A Clinical Study Of Orthognathic Surgery For Mandibular Protrusion

Objective: To investigate the clinical outcome and prognosis of the Orthognathic Surgery for mandibular protrusion patients. In oder to find the best treatment method of this kind of deformity, to study the factors of the relapse and to conclude the clinical experience, and summarized the introperative as well as postoperative cautions.Method: Twenty-three patients with mandibular protrusion underwent Orthognathic Surgery were retrospectively reviewed, in the department of oral and maxillary surgery, 1st affiliated hospital, medical school of Zhejiang University from March 1999 to January 2008. All patients did cephalometric before the operation,made night guard by model surgery ,performed the same Orthognathic Surgery. Clinical data was obtained from different ways, such as the reference of clinical records, telephone follow-up and recheck information.1. The gender, age and the deformity type, and complications postoperatively were achieved by looking up the illness record.2. Consulting the overall view , cephalometric and the pictures of the patients before the operation ,one month after operation and one year after operation. Statistics preoperative and postoperative changes in soft and hard tissue.3. Sending investigative questionnaire to the patients after the mandibular protrusion operation through out-patient review or e-mails, learning social and psychological implications of the patients, as well as satisfaction with treatment effect.Results: Twenty-three cases were followed up, the cephalometric statistical data of 1 month and 1 year after operation showed no obvious significant difference.All of patients had good mandibular shape.No case of recurrence, and no case of TMD,but one patient showed the lower lip numbness because of injury of inferior alveolar nerve during the operation.90% of patients were satisfied with their appearance after operation.Conclusion:1.Through observing the clinical practices and cases review, and contrasting different treatment methods by literature review, we believe that sagittal split ramus osteotomy through oral approach road provides a large area of bone contact surface, healed quickly,had low relapse rate and could effectively prevent postoperative complications.2. After more than three years follow-up, Bilateral sagittal split ramus osteotomy with the rigid internal fixation, accompanied by regularity and in time pre - and post -operational orthodontic therapy,it will have better effect and stability.3.The orthognatic surgery not only corrected the facial malformation and abnormal occlusion,but also has active ,far-reaching significance on the patient' spirit and mental status.The significance on the spirit and mental status is far more superior than the operation itself.