The hierarchy of stability and predictability in orthognathic surgery with rigid fixation: an update and extension

A hierarchy of stability exists among the types of surgical movements that are possible with orthognathic surgery. This report updates the hierarchy, focusing on comparison of the stability of procedures when rigid fixation is used. Two procedures not previously placed in the hierarchy now are included: correction of asymmetry is stable with rigid fixation and repositioning of the chin also is very stable. During the first post-surgical year, surgical movements in patients treated for Class II/long face problems tend to be more stable than those treated for Class III problems. Clinically relevant changes (more than 2 mm) occur in a surprisingly large percentage of orthognathic surgery patients from one to five years post-treatment, after surgical healing is complete. During the first post-surgical year, patients treated for Class II/long face problems are more stable than those treated for Class III problems; from one to five years post-treatment, some patients in both groups experience skeletal change, but the Class III patients then are more stable than the Class II/long face patients. Fewer patients exhibit long-term changes in the dental occlusion than skeletal changes, because the dentition usually adapts to the skeletal change

Orbital Anatomy for the Surgeon

An anatomic description of the orbit and its contents and the eyelids directed toward surgeons is the focus of this article. The bone and soft tissue anatomic nuances for surgery are highlighted, including a section on osteology, muscles, and the orbital suspensory system. Innervation and vascular anatomy are also addressed

Stability After Mandibular Setback: Mandible-Only Versus 2-Jaw Surgery

The objective of this study was to evaluate whether changes in the technique for mandibular setback surgery since the introduction of RIF have improved postsurgical stability in Class III correction with setback alone and 2-jaw surgery

Changes in the pattern of patients receiving surgical-orthodontic treatment

The characteristics of patients who seek and accept orthognathic surgery appear to be changing over time but have not been well documented in the 21st century

Perceptions of recovery and satisfaction in the short term after orthognathic surgery

A 2-arm, parallel-group, stratified-block, randomized clinical trial was designed to assess whether patients' perceptions of recovery and satisfaction 4 to 6 weeks after surgery were affected by 3 factors: preparation strategy (viewing a visual treatment simulation), attitudes (expectations about recovery), and psychologic distress (reported before surgery)

Self-Reinforced Biodegradable Screw Fixation Compared With Titanium Screw Fixation in Mandibular Advancement

This report compares the skeletal stability and treatment outcomes of 2 similar cohorts undergoing bilateral sagittal osteotomies of the mandible for advancement. The study groups included patients stabilized with 2-mm self-reinforced polylactate (PLLDL 70/30), biodegradable screws (group B), and 2-mm titanium screws placed in a positional fashion (group T)

Sensory Retraining After Orthognathic Surgery: Effect on Patients’ Perception of Altered Sensation

The primary research hypothesis was that the magnitude and duration of the perceived burden from altered sensation reported by patients following bilateral sagittal split osteotomy (BSSO) and trauma to the third division of the trigeminal nerve is lessened when facial sensory retraining exercises are performed in conjunction with standard opening exercises as compared to standard opening exercises alone

Asymmetry analysis of the arm segments during forward handspring on floor

Asymmetry in gymnastics underpins successful performance and may also have implications as an injury mechanism; therefore, understanding of this concept could be useful for coaches and clinicians. The aim of this study was to examine kinematic and external kinetic asymmetry of the arm segments during the contact phase of a fundamental skill, the forward handspring on floor. Using a repeated single subject design six female National elite gymnasts (age: 19 ± 1.5 years, mass: 58.64 ± 3.72 kg, height: 1.62 ± 0.41 m), each performed 15 forward handsprings, synchronised 3D kinematic and kinetic data were collected. Asymmetry between the lead and non-lead side arms was quantified during each trial. Significant kinetic asymmetry was observed for all gymnasts (p < 0.005) with the direction of the asymmetry being related to the lead leg. All gymnasts displayed kinetic asymmetry for ground reaction force. Kinematic asymmetry was present for more gymnasts at the shoulder than the distal joints. These findings provide useful information for coaching gymnastics skills, which may subjectively appear to be symmetrical. The observed asymmetry has both performance and injury implications

Multimodal Protocol Reduces Postoperative Nausea and Vomiting in Patients Undergoing Le Fort I Osteotomy

To assess the impact of a multimodal antiemetic protocol on postoperative nausea and vomiting (PONV) after LeFort I osteotomy

Three-dimensional cone-beam computed tomography for assessment of mandibular changes after orthognathic surgery

The purpose of this study was to assess alterations in the 3-dimensional (3D) position of the mandibular rami and condyles in patients receiving either maxillary advancement and mandibular setback or maxillary surgery only