Mandibular prognathism is one of the most concerning subjects in the oral and maxillofacial fields. In our previous studies, we attempted to clarify the etiology of mandibular prognathism. They revealed that one of the major characteristics of mandibular prognathism was the lower volume/length ratio of the mandibular condyle and body compared to normal, and the masseter muscle showed parallelism with this. This study aimed to evaluate the relationship between mandibular prognathism and the lateral pterygoid muscle by measuring the orientation and volume/length ratio of the lateral pterygoid muscle. Computed tomography was used to calculate the volume/length ratio of the lateral pterygoid muscle in 60 Korean individuals. Mimics 10.0 and Maya version 2018 were used to reconstruct the surface area and surface planes. The results showed that the prognathic group showed smaller lateral pterygoid volume/length ratios compared to the normal group (p < 0.05). In addition, the normal group displayed a larger horizontal angle (p < 0.05) to the mandibular and palatal planes than the prognathic group. This demonstrated that the mechanical drawback of the lateral pterygoid in the prognathic group is associated with mandibular prognathism.
The mini-screw is widely used in orthodontic treatment for anchorage reinforcement. In mild skeletal Class III patient, retraction of mandibular dentition using mini-screw has been accepted as a reliable and stable treatment approach. In addition, the mini-screw placed in the retromolar area could be used for the uprighting of the lower molar. However, the placement of the mini-screw on the retromolar trigone or anterior ramus region need to be careful because of the possible risk of the “slippage” or “displacement”. Once the mini-screw is displaced to the fascial space such as pterygomandibular space, sub- mandibular space or lateral pharyngeal space, it is difficult to remove. In this case report, we present a mini-screw removal case via an intraoral approach that was displaced into the pterygomandibular space while placing the orthodontic mini-screw on the anterior margin of mandibular ramus.
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