Teses / dissertações sobre o tema "Prognathism"

Orientador: Roger William Fernandes Moreira
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: O posicionamento adequado dos incisivos é um fator primordial para o sucesso do tratamento ortodôntico cirúrgico. A não descompensação dentária limita a quantidade de correção esquelética, levando a um resultado aquém do ideal. Durante o tratamento ortodôntico pré-operatório os dentes anteriores devem ser movimentados com o objetivo de se evidenciar a discrepância esquelética, posicionando os dentes superiores e inferiores nas respectivas bases ósseas. Após o posicionamento adequado deste grupo de dentes o tratamento do paciente portador de deformidade dentofacial poderá atingir resultados estéticos e funcionais desejados com estabilidade e previsibilidade. O posicionamento dos incisivos superiores e inferiores podem ser avaliados com a análise das seguintes medidas cefalométricas: U1-SN, U1-NA (mm), U1-NA (°), L1-NB (mm), L1-NB (°), IMPA e transpasse horizontal. Em vista dos fatos apresentados, o presente estudo teve como objetivo avaliar as alterações de posicionamento dos incisivos superiores e inferiores decorrentes do preparo ortodôntico pré-operatório em pacientes Classe III submetidos à cirurgia ortognática. Foram avaliados de forma retrospectiva 50 prontuários de pacientes operados no HFSE/MS entre 2007 e 2010. Apenas 24 pacientes se encontravam dentro dos critérios de inclusão do trabalho, destes 8 eram do gênero masculino e 16 do gênero feminino. O posicionamento dos incisivos foi avaliado utilizando a análise cefalométrica de McNamara e o software Dolphin Imaging 10.5 (Dolphing Imaging and Management Solutions, Chatsworth CA, EUA) em 2 períodos distintos: T1 - início do tratamento ortodôntico e T2 - pré-operatório. Foram obtidos dados de outras análises (Steiner, Tweed e Wits) e as normas cefalométricas das análises foram classificadas como 100% para efeito de comparação com os resultados obtidos. O transpasse horizontal, o U1-SN, o U1-NA (mm), o U1-NA (°), o L1-NB (mm), o L1-NB (°) e o IMPA apresentaram em T1 e T2 respectivamente: -233,50% (p<0,0001) e -371,00% (p<0,0001); 110,55% (p<0,0001) e 106,32% (p=0,004); 200,00% (p<0,0001) e 162,50% (p=0,004); 144,27% (p<0,0001) e 119,18% (p=0,042); 164,00% (p=0,002) e 195,25% (p<0,0001); 105,92 (p=0,298) e 121,84 (p=0,001); 94,33% (p=0,006) e 98,84 (p=0,544) se comparados com a normas cefalométricas. Após a análise dos resultados encontrados foi possível afirmar que os incisivos superiores não foram adequadamente descompensados e permaneceram vestibularizados antes do procedimento cirúrgico em relação ao U1-SN, U1-NA (mm) e U1-NA (°), os incisivos inferiores foram adequadamente descompensados em relação ao IMPA e o transpasse horizontal foi alterado entre os momentos estudados em -2,75 mm, em média.
Abstract: The correct position of the incisors is basic for the success of the orthognathic treatment. If the incisors are not right positioned, bone correction will be limited. During initial orthodontic treatment, anterior teeth should be moved in way to appear the bone discrepancy, and both lower and upper incisors should be positioned correctly on their basal bone. After these teeth are in the right place, the treatment of the patient with dentofacial deformities will reach the best esthetic and functional results with stability and foreseeability. The position of the upper and lower incisors can be evaluated throw the analysis of the following cephalometric mesurements: U1-SN, U1-NA (mm), U1-NA (°), L1-NB (mm), L1-NB (°), IMPA and the overjet. Based on facts presented, the purpose of this study was to evaluate the changes in position of the upper and lower incisors due to initial orthodontic treatment on patients Class III that were submitted to orthognatic surgery. We evaluated 50 records of patients operated on HFSE/MS between 2007 and 2010. Only 24 patients were suitable for the research, 8 males and 16 females. Incisors position were evaluated using McNamara analysis and Dolphin Imaging 10.5 software (Dolphing Imaging and Management Solutions, Chatsworth CA, EUA) in 2 different periods: T1 - before the orthodontic treatment and T2 - before orthognatic surgery. Results from other analyses were used (Steiner, Tweed and Wits) and the standards norms from these analyses were classified as 100% to compare with the results obtained. The overjet, U1-SN, U1-NA (mm), U1-NA (°), L1-NB (mm), L1-NB (°) and IMPA were in T1 e T2, respectively: -233,50% (p<0,0001) and -371,00% (p<0,0001); 110,55% (p<0,0001) and 106,32% (p=0,004); 200,00% (p<0,0001) and 162,50% (p=0,004); 144,27% (p<0,0001) and 119,18% (p=0,042); 164,00% (p=0,002) and 195,25% (p<0,0001); 105,92 (p=0,298) and 121,84 (p=0,001); 94,33% (p=0,006) and 98,84 (p=0,544) if we compared with standards cephalometric norms. As conclusion, it is possible to state that upper incisors were not in correct position and were proclined before surgery when related to U1-SN, U1-NA (mm) and U1-NA (°), lower incisors were uprighted when related to IMPA and the overjet were changed between T1 and T2 -2,75 mm, in average.
