Marine Anquetil1, Jacques Mercier2, Sophie Leveau3, Sarah Mrabet4, Thomas Durand5, Jean-Michel Salagnac6, Jean-Philippe Perrin7, Pierre Corre8, Hélios Bertin9. 1. Service de chirurgie Maxillo-faciale et stomatologie, CHU de Nantes, 1 place Alexis Ricordeau, 44093, Nantes Cedex 1, France. Electronic address: marine.anquetil@chu-nantes.fr. 2. Service de chirurgie Maxillo-faciale et stomatologie, CHU de Nantes, 1 place Alexis Ricordeau, 44093, Nantes Cedex 1, France. Electronic address: jacques.mercier@chu-nantes.fr. 3. Chirurgie Maxillo-faciale et stomatologie, clinique Jules Verne, 2-4 route de Paris, 44300, Nantes, France. Electronic address: sophie.leveau@mla.fr. 4. Service de chirurgie Maxillo-faciale et stomatologie, CHU de Nantes, 1 place Alexis Ricordeau, 44093, Nantes Cedex 1, France. Electronic address: mrabetsarra08@gmail.com. 5. Service de chirurgie Maxillo-faciale et stomatologie, CHU de Nantes, 1 place Alexis Ricordeau, 44093, Nantes Cedex 1, France. Electronic address: durand.ortho@yahoo.fr. 6. Service de chirurgie Maxillo-faciale et stomatologie, CHU de Nantes, 1 place Alexis Ricordeau, 44093, Nantes Cedex 1, France. Electronic address: jean-michel.salagnac@orange.fr. 7. Service de chirurgie Maxillo-faciale et stomatologie, CHU de Nantes, 1 place Alexis Ricordeau, 44093, Nantes Cedex 1, France. Electronic address: jeanphilippe.perrin@chu-nantes.fr. 8. Service de chirurgie Maxillo-faciale et stomatologie, CHU de Nantes, 1 place Alexis Ricordeau, 44093, Nantes Cedex 1, France; Laboratoire d'Ingénierie Ostéo-Articulaire et Dentaire (LIOAD), Faculté de Chirurgie Dentaire, 1 Place Alexis Ricordeau, 44042, Nantes, France. Electronic address: pierre.corre@chu-nantes.fr. 9. Service de chirurgie Maxillo-faciale et stomatologie, CHU de Nantes, 1 place Alexis Ricordeau, 44093, Nantes Cedex 1, France; Laboratoire des sarcomes osseux et remodelage des tissus calcifiés (PhyOs, UMR 1238), Faculté de médecine, 1 rue Gaston Veil, 44035, Nantes cedex, France. Electronic address: helios.bertin@chu-nantes.fr.
Abstract
PURPOSE: Unilateral posterior vertical insufficiency (PVI) is a growth defect of the mandibular condyle that results in a facial asymmetry. Various surgical procedures can be used to elongate the hypoplastic ramus. The aim of this study was to evaluate long-term aesthetic and architectural outcomes of vertical ramus osteotomy (VRO) in patients with unilateral PVI. MATERIALS AND METHODS: Patients operated on with unilateral VRO were included in this retrospective study. Aesthetic and architectural parameters were evaluated on frontal photographs as well as on frontal and lateral cephalograms preoperatively, postoperatively, at 1-year and at the end of the follow-up. RESULTS: A total of 48 patients were analyzed. The aesthetic assessment revealed significant correction of the chin deviation (CD) and of the lip commissural line tilt after VRO (p1 = 0.0038 and p2 = 0.0067, respectively) with stable results. The architectural analysis revealed significant improvement in the maxillary and mandibular occlusal planes, as well as the chin deviation (p < 0.0001). A tendency to relapse was noted for the mandibular canting and the CD during the follow-up. VRO allowed for a mean mandibular lengthening of 8.39 mm (ranging from 2.5 to 14 mm). CONCLUSION: VRO allows for immediate restoration of the symmetry of the lower third of the face in patients with unilateral PVI. A revisional procedure may be needed due to a tendency for the chin deviation to relapse.
PURPOSE: Unilateral posterior vertical insufficiency (PVI) is a growth defect of the mandibular condyle that results in a facial asymmetry. Various surgical procedures can be used to elongate the hypoplastic ramus. The aim of this study was to evaluate long-term aesthetic and architectural outcomes of vertical ramus osteotomy (VRO) in patients with unilateral PVI. MATERIALS AND METHODS:Patients operated on with unilateral VRO were included in this retrospective study. Aesthetic and architectural parameters were evaluated on frontal photographs as well as on frontal and lateral cephalograms preoperatively, postoperatively, at 1-year and at the end of the follow-up. RESULTS: A total of 48 patients were analyzed. The aesthetic assessment revealed significant correction of the chin deviation (CD) and of the lip commissural line tilt after VRO (p1 = 0.0038 and p2 = 0.0067, respectively) with stable results. The architectural analysis revealed significant improvement in the maxillary and mandibular occlusal planes, as well as the chin deviation (p < 0.0001). A tendency to relapse was noted for the mandibular canting and the CD during the follow-up. VRO allowed for a mean mandibular lengthening of 8.39 mm (ranging from 2.5 to 14 mm). CONCLUSION:VRO allows for immediate restoration of the symmetry of the lower third of the face in patients with unilateral PVI. A revisional procedure may be needed due to a tendency for the chin deviation to relapse.
Authors: Kamil Nelke; Klaudiusz Łuczak; Maciej Janeczek; Edyta Pasicka; Monika Morawska-Kochman; Maciej Guziński; Maciej Dobrzyński Journal: Int J Environ Res Public Health Date: 2022-08-13 Impact factor: 4.614