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Physiological positioning strategy alters condylar position after mandibular ramus sagittal split osteotomies for mandibular prognathism
Authors:Seigo Ohba  Hiroya Ozaki  Kei-ichirou Miura  Takamitsu Koga  Takako Kawasaki  Noriaki Yoshida
Affiliation:1. Department of Regenerative Oral Surgery, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan;2. Department of Orthodontics and Dentofacial Orthopedics, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
Abstract:Objective: The aim of this study was to elucidate the physiological position of the proximal segment for postoperative jaw movement in patients with mandibular prognathism.

Methods: Twenty-two patients with mandibular prognathism were treated by orthognathic surgery using bilateral mandibular sagittal split ramus osteotomies (SSRO) with a physiological positioning strategy. The skeletal stability was assessed, and the movement of the proximal segment was evaluated by cephalography and computed tomography performed preoperatively, immediately postoperatively, and one year postoperatively.

Results: The patients were divided into two groups: the stable group (SNB relapse <1.5°) and the relapse group (SNB relapse ≥1.5°). In the stable group at one year postoperatively, the average SNB relapse was only 0.29° (7%), the condylar head had moved posteriorly by 0.75 mm, and the proximal segment had rotated counterclockwise by 1.2°.

Conclusion: This new physiological positioning strategy improves the position of the condyle compared with the preoperative position in patients with mandibular prognathism.

Keywords:Physiological positioning strategy (PPS)  physiological position  proximal segment  condylar head  mandibular prognathism  orthognathic surgery
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