Long-term Observation of Masticatory Function and Neurosensory Disturbance after Mandibular Correction by Bilateral Sagittal Split Ramus Osteotomy
Bilateral sagittal split ramus osteotomy (SSRO) is commonly used to treat jaw deformities. The purpose of this study was to evaluate the postoperative course of patients that underwent SSRO from before operation to fiveyearsafteroperation. A total of 41 female patients with jaw deformities underwent...
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| Published in | Nihon Gaku Henkeishō Gakkai zasshi Vol. 17; no. 4; pp. 265 - 271 |
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| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
THE JAPANESE SOCIETY FOR JAW DEFORMITIES
2007
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0916-7048 1884-5045 1884-5045 |
| DOI | 10.5927/jjjd1991.17.265 |
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| Abstract | Bilateral sagittal split ramus osteotomy (SSRO) is commonly used to treat jaw deformities. The purpose of this study was to evaluate the postoperative course of patients that underwent SSRO from before operation to fiveyearsafteroperation. A total of 41 female patients with jaw deformities underwent SSRO and their masticatory functions and neurosensory recovery were examined with appropriate indicators pre-and posto-peratively. The control group consisted of 24 females with individual normal occlusion assessed as having normal masticatory function. The skeletal stability was well maintained for five years after the operation. The result was that masticatory function following orthognathic surgery showed a decline at one month after surgery, but gradually improved. Especially, the values of occlusal contact area and occlusal force reached the maximum level at four years after surgery. There were no significant differences between the levels of the patients and control subjects three to five years after surgery. The score of the Helkimo index for temporomandibular dysfunctions at one year after surgery was lower than that before surgery. However, this score increased from three years after surgery. The S-W sensory test was used for clinical sensory testing of the lower labiomental area, and differences in degree of sensory disturbance were statistically analyzed. Most patients experienced a marked sensory disturbance in the immediate postoperative period. These symptoms dramatically improved within one year after surgery. However, the result showed that recovery of sensation tended to be limited to within one year after surgery. |
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| AbstractList | Bilateral sagittal split ramus osteotomy (SSRO) is commonly used to treat jaw deformities. The purpose of this study was to evaluate the postoperative course of patients that underwent SSRO from before operation to fiveyearsafteroperation. A total of 41 female patients with jaw deformities underwent SSRO and their masticatory functions and neurosensory recovery were examined with appropriate indicators pre-and posto-peratively. The control group consisted of 24 females with individual normal occlusion assessed as having normal masticatory function. The skeletal stability was well maintained for five years after the operation. The result was that masticatory function following orthognathic surgery showed a decline at one month after surgery, but gradually improved. Especially, the values of occlusal contact area and occlusal force reached the maximum level at four years after surgery. There were no significant differences between the levels of the patients and control subjects three to five