THE DETERMINATION OF SAFE ZONE FOR HORIZONTAL RAMUS CUT IN SAGITTAL SPLIT RAMUS OSTEOTOMY WITH CONE BEAM COMPUTED TOMOGRAPHY: A RETROSPECTIVE PILOT STUDY

İbrahim Şevki Bayrakdar; Elif Bilgir

doi:10.17567/ataunidfd.522787

THE DETERMINATION OF SAFE ZONE FOR HORIZONTAL RAMUS CUT IN SAGITTAL SPLIT RAMUS OSTEOTOMY WITH CONE BEAM COMPUTED TOMOGRAPHY: A RETROSPECTIVE PILOT STUDY

Öz

ABSTRACT

Aim: Bilateral sagittal split ramus osteotomy (BSSRO) is commonly used to correct mandibular deformities. The first cut for this osteotomy is performed on the medial aspect above the lingula. During this procedure; The most feared intraoperative complication, the undesired fracture. Most of the BSSRO complications consist of condyle fracture or buccal/lingual plate fracture. The aim of this study was to determined the distance between the lingula and the sigmoid notch which is a surgical importance for BSSRO.

Material and Methods: This retrospective study composed of the cone beam computed tomography images that were obtained at the our clinic. The sample compromised 70 patients (32 males and 38 females, with an age range of 12 to 28 years). The perpendicular distance between the fixed plane and upper limit of lingula was measured. The sample comprised 70 subjects (32 males and 38 females, with an age range of 12 to 28 years). The obtained data were statistically evaluated.

Results: The minimum distance of the between fixed plane passing from sigmoid notch with lingula was found as a minimum of 4.80mm and a maximum of 19.20mm (mean±std. dev.= 11.99mm±2.40, n=140). The right and left side measurement ranged from 4.80mm to 16.4mm (mean±std. dev=11.34mm±2.26, n=70) and 7.72mm to 19.20mm (mean±std. dev.= 12.64mm±2.39, n=70), respectively.

Conclusion: The findings obtained in this study provide a guideline for surgeons performing BSSRO on young populations in Turkey. Pre-procedural three-dimensional evaluation provides valuable information to prevent undesirable fractures.

Keywords: Horizontal Ramus Osteotomy, CBCT, Sagittal Split Osteotomy

SAGİTTAL SPLİT RAMUS OSTEOTOMİSİNDE RAMUS KESİSİ İÇİN GÜVENİLİR SINIRLARIN KONİK IŞINLI BİLGİSAYARLI TOMOGRAFİ İLE BELİRLENMESİ: RETROSPEKTİF PİLOT ÇALIŞMA

ÖZ

Amaç: Bilateral sagittal split ramus osteotomisi, mandibular deformiteleri düzeltmek için sıklıkla kullanılan cerrahi bir yöntemdir. Bu osteotomi için ilk kesi lingula üzerinden geçen bir hat üzerinde gerçekleştirilir. Bu cerrahi sırasında en korkulan intraoperatif komplikasyon istenmeyen kırık oluşumudur. Operasyon esnasında hem proksimal hem de distal segmentlerde kırık oluşabilir. Bu çalışmanın amacı, güvenli bir bilateral sagittal split ramus osteotomisi için cerrahi önemi olan lingula ve sigmoid çentik arasındaki mesafeyi belirlemektir.

Gereç ve Yöntem: Bu retrospektif çalışma, kliniğimizde çeşitli dental sebeplerle elde edilen konik ışınlı bilgisayarlı tomografi görüntüleri üzerinde gerçekleştirildi.

Aksiyel düzlem, sigmoid çentikten geçecek şekilde konumlandırılarak, oluşturulan sabit düzlem ile lingula üst sınırı arasındaki dikey mesafe ölçüldü. Örneklem 70 kişinin (12-28 yaş aralığında, 32 erkek, 38 kadın) verilerini içermekteydi. Veriler istatistiksel olarak değerlendirildi.

Bulgular: Minimum mesafe 4.8 mm maksimum mesafe 19 mm olarak bulundu (ort±std sapma=11,99 mm±2.40, n=140). Sağ ve sol taraf ölçümleri sırasıyla 4.80 mm’den16.4mm’ye (ort±std. sapma= 11.34mm± 2.26, n=70), 7.72mm’den 19.20mm’ye (std. dev.= 12.64mm±2.39, n=70) değişmekteydi.

Sonuç: Bu çalışmada elde edilen bulgular genç Türk popülasyonuna bilateral sagittal split ramus osteotomisi için cerrahlara bir rehber olabilir. Prosedür öncesi üç boyutlu değerlendirme, istenmeyen fraktürlerin önlenmesinde değerli bilgiler sağlar.