Doutorado
Cirurgia e Traumatologia Buco-Maxilo-Faciais
Doutor em Clínica Odontológica

Mechanical forces, such as mastication, influence morphological characteristics of the cranium. With varying degrees of prognathism found within and between populations, the ability to accommodate masticatory stress may vary, and this will have profound effects on final craniofacial form. The purpose of this research is a two-fold examination of mid-facial prognathism in modern African males. First, an osteometric and morphological examination of specific areas of the cranium involved in the masticatory apparatus was performed, and its relationship with prognathism assessed. Second, finite element analysis (FEA) was used to interpret the distribution of stress during mastication and the contribution of prognathism to this stress distribution. Two diametrically opposed facial forms (prognathic and orthognathic) were modelled to observe variation in displacement, pressure, and Von Mises stress patterns using linear elastic homogenous isotropic material properties. Boundary conditions simulating muscle contraction of the masseter, medial pterygoid, and temporalis were attributed to the models. A vertical compressive bite-force was applied at the left central incisor and the first molar, respectively. With the use of FEA, differences in the pattern and magnitude of Von Mises stress were noted under simulated mastication. The prognathic model consistently experienced more stress for a molar and incisal bite-force than the orthognathic model. More specifically, the prognathic model accommodated for larger areas of Von Mises stress in the regions of the zygomatic arch, nasal aperture, margins of the orbits, and in the inter-orbital area. As individual muscle forces were modeled, the temporalis and medial pterygoid caused the greatest difference in the stress at the articular eminence between the working and balancing sides. These muscles and their forces should be further investigated to understand their role in temporomandibular joint disorders. Several cranial dimensions were shown to increase or decrease with prognathism. The relationship between the gnathic index and facial parameters were statistically significant for nine cranial and seven dental dimensions. The orthognathic group showed a larger inter-orbital dimension with a subsequent decrease in stress in that area. The upper facial index, maxillary molar crown area and the dental arcade shape demonstrated statistically significant shape changes associated with the degree of prognathism. Morphological analysis did not show a significant distribution in browridge expression and robusticity as a means to accommodate masticatory stress. Stress distribution patterns were correlated with osteometric data and showed a significant difference in inter-orbital breadth between the two groups. Mechanical action of mastication may influence prognathic more than orthognatic facial forms. An orthognatic facial form is biomechanically more efficient under masticatory stress. Mechanical loading during mastication greatly influences the morphological patterns of the facial skeleton. Further investigation into patterns of stress is necessary when changes to the masticatory apparatus arises from clinical involvement, trauma, or as a means to avoid or predict failure in the underlying skeletal architectu
Thesis (PhD)--University of Pretoria, 2014.
