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Raphael Olszewski - One of the best experts on this subject based on the ideXlab platform.

  • preoperative intraoperative and postoperative complications in Orthognathic Surgery a systematic review
    Clinical Oral Investigations, 2015
    Co-Authors: Marcin Jedrzejewski, Tomasz Smektala, Katarzyna Sporniaktutak, Raphael Olszewski
    Abstract:

    Objectives The aim of this study was to determine whether Orthognathic Surgery is associated with any complications, and what type of complications may occur.

  • towards an integrated system for planning and assisting maxillofacial Orthognathic Surgery
    Computer Methods and Programs in Biomedicine, 2008
    Co-Authors: Raphael Olszewski, Marta Becker Villamil, Daniela Trevisan, Luciana Nedel, Carla M D S Freitas, Herve Reychler, Benoit Macq
    Abstract:

    Computer-assisted maxillofacial Orthognathic Surgery is an emerging and interdisciplinary field linking Orthognathic Surgery, remote signal engineering and three-dimensional (3D) medical imaging. Most of the computational solutions already developed make use of different specialized systems which introduce difficulties both in the information transfer from one stage to the others and in the use of such systems by surgeons. Trying to address such issue, in this work we present a common computer-based system that integrates proposed modules for planning and assisting the maxillofacial Surgery. With that we propose to replace the current standard Orthognathic preoperative planning, and to bring information from a virtual planning to the real operative field. The system prototype, including three-dimensional cephalometric analysis, static and dynamic virtual Orthognathic planning, and mixed reality transfer of information to the operation room, is described and the first results obtained are presented.

Jesse A Taylor - One of the best experts on this subject based on the ideXlab platform.

  • influence of repaired cleft lip and palate on layperson perception following Orthognathic Surgery
    Plastic and Reconstructive Surgery, 2018
    Co-Authors: Lawrence O Lin, Rosaline S Zhang, Daniel M Mazzaferro, Ian C Hoppe, Rebecca L Pearl, Jordan W Swanson, Scott P Bartlett, Jesse A Taylor
    Abstract:

    BACKGROUND Facial scarring and disharmony caused by clefting are associated with psychosocial stress, which may be improved by Orthognathic Surgery. The authors examine how clefting influences change in layperson perception of a patient following Orthognathic Surgery. METHODS One thousand laypersons were recruited through Mechanical Turk to evaluate patient photographs before and after Orthognathic Surgery. Nineteen patients-five with unilateral and five with bilateral clefting-were included. Respondents assessed six personality traits, six emotional expressions, and likelihood of seven interpersonal experiences on a scale from 1 to 7. RESULTS Changes in all aspects of social perception after the procedure differed significantly between cleft versus noncleft cohorts (p < 0.01 for all). Respondents evaluated the change for the cleft cohort compared with the noncleft cohort as more trustworthy, friendly, sad, and afraid; more likely to feel lonely, be teased or bullied by others, or feel anxious around others; less angry, disgusted, threatening, dominant, intelligent, happy, and attractive; and less likely to have romantic relationships, friends, or be praised by others. For unilateral versus bilateral cleft cohorts, change in social perception was significantly different in four of the 19 items (p < 0.05 for all). Social perception change for the unilateral cohort was less surprised, sad, dominant, or happy compared with the bilateral cohort (p < 0.05 for all). CONCLUSIONS Despite significant improvements in social perception following Orthognathic Surgery, cleft patients benefit less than noncleft patients. These findings may be useful to counsel postsurgical expectations for cleft patients undergoing Orthognathic Surgery.