Anahtar Kelimeler: Horizontal Ramus Kesisi, KIBT, Sagittal Split Osteotomisi

Anahtar Kelimeler

Horizontal Ramus Osteotomy,CBCT

Kaynakça

1. Baek SM, Kim SS, Bindiger A. The prominent mandibular angle: preoperative management, operative technique, and results in 42 patients. Plast Reconstr Surg 1989;83:272-80.
2. Deguchi M, Iio Y, Kobayashi K, Shirakabe T. Angle-splitting ostectomy for reducing the width of the lower face. Plast Reconstr Surg 1997;99:1831-9.
3. Ertas Ü, Saruhan N, Yalçin E. Surgical treatment of class iii malocclusion: monozygotic twin. J Craniofac Surg 2016;27:e471-e3.
4. Dal Pont G. Retromolar osteotomy for correction of prognathism. J Oral Surg 1961;19:42-7.
5. Hunsuck E. A modified intraoral sagittal splitting technique for correction of mandibular prognathism. J Oral Surg 1968;26:249-52.
6. Epker B. Modifications in the sagittal osteotomy of the mandible. J Oral Surg 1977;35:157-9.
7. Mehra P, Castro V, Freitas RZ, Wolford LM. Complications of the mandibular sagittal split ramus osteotomy associated with the presence or absence of third molars. J Oral Maxillofac Surg 2001;59:854-8.
8. Joseph P. McCain KK. Endoscopic oral and maxillofacial surgery. in: shahrakh c. bagheri rbb, husain ali khan., editor. curr theraphy oral maxillofac surg. United Kiingdom: Saunders; 2012. p. 45-7.

9. Wang T1, Han JJ, Oh HK, Park HJ, Jung S, Park YJ, Kook MS. Evaluation of mandibular anatomy associated with bad splits in sagittal split ramus osteotomy of mandible. J Craniofac Surg 2016; 27:e500-e4.
10. Blomqvist JE, Alberius P, Isaksson S. Sensibility following sagittal split osteotomy in the mandible: a prospective clinical study. Plast Reconstr Surg 1998;102:325-33.
11. Lee. JJ. Mandibular Asymmetry: diagnosis and treatment considerations. In: shahrakh c. bagheri rbb, husain ali khan., editor. curr Theraphy Oral Maxillofac Surg. United Kingdom: Saunders; 2012. p. 617-84.
12. Smith BR, Rajchel JL, Waite DE, Read L. Mandibular ramus anatomy as it relates to the medial osteotomy of the sagittal split ramus osteotomy. J Oral Maxillofac Surg 1991;49:112-6.
13. Aarabi M, Tabrizi R, Hekmat M, Shahidi S, Puzesh A. Relationship between mandibular anatomy and the occurrence of a bad split upon sagittal split osteotomy. J Oral Maxillofac Surg 2014; 72:2508-13.
14. Trost O, Kazemi A, Cheynel N, Benkhadra M, Soichot P, Malka G, Trouilloud P. Spatial relationships between lingual nerve and mandibular ramus: original study method, clinical and educational applications. Surg Radiol Anatomy 2009;31:447-52.
15. Fujimura K, Segami N, Kobayashi S. Anatomical study of the complications of intraoral vertico-sagittal ramus osteotomy. J Oral Maxillofac Surg 2006;64:384-9.
16. Yeh AY, Finn BP, Jones RH, Goss AN. The variable position of the inferior alveolar nerve (IAN) in the mandibular ramus: a computed tomography (CT) study. Surg Radiologic Anatomy 2018:1-13.
17. Shaeran TAT, Shaari R, Rahman SA, Alam MK, Husin AM. Morphometric analysis of prognathic and non-prognathic mandibles in relation to BSSO sites using CBCT. J Oral Biolog Craniofacial Res 2017;7:7-12.
18. Sahoo N, Kaur P, Roy I, Sharma R. Complications of sagittal split ramus osteotomy. J Oral Maxillofac Surg, Medicine Pathol 2017;29:100-4.
19. Agbaje JO, Sun Y, De Munter S, Schepers S, Vrielinck L, Lambrichts I, et al. CBCT-based predictability of attachment of the neurovascular bundle to the proximal segment of the mandible during sagittal split osteotomy. Int J oral maxillofac surg. 2013;42:308-15.
20. Motta ATSd, Carvalho FdAR, Cevidanes LHS, Almeida MAdO. Assessment of mandibular advancement surgery with 3D CBCT models superimposition. Dent Press J Orthod. 2010; 15: e1-12.

