal splitting ramus osteotomy under general anesthesia. Because hypokalemia might occur during and after surgery, we consulted a medical doctor in Metabolism and Endocrinology at our hospital, and administered potassium chioride preoperatively. As a result, postoperative hypokalemia did not develop and her general condition remained good. After surgery, the patient showed good occlusion.

View full abstract