Anatomy
unrestricted

Orientador: Valfrido Antônio Pereira Filho, Márcio de Moraes
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: A configuração e as dimensões da via aérea superior são determinadas pelas estruturas anatômicas como: tecidos moles, musculatura e esqueleto craniofacial, que compõem ou circundam a faringe. As alterações anatômicas dos tecidos moles e/ou do esqueleto craniofacial poderão tornar a via aérea superior (VAS) mais estreita. Estes pontos são os principais fatores etiológicos de um distúrbio cada vez mais diagnosticado na população brasileira conhecida como síndrome da apnéia e hipoapnéia obstrutiva do sono (SAHOS). A cirurgia ortognática, que é utilizada na correção das deformidades dento-esqueléticas, tem se mostrado como o tratamento mais eficiente nos casos graves de SAHOS. Boa parte dos pacientes portadores da síndrome apresenta deformidade dento-esquelética. A síndrome é mais comum nos pacientes portadores de deformidade do tipo classe II. Pacientes com deformidade dento-esquelética de classe III resultante do prognatismo mandibular e/ou deficiência maxilar apresentam uma diminuição da VAS após a cirurgia ortognática de recuo mandibular, embora seja menos tratada na literatura, não deixando claras as consequências dos recuos mandibulares isolados, bem como das cirurgias combinadas de avanço maxilar e recuo mandibular na via aérea superior a longo prazo. Em vista dos fatos apresentados, o presente estudo teve como objetivo avaliar as alterações da via aérea superior em pacientes com deformidade dento-esquelética classe III submetidos à cirurgia ortognática e se há diferença na resposta da via aérea superior quando comparados os gêneros. Para tanto, foi realizada uma avaliação cefalométrica de 45 pacientes divididos em três grupos: grupo 1- cirurgia bimaxilar (23 pacientes); grupo 2- cirurgia de avanço maxilar (15 pacientes) e grupo 3- cirurgia de recuo mandibular (7 pacientes). Desses 45 pacientes, 25 são do gênero masculino e 20 do gênero feminino. A via aérea superior foi avaliada utilizando a análise cefalométrica de Arnett-Gunson FAB-Surgery e o software Dolphin Imaging 11 (Dolphing Imaging and Management Solutions, Chatsworth CA, EUA) em 3 períodos distintos: T0 - pré-operatório; T1 - pós-operatório de 1 semana e T2 - pós-operatório de no mínimo 1 ano. Nos pacientes submetidos à cirurgia bimaxilar houve alteração da VAS no pós-operatório imediato, porém, a longo prazo, a medida da orofaringe voltou ao valor pré-operatório. No grupo 2 existiu um aumento da VAS que se manteve por longo tempo. Nos pacientes submetidos ao recuo mandibular não houve alterações da VAS. Quando se comparou a VAS entre os gêneros, observou-se que tanto os homens quanto as mulheres apresentaram alteração na região da nasofaringe, porém só as mulheres apresentaram uma alteração significativa na aérea da orofaringe. Como conclusão foi possível afirmar que: nos pacientes submetidos à cirurgia bimaxilar o avanço maxilar compensou as alterações na VAS acarretadas pelo recuo mandibular; os pacientes submetidos à cirurgia de recuo mandibular não apresentaram mudanças na VAS; o grupo submetido ao avanço maxilar apresentou um ganho significativo da VAS que se manteve estável pelo período avaliado e que as mulheres registraram alterações na região da nasofaringe e orofaringe, enquanto os homens somente na região da nasofaringe.
Abstract: The configuration and dimensions of the upper airway are determined by the anatomical structures such as soft tissue, muscles and craniofacial skeleton, which comprise or surround the pharynx. Anatomic abnormalities of the soft tissue and/or the craniofacial skeleton may narrow the upper airway leading to obstructive sleep apnea. Class III patients, after orthognathic surgery frequently show a decrease in upper airway which has been less evaluated in the literature. These points are the main factors influencing a disorder increasingly being diagnoses in our population known as obstructive sleep apnea. Orthognathic surgery that is used in the correction of dento-skeletal deformities has been shown to be the most effective treatment in severe cases of obstructive sleep apnea. Many of the patients with the syndrome have dento-skeletal deformities in various degrees. The syndrome is more common in patients with class II deformity. However patients with class III deformity resulting from mandibular prognathism and/or maxillary deficiency after a mandibular setback orthognathic surgery showed a decrease in upper airway which has been less evaluated in the literature. The influence of not making clear the influenced of isolated mandibular setbacks and bimaxillary surgery on the upper airway lacks long-term evaluation. This study aimed to evaluate the changes of upper airway dimensions in patients with class III dento-skeletal deformity treated with orthognathic surgery and the difference in the response of the upper airway between genders. A cephalometric evaluation of 45 patients was performed. The subjects were divided into three groups: group 1 - bimaxillary surgery (23 patients), group 2 - maxillary advancement surgery (15 patients) and group 3 - mandibular setback surgery (7 patients). Of these 45 patients 25 were males and 20 females. The upper airway was evaluated through the cephalometric analysis of Arnett-Gunson FAB-Surgery and the software Dolphin Imaging 11 (Dolphing Imaging and Management Solutions, Chatsworth CA, EUA) in three distinct periods: T0 - preoperative, T1 - one week postoperative and T2 - at least one year postoperative. In patients undergoing bimaxillary surgery we observed changes in the upper airway in the immediate postoperative period, but long-term measures the oropharynx returned to preoperative values. In maxillary advancement there was an increase in the upper airway that remained long-term. In patients who underwent mandibular setback no changes in the upper airway was observed. When comparing the upper airway between the genders we found that both men and women showed abnormalities in the nasopharynx, but only women showed a significant change in the oropharynx area. As conclusion, it was possible to state that: in patients who underwent bimaxillary surgery the jaw advancement compensated the changes of the upper airway brought about by the mandibular setback, the patients who received mandibular setback surgery showed no changes in the upper airway, and the group submitted to maxillary advancement showed a significant increase of the upper airway and that remained stable for the evaluation period. Women had abnormalities in the nasopharynx and oropharynx while men presented abnormalities only in the nasopharynx.
