下顎枝矢状分割ネジ止め固定法における下顎枝外側骨片の位置復元法の開発

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Sagittal split osteotomy of ascending ramus is a well-founded method to correct mandibular protrusion. But it requires intramaxillary fixation for 6-8 weeks as in other operation methods. The use of compression screw or ceramic screw fixation shortens the period of intramaxillary immobilization and prevents relapse. On the other hand there are some problems in screw fixation techniques. The greatest problem is the displacement of the mandibular condyle, because it is difficult to reposition the external fragment of the ascending ramus after splitting. A new repositioning technique of the external fragment of the ascending ramus has been used in 9 cases of ceramic screw fixation in sagittal split osteotomy in our department. The characteristics of this technique are as follows; 1. A cortical bone incision of internal surface and anterior border of the ascending ramus and buccal side of the mandibular corpus is made. In order to fix the position of the ascending ramus, Champy's mini-plate is attached between an acrylic resin plate set on the maxillary wire splint and the external anterior border of the ascending ramus. 2. Removal of Champy's mini-plate and intramaxillary fixation. 3. Sagittal splitting of the ascending ramus. 4. Intramaxillary fixation and Champy's mini-plate is applied again. This procedure leads to correct condyle positioning. 5. Ceramic screws are inserted percutaneously through a trocar to fix the fragments in the sagittal split osteotomy. 6. Removal of Champy's mini-plate and suture of cutaneous and oral mucosal wounds.
社団法人日本口腔外科学会の論文

下顎枝矢状分割ネジ止め固定法における下顎枝外側骨片の位置復元法の開発

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