years after surgery. The score of the Helkimo index for temporomandibular dysfunctions at one year after surgery was lower than that before surgery. However, this score increased from three years after surgery. The S-W sensory test was used for clinical sensory testing of the lower labiomental area, and differences in degree of sensory disturbance were statistically analyzed. Most patients experienced a marked sensory disturbance in the immediate postoperative period. These symptoms dramatically improved within one year after surgery. However, the result showed that recovery of sensation tended to be limited to within one year after surgery. |
| Author | IHARA, KOICHIRO SHIGEMATSU, MASAHITO SHIKIMORI, MICHIO GOTO, MASAAKI YAMASHITA, YOSHIO NOGUCHI, NOBUHIRO SANO, NAOTO TSUJI, MITSUHIRO NARITOMI, SADAYUKI KONDO, SHIGETOMO |
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| References | 30) 清水真知男, 他: 成人における咀嚼訓練用ガムを用いた咀嚼機能の訓練効果, 岐歯学誌, 25: 51-58, 1998. 6) Kim, Y. G., et al.: Effect of mandibular setback surgery on occlusal force, J Oral Maxillofac Surg, 55: 121-126, 1997. 20) Bell, J. A.: Sensibility evaluation. In Rehabilitation of the Hand. First ed., CV Mosby, Saint Louis, 1978, p273-291. 2) Blomqvist, J. E., et al.: Skeletal stability after mandibular advancement: A comparison of two rigid internal fixation techniques, J Oral Maxillofac Surg, 52: 1133-1137, 1994. 16) Werner, J., et al.: Evaluating cutaneous pressure sensation of the hand, J Occup Ther, 24: 347-356, 1970. 21) 徐完植, 他: 下顎前突症における顎矯正手術後の咀嚼能力の改善に関する研究, 日口診誌, 15: 18-25, 2002. 33) Yamashita, Y., et al.: Masticatory function and neurosensory disturbance after mandibular correction by bilateral sagittal split ramus osteotomy: a comparison between miniplate and bicortical screw rigid internal fixation, Int J Oral Maxillofac Surg, 36: 118-122, 2007. 3) Shetty, V., et al.: Functional stability of sagittal split ramus osteotomies: Effects of positional screw size and placement configuration, J Oral Maxillofac Surg, 54: 601-609, 1996. 34) Hall, H. D.: 1. Intraoral Surgery. Modern Practice in Orthognathic and Reconstructive Surgery, Saunders Co., Philadelphia, 1992, p2110-2139. 12) Helkimo, M.: Studies on function and dysfunction of the masticatory system. II. Index for anamnestic and clinical dysfunction and occlusal state, Swed Dent J, 67: 101-121, 1974. 9) 高嶋はる奈, 他: 下顎枝矢状分割術後の咀嚼機能の変化-術直後から術後1年までの調査-, 日顎変形誌, 9: 157-166, 1999. 10) Matsui, Y., et al.: Application of a low-adhesive colordeveloping chewing gum system to patients with osseointegrated implant-supported prostheses, Int J Oral Maxillofac Implants, 10: 583-588, 1995. 29) Ochs, M. W.: Bicortical screw stabilization of sagittal split osteotomies, J Oral Maxillofac Surg, 61: 1477-1484, 2003. 31) 坂本一郎, 他: 顎関節症における下顎頭骨形態変化と加齢との関係, 口病誌, 65: 313-318, 1998. 11) Helkimo, M.: Studies on function and dysfunction of the masticatory system. I. An epidemiological investigation of symptoms of dysfunction in Lapps in the north of Finland, Proc Finn Dent Soc, 70: 37-49, 1974. 28) 白石芳, 他: 顎変形症手術の前後における顎関節症状の推移に関する臨床統計的観察, 日顎変形誌, 3: 147-153, 1993. 4) Borstlap, W. A., et al.: Stabilisation of sagittal split set-back osteotomies with miniplates: a prospective, multicentre study with 2-year follow-up, Int J Oral Maxillofac Surg, 34: 487-494, 2005. 27) 大塚純正: 顎変形症による咀嚼障害の臨床評価法の開発, 日顎変形誌, 1: 145-147, 1991. 32) 野村泰慎, 他: レーザー3次元形状計測装置を使った顎矯正手術による顔面形態変化の分析, 口科誌, 47: 408-416, 1998. 15) 栗田賢一, 他: 顎関節機能障害の検診-第1報簡易検診法について-, 日口外誌, 37: 1499-1505, 1991. 19) Bell-Krotoski, J., et al.: The repeatability of testing with Semmes-Weinstein monofilaments, Hand Surg, 12A: 155-161, 1987. 