A new 3D analysis on displacement of proximal segment after bilateral sagittal split osteotomy for class III asymmetry
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ORIGINAL ARTICLE
A new 3D analysis on displacement of proximal segment after bilateral sagittal split osteotomy for class III asymmetry Worraruthai Titiroongruang 1 & Yu-Fang Liao 1,2,3,4 & Ying-An Chen 3,4,5 & Chuan-Fong Yao 3,4,5 & Yu-Ray Chen 1,3,4,5 Received: 28 July 2019 / Accepted: 12 February 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objectives We aimed to quantify the displacement of the proximal segment after bilateral sagittal split osteotomy in patients with class III asymmetry and evaluate if the displacement was related to the movement of the distal segment. Material and methods Forty adults with class III asymmetry corrected by bimaxillary surgery were studied. Cone-beam computed tomography taken before and 1 week after surgery was used to measure the displacement of proximal segments and movement of the distal segment in terms of translation and rotation. The relationship between the displacemnt of the proximal segment and the movement of the distal segment was evaluated. Results After surgery, the deviated proximal segment was displaced forward and to the deviated side, rotated downward, tilted, and turned to the opposite side. The opposite proximal segment was displaced forward and rotated downward. The roll rotation of the proximal segment was correlated with the left/right movement and roll rotation of the distal segment. Conclusion Early after orthognathic correction for class III asymmetry, the deviated proximal segment was displaced in a direction favorable for correction of asymmetry. The roll rotation of the proximal segment was affected by the transverse movement and roll rotation of the distal segment. Clinical relevance Knowledge of the ability and limitation of the proximal segment rotation improves the virtual simulation. Keywords Orthognathic surgery . Facial asymmetry . Class III malocclusion . Sagittal split osteotomy . Proximal segment
Introduction The incidence of a class III malocclusion is high in Asian populations and mandibular prognathism, and deviation is one of the chief complaints [1]. Bilateral sagittal split
* Yu-Fang Liao [email protected] 1
Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan
2
Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, No. 123, Dinghu Road, Guishan District, Taoyuan City 333, Taiwan
3
Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
4
Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
5
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
osteotomy (BSSO) is one of the most favored surgical procedures for the management of mandibular prognathism and deviation. This osteotomy produces a larger bone interface between the proximal and distal segments compared with the intraoral vertical ramus osteotomy, therefore enhancing the healing process and allowing a versatility of movements of the mandible [2, 3]. When a BSSO procedure is used for patients with class
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