  • current concepts in Orthognathic Surgery
    Plastic and Reconstructive Surgery, 2018
    Co-Authors: Sanjay Naran, Derek M Steinbacher, Jesse A Taylor
    Abstract:

    Learning Objectives:After studying this article, the participant should be able to: 1. Identify skeletal differences that are treated with Orthognathic Surgery; describe the goals of Orthognathic Surgery; and understand modern virtual surgical planning of Orthognathic movement of the mandible, maxil

  • Orthognathic Surgery has a significant effect on perceived personality traits and emotional expressions
    Plastic and Reconstructive Surgery, 2017
    Co-Authors: Daniel M Mazzaferro, Rebecca L Pearl, Scott P Bartlett, Sanjay Naran, Ari M Wes, Jesse A Taylor
    Abstract:

    BACKGROUND The effects of Orthognathic Surgery go beyond objective cephalometric correction of facial and dental disproportion and malocclusion, respectively. The authors hypothesized that there is tangible improvement following Surgery that alters publicly perceived personality traits and emotions. METHODS The authors used Amazon.com's Mechanical Turk (MTurk), a crowdsourcing tool, to determine how preoperative and postoperative images of Orthognathic Surgery patients were perceived on six personality traits and six emotional expressions based on posteroanterior and lateral photographs. Blinded respondents provided demographic information and were randomly assigned to one of two sets of 20 photographs (10 subjects before and after Surgery). RESULTS Data on 20 Orthognathic Surgery patients were collected from 476 individuals. The majority of participants were female (52.6 percent), 18 to 39 years old (67.9 percent), Caucasian (76.6 percent), had some college or technical training or graduated college (72.7 percent), and had an annual income between $20,000 and $99,999 (74.6 percent). A paired t test analysis found that subjects were perceived significantly more favorably after Orthognathic Surgery in 12 countenance categories: more dominant, trustworthy, friendly, intelligent, attractive, and happy; and also less threatening, angry, surprised, sad, afraid, and disgusted (p < 0.05). Raters with the highest annual income perceived a greater magnitude of dominance after Surgery than those earning less (p < 0.001). CONCLUSIONS There is significant improvement in the countenance of patients after Orthognathic Surgery, with both perceived personality traits and emotions deemed more favorable. Additional work is needed to better understand the physiologic underpinnings of such findings. Crowdsourcing technology offers a unique opportunity for surgeons to gather data regarding laypeople's perceptions of surgical outcomes in areas such as Orthognathic Surgery.

Mark M Urata - One of the best experts on this subject based on the ideXlab platform.

  • orthodontic considerations for cleft Orthognathic Surgery
    Oral and Maxillofacial Surgery Clinics of North America, 2020
    Co-Authors: Stephen L K Yen, Jeffrey A Hammoudeh, Sean P Edwards, Mark M Urata
    Abstract:

    Preparation and planning for Orthognathic Surgery in late adolescence depends on the complexity of unresolved problems with which the patient presents. Different strategies are presented to address these unresolved problems in the adult patient with cleft lip and palate. Different surgical and orthodontic treatments are presented to correct the class III malocclusion in patients with cleft lip and palate in ranges that are analogous to the envelope of discrepancy. For complex cases, the principles of achievability, stability, and esthetics should guide the decision-making process for planning the preparation for Orthognathic Surgery.

  • current status of surgical planning for Orthognathic Surgery traditional methods versus 3d surgical planning
    Plastic and reconstructive surgery. Global open, 2015
    Co-Authors: Jeffrey A Hammoudeh, Lori K Howell, Shadi Boutros, Michelle A Scott, Mark M Urata
    Abstract:

    Orthognathic Surgery requires precise evaluation of complex dentofacial deformities of the craniofacial skeleton. The success of the surgical plan is not only dependent on the accuracy of the skeletal and dental diagnosis of the deformity but also is unequivocally dependent on presurgical prediction of the proposed jaw movements. It is the task of the surgeon to first define the original position of the dentofacial skeleton and then to estimate the desired final position and finally to develop a 3-dimensional representation of the movements necessary to accomplish the intended goal.1 Traditionally, this has involved detailed preoperative clinical examination, standard facial photography, cephalometric radiographs with tracings, dental impressions, and articulator-mounted models. The end goal of all of these steps is to develop a representative blueprint of the current relationship of the maxilla/mandible and the associated dentofacial skeletal dysplasia. That relationship then is used to facilitate model Surgery to determine the feasibility of the proposed jaw movements and to subsequently directly fabricate surgical guide splints which are critical for the accurate intraoperative positioning of the maxilla and/or mandible. This traditional analytical model Surgery integrates the quantitative data and allows transfer of the anticipated 3D movements directly to the patient to facilitate the intraoperative position of the maxilla and/or the mandible.2 This technique has stood the test of time and has allowed for accurate and reproducible surgical correction of the dentofacial skeleton. This technique, however, requires an extensive process of analytical and radiographic analysis, dental model fabrication and splint preparation which require an extensive time commitment, and a firm grasp of dental materials and has the potential to have inaccuracies amplified during the algorithmic process. The advent of virtual surgical planning (VSP) has recently called into question the efficacy and accuracy of traditional analytical model Surgery. Maxillofacial Surgery as a discipline was not an organized specialty until the latter half of the 20th century requiring particularly trained surgeons with masterful knowledge of both anatomy and surgical techniques to accomplish successful bony reconstruction.3 Orthognathic Surgery in patients with dentofacial abnormalities is an original field within maxillofacial Surgery. Modern practices within this particular field have undergone evolutionary development and refinement since its derivation by the first teachers in the early 1900s. The historic development traces its roots back to 1906 when the first Surgery to correct at prognathic mandible was performed on a Washington University medical student by plastic Surgery pioneer Vilray Blair.4 This ushered in decades of jaw Surgery eclipsed by Obwegeser’s introduction of the sagittal split osteotomy in the 1950s and Bell’s research on the vascularization of the upper jaw leading to the safe downfracture of the maxilla in a LeFort I osteotomy.5 In present-day Orthognathic Surgery, the spectrum of surgical intervention ranges from simple single-jaw and double-jaw Surgery to complex cleft craniomaxillofacial Orthognathic Surgery. Albeit more than 20 years ago and likely an underestimation, a survey performed in 1990 estimated that the current number of people in the United States benefiting from Orthognathic Surgery was more than 1.5 million.6 With the likelihood of craniomaxillofacial surgeons facing a growing number of patients requiring Orthognathic Surgery, it is imperative for the clinician to have a sound understanding of dental facial proportions, development of the craniofacial skeleton, orthodontic preparation for surgical intervention requiring a collaborative team approach with the patient’s orthodontist, and the ability to plan and execute single- and double-jaw Surgery. Throughout the last 100 years, the field has undergone significant refinement and development as it relates to technique modification, innovation as it relates to rigid fixation, and recent technological advancements in presurgical planning and splint fabrication. Any discussion surrounding Orthognathic Surgery in present-day medicine now includes the argument of traditional model Surgery versus VSP. In review of recent literature, one can identify a number of articles defining and celebrating the use of computer-aided design/computer-aided manufacturing (CAD/CAM) in development of surgical planning for the treatment of complex craniomaxillofacial deformities.3,7–12 In addition to the gaining popularity of VSP within Orthognathic Surgery, a series of recent investigations performed at multiple institutions have confirmed the accuracy of this technique.10 As VSP is proving both highly accurate and efficient, the future of traditional model Surgery comes into question. It is our objective in this article to (1) define both traditional model Surgery and VSP and (2) determine the accuracy and relevance of the 2 methods.

Yuray Chen - One of the best experts on this subject based on the ideXlab platform.

  • orthodontic principles and guidelines for the Surgery first approach to Orthognathic Surgery
    International Journal of Oral and Maxillofacial Surgery, 2015
    Co-Authors: Chiungshing Huang, Yuray Chen
    Abstract:

    The Surgery-first approach has become a new paradigm in Orthognathic Surgery. With the Surgery-first approach, most of the patient's teeth are in their original positions and have not undergone orthodontic treatment prior to the patient undergoing Orthognathic Surgery. A 'treatable' malocclusion should be attained following Orthognathic Surgery. Orthodontists must ensure that they can manage the 'treatable' malocclusion by actively participating in the patient's surgical plan. Therefore, orthodontic principles and guidelines must be established. Three-dimensional computed tomography should be used to construct the midfacial plane and then to assess discrepancies in the midfacial structures as well as yaw and roll of the bilateral facial structures. Orthognathic Surgery should be performed to improve the alignment of such discrepancies to attain a skeletal class I relationship and to attain an aesthetically pleasing face. The Surgery-first approach uses osteotomy to solve most of the skeletal and dental problems and to simplify postoperative orthodontic treatment by providing a treatable malocclusion for which mostly only anteroposterior orthodontic movement is required, with minimal transverse or vertical orthodontic movements. Numerous studies have documented the efficacy and long-term stability. Patients undergoing the Surgery-first approach benefit from an immediate improvement in facial aesthetics, oral function, and self-confidence, with a shorter total treatment period.