Ayrıntılar

Birincil Dil

İngilizce

Konular

Sağlık Kurumları Yönetimi

Bölüm

Araştırma Makalesi

Yazarlar

İbrahim Şevki Bayrakdar
0000-0001-5036-9867

Elif Bilgir Bu kişi benim
0000-0001-9521-4682

Yayımlanma Tarihi

15 Ocak 2019

Gönderilme Tarihi

28 Ağustos 2018

Kabul Tarihi

5 Aralık 2018

Yayımlandığı Sayı

Yıl 2019 Cilt: 29 Sayı: 1

DOI

https://doi.org/10.17567/ataunidfd.522787

IZ

https://izlik.org/JA96NA72WB

Kaynak Göster

RIS / Bibtex

APA

Bayrakdar, İ. Ş., & Bilgir, E. (2019). THE DETERMINATION OF SAFE ZONE FOR HORIZONTAL RAMUS CUT IN SAGITTAL SPLIT RAMUS OSTEOTOMY WITH CONE BEAM COMPUTED TOMOGRAPHY: A RETROSPECTIVE PILOT STUDY. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi, 29(1), 98-102. https://doi.org/10.17567/ataunidfd.522787

AMA

1.Bayrakdar İŞ, Bilgir E. THE DETERMINATION OF SAFE ZONE FOR HORIZONTAL RAMUS CUT IN SAGITTAL SPLIT RAMUS OSTEOTOMY WITH CONE BEAM COMPUTED TOMOGRAPHY: A RETROSPECTIVE PILOT STUDY. Ata Diş Hek Fak Derg. 2019;29(1):98-102. doi:10.17567/ataunidfd.522787

Chicago

Bayrakdar, İbrahim Şevki, ve Elif Bilgir. 2019. “THE DETERMINATION OF SAFE ZONE FOR HORIZONTAL RAMUS CUT IN SAGITTAL SPLIT RAMUS OSTEOTOMY WITH CONE BEAM COMPUTED TOMOGRAPHY: A RETROSPECTIVE PILOT STUDY”. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi 29 (1): 98-102. https://doi.org/10.17567/ataunidfd.522787.

EndNote

Bayrakdar İŞ, Bilgir E (01 Ocak 2019) THE DETERMINATION OF SAFE ZONE FOR HORIZONTAL RAMUS CUT IN SAGITTAL SPLIT RAMUS OSTEOTOMY WITH CONE BEAM COMPUTED TOMOGRAPHY: A RETROSPECTIVE PILOT STUDY. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi 29 1 98–102.

IEEE

[1]İ. Ş. Bayrakdar ve E. Bilgir, “THE DETERMINATION OF SAFE ZONE FOR HORIZONTAL RAMUS CUT IN SAGITTAL SPLIT RAMUS OSTEOTOMY WITH CONE BEAM COMPUTED TOMOGRAPHY: A RETROSPECTIVE PILOT STUDY”, Ata Diş Hek Fak Derg, c. 29, sy 1, ss. 98–102, Oca. 2019, doi: 10.17567/ataunidfd.522787.

ISNAD

Bayrakdar, İbrahim Şevki - Bilgir, Elif. “THE DETERMINATION OF SAFE ZONE FOR HORIZONTAL RAMUS CUT IN SAGITTAL SPLIT RAMUS OSTEOTOMY WITH CONE BEAM COMPUTED TOMOGRAPHY: A RETROSPECTIVE PILOT STUDY”. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi 29/1 (01 Ocak 2019): 98-102. https://doi.org/10.17567/ataunidfd.522787.

JAMA

1.Bayrakdar İŞ, Bilgir E. THE DETERMINATION OF SAFE ZONE FOR HORIZONTAL RAMUS CUT IN SAGITTAL SPLIT RAMUS OSTEOTOMY WITH CONE BEAM COMPUTED TOMOGRAPHY: A RETROSPECTIVE PILOT STUDY. Ata Diş Hek Fak Derg. 2019;29:98–102.

MLA

Bayrakdar, İbrahim Şevki, ve Elif Bilgir. “THE DETERMINATION OF SAFE ZONE FOR HORIZONTAL RAMUS CUT IN SAGITTAL SPLIT RAMUS OSTEOTOMY WITH CONE BEAM COMPUTED TOMOGRAPHY: A RETROSPECTIVE PILOT STUDY”. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi, c. 29, sy 1, Ocak 2019, ss. 98-102, doi:10.17567/ataunidfd.522787.

Vancouver

1.İbrahim Şevki Bayrakdar, Elif Bilgir. THE DETERMINATION OF SAFE ZONE FOR HORIZONTAL RAMUS CUT IN SAGITTAL SPLIT RAMUS OSTEOTOMY WITH CONE BEAM COMPUTED TOMOGRAPHY: A RETROSPECTIVE PILOT STUDY. Ata Diş Hek Fak Derg. 01 Ocak 2019;29(1):98-102. doi:10.17567/ataunidfd.522787