Mestrado
Cirurgia e Traumatologia Buco-Maxilo-Faciais
Mestre em Clínica Odontológica

Ce travail de thèse porte sur l'intégration des structures craniofaciales au sein de la famille des hominidés. Au cours de l'évolution, une réduction du prognathisme et une diminution de la longueur de la face sont observées chez les taxons appartenant au rameau humaine. Cette réduction des structures faciales est associée à une base du crâne plus fléchie et à une mandibule plus gracile. L'objectif de ce travail est de définir le rôle joué par les changements basicrâniens et mandibulaires dans la mise en place de la face courte et droite des humains modernes. Dans ce contexte, les schémas d'intégration liant la face et les autres structures crâniennes (basicrâne et mandibule) ont été décrits et quantifiés dans ce mémoire. Ce travail a été effectué sur la base d'un échantillon de crânes incluant l'ensemble des genres d'hominidés actuels : les humains modernes, les chimpanzés, les gorilles et les orangs-outans. Les crânes ont été préalablement numérisés à l'aide d'un scanner médical. Les schémas d'intégration craniofaciaux ont alors été étudiés à l'aide d'outils statistiques et de méthodes d'analyses en morphométrie géométrique. Ce travail a permis de mettre en avant plusieurs mécanismes d'intégration craniofaciale, propres aux humains modernes. Ces schémas d'intégration spécifiques permettent d'expliquer en grande partie la mise en place de la face réduite des humains modernes. Ces résultats permettent donc d'éclairer les mécanismes d'évolution et de mise en place des structures faciales chez les hominidés et dans le rameau humain
This thesis dissertation is dedicated to the study of craniofacial structures within the hominid family. Throughout evolution, a reduction of facial prognathism and a diminution of the facial length are observed in the taxa which belong to the human lineage. This reduction of facial structures is associated to a more flexed cranial base and to a shorter mandible. The aim of this work is to define the role played by the basicranial and mandibular changes in the set up of the short and straight face of modern humans. In this context, the patterns of integration linking the face and the other cranial structures (basicranium and mandible) are decrypted and quantified in this thesis dissertation. This work has been done with a sample including all the extant hominid genera: modern humans, chimpanzees, gorillas, orang-utans. The skulls were first scanned using a medical scanner. Patterns of craniofacial integration were then studied using statistical tools and geometric morphometric analysis methods. This work underlined several mechanisms of craniofacial integration, unique to modern humans. These specific patterns of integration can explain an important part of the set up of modern humans reduced face. Thus, these results enlighten the evolution mechanisms and the set up of facial structures in hominids and in the human lineage

Orientador: Fausto Berzin
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: Objetivos: Avaliar os sinais e sintomas das disfunções temporomandibulares, a dor crônica, a depressão, assim como também avaliar a função muscular dos masseteres e do temporal na mastigação habitual. Todas estas variáveis foram analisadas pré e após cinco anos da cirurgia ortognática. Materiais: Foi utilizado o questionário RDC (reseach diagnostic Criteria), para avaliar e classificar o tipo de disfunção temporomandibular (DTM), assim como para observar o grau de dor crônica e depressão (eixo II), para a análise dos sinais e sintomas das DTMs foi utilizado o eixo I do RDC. Na análise do ciclo mastigatório foi utilizado o eletromiógráfo Myosystem I e software Myosystem BRI, versão 2.52 (DataHominis Tecnologia Ltda). Os músculos avaliados foram a parte anterior do temporal e a parte superficial do masseter de ambos os lados. O comportamento muscular foi avaliado em cinco períodos: pré-cirurgia 2-3 meses (T0); Pós-cirurgia 6 meses (T1), 12 meses (T2), 24 meses (T3) e 60 meses (T4). Resultados: A dor crônica e a depressão apresentaram melhoras após 5 anos do tratamento cirúrgico. Em relação às outras variáveis analisadas, observamos, que após 12, 24 e 60 meses da cirurgia, existe um aumento do tempo e do instante máximo da atividade do ciclo mastigatório. O RMS apresenta o sinal eletromiográfico mais estável após cinco anos do tratamento cirúrgico. Conclusão: A cirurgia ortognatica não é tratamento para as disfunções temporomandibulares. O ciclo mastigatório mostra melhoras no sinal eletromiográfico para pacientes prognatas que não apresentem nenhum tipo de disfunção temporo mandibular