  • systematic review of the Surgery first approach in Orthognathic Surgery
    Biomedical journal, 2014
    Co-Authors: Chiungshing Huang, Sam Shengpin Hsu, Yuray Chen
    Abstract:

    The Surgery-first approach in Orthognathic Surgery has recently created a broader interest in completely eliminating time-consuming preoperative orthodontic treatment. Available evidence on the Surgery-first approach should be appraised to support its use in Orthognathic Surgery. A MEDLINE search using the keywords "Surgery first" and "Orthognathic Surgery" was conducted to select studies using the Surgery-first approach. We also manually searched the reference list of the selected keywords to include articles not selected by the MEDLINE search. The search identified 18 articles related to the Surgery-first approach. There was no randomized controlled clinical trial. Four papers were excluded as the content was only personal opinion or basic scientific research. Three studies were retrospective cohort studies in nature. The other 11 studies were case reports. For skeletal Class III surgical correction, the final long-term outcomes for maxillofacial and dental relationship were not significantly different between the Surgery-first approach and the orthodontics-first approach in transverse (e.g., intercanine or intermolar width) dimension, vertical (e.g., anterior open bite, lower anterior facial height) dimension, and sagittal (e.g., anterior-posterior position of pogonion and lower incisors) dimension. Total treatment duration was substantially shorter in cases of Surgery-first approach use. In conclusion, most published studies related to the Surgery-first approach were mainly on Orthognathic correction of skeletal Class III malocclusion. Both the Surgery-first approach and orthodontics-first approach had similar long-term outcomes in dentofacial relationship. However, the Surgery-first approach had shorter treatment time.

  • Surgery first accelerated Orthognathic Surgery postoperative rapid orthodontic tooth movement
    Journal of Oral and Maxillofacial Surgery, 2011
    Co-Authors: Eric J.w. Liou, P K T Chen, Yuchih Wang, Chiungshing Huang, Yuray Chen
    Abstract:

    Purpose Clinically, we have observed the phenomenon of postoperatively accelerated orthodontic tooth movement in patients who had Orthognathic Surgery. This phenomenon lasts for a period of 3 to 4 months. However, the underlying mechanisms of this phenomenon have not been well studied yet. The purpose of this prospective clinical pilot study was to study the postoperative changes in bone physiology and metabolism and the corresponding responses in the dentoalveolus, such as the changes in tooth mobility. Materials and Methods Twenty-two consecutive adult patients who had 2-jaw Orthognathic Surgery were included in this study. The levels of serum alkaline phosphatase and C-terminal telopeptide of type I collagen (ICTP), as well as the tooth mobility of the maxillary and mandibular incisors based on the Periotest method (Siemens AG, Bensheim, Germany), were examined preoperatively and 1 week, 1 month, 2 months, 3 months, and 4 months postoperatively. The data were analyzed statistically. Results Both tooth mobility of the maxillary and mandibular incisors and ICTP significantly increased from 1 week to 3 months postoperatively and then decreased to their preoperative levels in the fourth month postoperatively. The changes in tooth mobility were significantly in correspondence with the changes in ICTP. The alkaline phosphatase level significantly increased from the first to fourth month postoperatively, but it was not significantly correlated to the changes in tooth mobility. Conclusion The Orthognathic Surgery triggers a 3- to 4-month period of higher osteoclastic activities and metabolic changes in the dentoalveolus postoperatively, which possibly accelerates postoperative orthodontic tooth movement.

Marcin Jedrzejewski - One of the best experts on this subject based on the ideXlab platform.