ObjectivesIn three-dimensional computed tomography (3D-CT), the cant is evaluated by measuring the distance between the reference plane (or line) and the tooth. The purpose of this study was to determine the horizontal skeletal reference plane that showed the greatest correlation with clinical evaluation.Materials and MethodsThe subjects were 15 patients who closed their eyes during the CT image taking process. The menton points of all patients deviated by more than 3 mm. In the first evaluation, clinical cant was measured. The distance from the inner canthus to the ipsilateral canine tip and the distance from the eyelid to the ipsilateral first molar were obtained. The distance between the left and right sides was also measured. In the second evaluation, skeletal cant was measured. Six reference planes and one line were used for the evaluation of occlusal cant: 1) FH plane R: Or.R - Or.L - Po.R; 2) FH plane L: Or.R - Or.L - Po.L; 3) F. Ovale plane R: Rt.F.Ovale - Lt.F.Ovale - Or.R; 4) F. Ovale plane L: Rt.F.Ovale - Lt.F.Ovale - Or.L; 5) FZS plane R: Rt.FZS - Lt.FZS - Po.R; 6) FZS plane R: Rt.FZS - Lt.FZS - Po.L, and; 7) FZS line: Rt.FZS - Lt.FZS.ResultsThe clinical and skeletal cants were compared using linear regression analysis. The FH plane R, FH plane L, and FZS line showed the highest correlation (P<0.05).ConclusionThe FH plane R and FH plane L are the most appropriate horizontal reference plane in evaluation of occlusal cant on 3D-CT.
BackgroundBimaxillary orthognathic surgery with maxillomandibular setback is often accompanied by changes in airway space. We analyzed the changes in airway space before and after surgery and assessed their association with obstructive sleep apnea.MethodsThis study is based on the cohort of 13 adult patients (9 males, 4 females, average age 23.85 years) who underwent bimaxillary orthognathic surgery with maxillomandibular setback.We performed computed tomography and portable polysomnography before and after the surgery to assess changes in airway space and Apnea-Hypopnea Index (AHI) values (total, supine, non-supine).ResultsThe oropharyngeal airway volume decreased by 29% after the surgery, which was statistically significant (p < .05). The upper airway volume and hypopharyngeal airway volume were decreased, but not significantly (4 and 19%, respectively). The changes in airway surface area were statistically significant at all levels examined (p < .05). Changes in the maximum anteroposterior width of the airway were also significant at all levels (p < .05). However, the changes in maximum lateral width were only statistically significant at C2 level (p < .05). AHI values were increased after the surgery but not significantly at any position.ConclusionsAlthough bimaxillary surgery with maxillomandibular setback significantly reduces the airway space, it does not affect AHI values or induce obstructive sleep apnea.
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