Abstract: Objectives : To evaluate the signs and symptoms of temporomandibular disorders , chronic pain , depression , as well as evaluate the muscle function of the masseter and temporal in mastication . All these variables were analyzed before and five years after orthognathic surgery. Materials : RDC ( reseach diagnostic Criteria) questionnaire was used to assess and classify the type of temporomandibular disorders ( TMD ) , as well as to observe the degree of chronic pain and depression ( axis II ) , for the analysis of the signs and symptoms of the TMD axis I RDC was used . In the analysis of the masticatory cycle Myosystem I electromyography and software Myosystem BRI , version 2.52 ( DataHominis Technology Ltd. ) was used . The muscles tested were the anterior part of the temporal and superficial part of the masseter muscle on both sides . Muscle performance was evaluated in five periods : pre - surgery 2-3 months ( T0 ), 6 months post- surgery ( T1 ) , 12 months ( T2 ) , 24 months ( T3 ) and 60 months ( T4 ) . Results: Chronic pain and depression showed improvement after 5 years of surgical treatment . Regarding the other variables , we observe that 12 , 24 and 60 months after surgery , there is an increase in the time and the maximum moment of the masticatory cycle activity. The RMS has the most stable EMG signal after five years of surgical treatment Conclusion : orthognathic surgery is no treatment for temporomandibular disorders . The masticatory cycle shows improvement in electromyographic signal for prognathic patients without any type of temporomandibular disorders
Doutorado
Anatomia
Doutora em Biologia Buco-Dental

In the last 20 years, the production of farmed marine fish species has increased rapidly, mainly as a consequence of improved breeding methods and technologies. Skeletal malformations and others severe production bottlenecks such as high larval mortality or susceptibility to stress and disease, remain to be solved. Skeletal anomalies in farmed fish are a relevant issue affecting animal welfare and health and cause significant economic losses. The constant progress of genomic technologies promises to rapidly increase our knowledge on molecular mechanisms underlying productive traits of economic relevance in farmed species. The main objective of this PhD research was to investigate the molecular basis underlying the mandibular prognathism (MP), a skeletal malformation with a moderate incidence in intensively reared European seabass (Dicentrarchus labrax). To this aim, we applied a 2bRAD (type IIB endonucleases restriction-site associated DNA) pipeline, a widely used NGS (Next Generation Sequencing) technique for genome-wide genotyping. The reliability and reproducibility of the 2bRAD protocol has been preliminary tested on two organisms of veterinary relevance: the yellowfin tuna (Thunnus albacares), a fish with great biological and economic importance at global scale and the Listeria monocytogenes, a pathogenic bacterium that causes the infection listeriosis. In total, 6772 high-quality genome-wide SNPs (Single Nucleotide Polymorphism) were identified for the yellowfin tuna, in across population samples collected from the Atlantic, Indian and Pacific oceans and covering the entire distribution area. Discriminant Analysis of Principal Components (DAPC) endorsed the presence of genetically discrete yellowfin tuna populations among three oceanic pools. These results showed the efficiency of this genotyping technique in assessing genetic divergence in a marine fish with high dispersal potential. A total of 1279 unique SNPs loci were identified for Listeria monocytogenes. This research represents a first example of application of RAD-like technologies in microbial genetics. Results obtained for L. monocytogenes suggest that 2b-RAD is an effective tool for molecular epidemiology and public health, as well as proved in other areas such as phylogenetics, taxonomy, population genetics and biosafety. Once the 2bRAD technique was optimized as described above, a high-density genetic map of European seabass for QTL mapping of jaw deformity was constructed and a genome-wide association study (GWAS) was carried out on a total of 298 juveniles, 148 of which belonged to four full-sib families. A total of 7362 SNP markers was genotyped in more than 80% of the experimental population. Three significant QTLs were detected as significantly associated to MP by applying a half-sib regression analysis. The first QTL was located on linkage group LG18, the second one on LG20 and the third on LG22, each of them explaining 11-13% of the phenotypic variation. Two SNPs associated with MP were identified with GWAS analysis. Candidate markers were located on chromosome ChrX and chromosome Chr17, both in close proximity with the peaks of the two most significant QTLs. Notably, the SNP marker on Chr17 was positioned within the Sobp (Sine Oculis Binding Protein) gene coding region, which plays a pivotal role in craniofacial development. The analysis of differentially expressed genes in jaw-deformed animals highlighted the “nervous system development” as a crucial pathway in MP. In particular, Zic2, a key gene for craniofacial morphogenesis in model species, was significantly down-regulated in MP-affected animals. By integrating transcriptomic and GWA methods, the analysis developed during this PhD study, provides evidence for putative mechanisms underlying seabass jaw deformity.
