Long-term clinical and radiographic stability of anterior maxillary setback using biodegradable Inion plates for osteosynthesis

Stability of Anterior Maxillary Osteotomy Using Microplates

“…Through this study the gray scale level increased gradually through the post operative periods and it was similar to that of perioperative at the third and 6th month indicating normal bone healing ,IMAGE J software used to measure the gray scale according to the study of Aditya et al [14] because it is accurate friendly use soft ware All the patients through this study were satisfied,SNA angle was reduced from 87,4 to 80.6 and this was similar to the study of Essa, E and. Elshall [5] also nasaolabial angle increased from 87,8 to 106.8 and this is within the normal range of this angle according to the study of Park and Hwang [15] . where anterior maxillary osteotomy in their study on 30 patients lead to change of nasolabial angle from 94.9 to 109.03 , also the overjet throught this study decreased fom10.48mm to 1,86mm and this lead to more improvement in aesthetics also over bite decreased from 5,6 to 1,2 also the vertical distance from anterior nasal spine was reduced from53.56 to 42.84 and this significant decrease in vertical dimension not only due to set up of the premaxilla but also due to modification iof the anterior nasal spine ,and this leads to decreased gum showing mall this finding was in accordance to the study of Venkategowda et al [16] and Garvill [17] .…”

“…Anterior maxillary osteotomy is an effective method for management of maxillary excess while posterior occlusion is optimum [5] Anterior maxillary osteotomy can be done using Wassmund technique [6] where labial and palatal mucosa left intact, while the alveolar bone osteotomy approached through vertical incison at the region of 1st premolar on both sides while labial bone osteotomy completed through tunneling of labial mucosa also palatal bone osteotomy is done through tunneling of the palatal mucosa with aid of midpalatal sagittal incision ,also anterior maxillary osteotomy can be done through transverse palatal incision and the blood supply is maintained by labial flap according to Wunderer technique [7] also the anterior maxillary osteotomy can be done using CUPAR [4] where circumvestibular incision is done to expose the labial bone where bone ostetomized 5 mm above the dental apices and the palatal bone ostetomized through the vertical osteotomy on the premolar region through this study CUPAR approach was used due to ease of bone osteotomy with good exposure and saving time according to the study of Gupta et al [2] through this study the postoperative events as oedema ,pain ,tissue healing passed smoothly without complication and this can be explained by conservative and minimal mucoperiostium dissection required to apply the microplates that have small size and need only little bone drilling , this finding is in accordance to the study of Panthagada and Saripalli [8] also intraoperative and postoperative stability was noted through this study and this is evedinced by stable angular and linear measurements used throught this study in all postoperative follow up periods and this stable results can be explained by three dimensional stability provided by easily adaptable microplates also there is no muscular force or tension in anterior maxillary segments ,, also the anterior bite force between upper and lower anterior teeth is less than molar bite force as stated in the literature [9,10] Microplate had an aesthetic effect due to low thickness profile and showed the least palpability in addition to decreased radiographic scattering on computerozed tomography [11,12] Through this study only three angular and four vertical and horizontal cephalometric measurements were used to evaluate the stability of anterior maxillary segment to facilitate the study and make its message more obvious, SNA angle used to evaluate the skeletal stability, nasolabial angle was used to evaluate soft tissue changes and interincisal angle to evaluate dental stability also horizontal and vertical dimensions for the point A, ANS, were used to evaluate stability of bone segment, while the vertical and horizontal measurements from UI points and overbite and overjet were used to evaluate dental stability, Digimizer soft ware was used through this study for orthodontic evaluation because it is an accurate and valuable software according to the study of Salvarzi et al [13] ,…”