22) 野口信宏, 他: 下顎枝矢状分割術前後における最大開口距離, 咬筋活動性, 顎関節雑音の評価, 日顎変形誌, 8: 222-228, 1998. 24) 平井敏博, 他: 全部床義歯の咀嚼機能評価法. 摂取可能食品アンケート, 歯界展望, 72: 1125-1138, 1988. 37) 藤川真紀, 他: 下顎枝矢状分割術後の知覚障害に関する臨床的研究, 日口外誌, 47: 495-506, 2001. 17) 高崎義人, 他: 下顎枝矢状分割術後のオトガイ神経知覚検査に関する臨床的研究-第二報知覚障害程度の違いによる回復過程の差について-, 日顎変形誌, 14: 101-110, 2004. 25) 笹岡邦典, 他: 下顎前突症手術患者の臨床的検討-特に咀嚼能率について-, 北関東医学, 54: 97-104, 2004. 36) 藤田佳子, 他: 下顎枝矢状分割術後の長期経過例における知覚障害発現率, 日口診誌, 19: 265-272, 2006. 18) Takasaki, Y., et al.: A clinical analysis of the recovery from sensory disturbance after sagittal splitting ramus osteotomy using a Semmes-Weinstein pressure aesthesiometer, Bull Tokyo dent Coll, 39: 189-197, 1998. 7) Kobayashi, T., et al.: Masticatory function in patients with mandibular prognathism before and after orthognathic surgery, J Oral Maxillofac Surg, 51: 997-1001, 1993. 26) 橋本譲: 節分法による各種咀嚼試験用食品の比較について, 日病誌, 26: 648, 1959. 23) 根岸正志: 骨格性下顎前突症患者の咀嚼筋に関する筋電図学的ならびに組織化学的研究, 日口外誌, 40: 651-663, 1994. 5) Throckmorton, G. S., et al.: Improvement of maximum occlusal forces after orthognathic surgery, J Oral Maxillofac Surg, 54: 1080-1086, 1996. 35) Panula, K., et al.: Incidence of complications and problems related to orthognathic surgery: A review of 655 patients, J Oral Maxillofac Surg, 59: 1128-1136, 2001. 8) 見崎晶, 他: 下顎前突症患者における術前術後の咬合力・咬合接触面積の変化. 咬合感圧シートを用いた術後長期観察, 日口外誌, 47: 545-550, 2001. 1) Dolce, C., et al.: Skeletal stability after mandibular advancement with rigid versus wire fixation, J Oral Maxillofac Surg, 58: 1219-1227, 2000. 14) Helkimo, M.: Studies on function and dysfunction of the masticatory system. IV. Aged and sex distribution of symptoms of dysfunction of the masticatory system in Lapps in the north of Finland, Acta Odont Scand, 32: 255-267, 1974. 13) Helkimo, M.: Studies on function and dysfunction of the masticatory system. III. Analyses of anamnestic and clinical recordings of dysfunction with the aid of indices, Swed Dent J, 67: 165-182, 1974. |
| References_xml | – reference: 2) Blomqvist, J. E., et al.: Skeletal stability after mandibular advancement: A comparison of two rigid internal fixation techniques, J Oral Maxillofac Surg, 52: 1133-1137, 1994. – reference: 37) 藤川真紀, 他: 下顎枝矢状分割術後の知覚障害に関する臨床的研究, 日口外誌, 47: 495-506, 2001. – reference: 16) Werner, J., et al.: Evaluating cutaneous pressure sensation of the hand, J Occup Ther, 24: 347-356, 1970. – reference: 24) 平井敏博, 他: 全部床義歯の咀嚼機能評価法. 摂取可能食品アンケート, 歯界展望, 72: 1125-1138, 1988. – reference: 4) Borstlap, W. A., et al.: Stabilisation of sagittal split set-back osteotomies with miniplates: a prospective, multicentre study with 2-year follow-up, Int J Oral Maxillofac Surg, 34: 487-494, 2005. – reference: 26) 橋本譲: 節分法による各種咀嚼試験用食品の比較について, 日病誌, 26: 648, 1959. – reference: 33) Yamashita, Y., et al.: Masticatory function and neurosensory disturbance after mandibular correction by bilateral sagittal split ramus osteotomy: a comparison between miniplate and bicortical screw rigid internal fixation, Int J Oral Maxillofac Surg, 36: 118-122, 2007. – reference: 34) Hall, H. D.: 1. Intraoral Surgery. Modern Practice in Orthognathic and Reconstructive Surgery, Saunders Co., Philadelphia, 1992, p2110-2139. – reference: 19) Bell-Krotoski, J., et al.: The repeatability of testing with Semmes-Weinstein monofilaments, Hand Surg, 12A: 155-161, 1987. – reference: 12) Helkimo, M.: Studies on function and dysfunction of the masticatory system. II. Index for anamnestic and clinical dysfunction and occlusal state, Swed Dent J, 67: 101-121, 1974. – reference: 6) Kim, Y. G., et al.: Effect of mandibular setback surgery on occlusal force, J Oral Maxillofac Surg, 55: 121-126, 1997. – reference: 21) 徐完植, 他: 下顎前突症における顎矯正手術後の咀嚼能力の改善に関する研究, 日口診誌, 15: 18-25, 2002. – reference: 13) Helkimo, M.: Studies on function and dysfunction of the masticatory system. III. Analyses of anamnestic and clinical recordings of dysfunction with the aid of indices, Swed Dent J, 67: 165-182, 1974. – reference: 3) Shetty, V., et al.: Functional stability of sagittal split ramus osteotomies: Effects of positional screw size and placement configuration, J Oral Maxillofac Surg, 54: 601-609, 1996. – reference: 17) 高崎義人, 他: 下顎枝矢状分割術後のオトガイ神経知覚検査に関する臨床的研究-第二報知覚障害程度の違いによる回復過程の差について-, 日顎変形誌, 14: 101-110, 2004. – reference: 32) 野村泰慎, 他: レーザー3次元形状計測装置を使った顎矯正手術による顔面形態変化の分析, 口科誌, 47: 408-416, 1998. – reference: 8) 見崎晶, 他: 下顎前突症患者における術前術後の咬合力・咬合接触面積の変化. 咬合感圧シートを用いた術後長期観察, 日口外誌, 47: 545-550, 2001. – reference: 14) Helkimo, M.: Studies on function and dysfunction of the masticatory system. IV. Aged and sex distribution of symptoms of dysfunction of the masticatory system in Lapps in the north of Finland, Acta Odont Scand, 32: 255-267, 1974. – reference: 29) Ochs, M. W.: Bicortical screw stabilization of sagittal split osteotomies, J Oral Maxillofac Surg, 61: 1477-1484, 2003. – reference: 20) Bell, J. A.: Sensibility evaluation. In Rehabilitation of the Hand. First ed., CV Mosby, Saint Louis, 1978, p273-291. – reference: 27) 大塚純正: 顎変形症による咀嚼障害の臨床評価法の開発, 日顎変形誌, 1: 145-147, 1991. – reference: 5) Throckmorton, G. S., et al.: Improvement of maximum occlusal forces after orthognathic surgery, J Oral Maxillofac Surg, 54: 1080-1086, 1996. – reference: 18) Takasaki, Y., et al.: A clinical analysis of the recovery from sensory disturbance after sagittal splitting ramus osteotomy using a Semmes-Weinstein pressure aesthesiometer, Bull Tokyo dent Coll, 39: 189-197, 1998. – reference: 1) Dolce, C., et al.: Skeletal stability after mandibular advancement with rigid versus wire fixation, J Oral Maxillofac Surg, 58: 1219-1227, 2000. – reference: 9) 高嶋はる奈, 他: 下顎枝矢状分割術後の咀嚼機能の変化-術直後から術後1年までの調査-, 日顎変形誌, 9: 157-166, 1999. – reference: 30) 清水真知男, 他: 成人における咀嚼訓練用ガムを用いた咀嚼機能の訓練効果, 岐歯学誌, 25: 51-58, 1998. – reference: 22) 野口信宏, 他: 下顎枝矢状分割術前後における最大開口距離, 咬筋活動性, 顎関節雑音の評価, 日顎変形誌, 8: 222-228, 1998. – reference: 15) 栗田賢一, 他: 顎関節機能障害の検診-第1報簡易検診法について-, 日口外誌, 37: 1499-1505, 1991. – reference: 7) Kobayashi, T., et al.: Masticatory function in patients with mandibular prognathism before and after orthognathic surgery, J Oral Maxillofac Surg, 51: 997-1001, 1993. – reference: 10) Matsui, Y., et al.: Application of a low-adhesive colordeveloping chewing gum system to patients with osseointegrated implant-supported prostheses, Int J Oral Maxillofac Implants, 10: 583-588, 1995. – reference: 11) Helkimo, M.: Studies on function and dysfunction of the masticatory system. I. An epidemiological investigation of symptoms of dysfunction in Lapps in the north of Finland, Proc Finn Dent Soc, 70: 37-49, 1974. – reference: 28) 白石芳, 他: 顎変形症手術の前後における顎関節症状の推移に関する臨床統計的観察, 日顎変形誌, 3: 147-153, 1993. – reference: 31) 坂本一郎, 他: 顎関節症における下顎頭骨形態変化と加齢との関係, 口病誌, 65: 313-318, 1998. – reference: 35) Panula, K., et al.: Incidence of complications and problems related to orthognathic surgery: A review of 655 patients, J Oral Maxillofac Surg, 59: 1128-1136, 2001. – reference: 25) 笹岡邦典, 他: 下顎前突症手術患者の臨床的検討-特に咀嚼能率について-, 北関東医学, 54: 97-104, 2004. – reference: 23) 根岸正志: 骨格性下顎前突症患者の咀嚼筋に関する筋電図学的ならびに組織化学的研究, 日口外誌, 40: 651-663, 1994. – reference: 36) 藤田佳子, 他: 下顎枝矢状分割術後の長期経過例における知覚障害発現率, 日口診誌, 19: 265-272, 2006. |
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| Title | Long-term Observation of Masticatory Function and Neurosensory Disturbance after Mandibular Correction by Bilateral Sagittal Split Ramus Osteotomy |
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