Negli ultimi 20 anni, l’allevamento di specie ittiche marine ha avuto un rapido incremento, grazie principalmente al continuo sviluppo e miglioramento delle tecniche di produzione. Rimangono comunque ancora da risolvere diversi problemi nei processi di produzione, come ad esempio la presenza di malformazioni scheletriche, l'elevata mortalità delle larve o la suscettibilità allo stress e le malattie. Le anomalie scheletriche nei pesci d'allevamento incidono in maniera rilevante anche sul benessere e la salute degli animali, causando notevoli perdite economiche per gli allevatori. Tuttavia, il costante progresso delle tecniche di biologia molecolare e di genetica hanno permesso di ampliare notevolmente le nostre conoscenze sui meccanismi molecolari alla base di molti caratteri produttivi di rilevanza economica nelle specie allevate. L'obiettivo principale di questo studio è stato quello di indagare le basi genetiche del prognatismo mandibolare (MP), una malformazione scheletrica presente, con una moderata incidenza, negli allevamenti intensivi di branzino (Dicentrarchus labrax). A questo scopo, abbiamo applicato un particolare protocollo di analisi, il 2bRAD (type IIB endonucleases restriction-site associated DNA), ampiamente utilizzato per lo sviluppo di marcatori genetici affiancato a tecniche di sequenziamento massivo NGS (Next Generation Sequencies). L'affidabilità e la riproducibilità del protocollo 2bRAD è stata prima testata su due organismi di una certa rilevanza veterinaria: il tonno pinna gialla (Thunnus albacares), un pesce importante sia dal punto di vista biologico che economico, e la Listeria monocytogenes, un batterio patogeno che può causare la listeriosi. Nel tonno pinna gialla sono stati identificati 6772 marcatori SNP (Single Nucleotide Polymorphism) in popolazioni campionate su tutto l’areale di distribuzione negli Oceani Atlantico, Indiano e Pacifico. L’analisi discriminante delle componenti principali (DAPC) ha permesso di rilevare la presenza di popolazioni distinte di tonno pinna gialla nei tre Oceani. Questi risultati hanno dimostrato quindi l'efficacia del 2bRAD nello studio della divergenza genetica in un pesce marino ad alto potenziale di dispersione. Un totale di 1279 loci SNP sono stati identificati per Listeria monocytogenes, e questo lavoro rappresenta un primo esempio di applicazione di tecnologie “RAD-like” nel campo della genetica microbica. I risultati ottenuti suggeriscono che il 2bRAD potrebbe rivelarsi uno strumento estremamente utile per l'epidemiologia molecolare, così come in altri settori di studio come la filogenesi, la tassonomia, la genetica di popolazione e la salute pubblica. Nel lavoro sul prognatismo mandibolare del branzino, è stata inizialmente sviluppata una mappa di linkage ad alta densità utilizzata per la mappatura dei QTL potenzialmente associati alla patologia; successivamente è stato fatto uno studio di associazione (GWAS) scansionando l’intero genoma di branzino per trovare marcatori SNP putativamente associati al prognatismo. Sono stati utilizzati 298 esemplari giovanili in totale, di cui 148 appartenenti a quattro famiglie full-sib. Un totale di 7362 marcatori SNP sono stati genotipizzati in più del 80% della popolazione sperimentale. Tre QTL significativi sono stati rilevati per il prognatismo utilizzando un’analisi di regressione half-sib. Il primo è stato mappato sul gruppo di linkage LG18, il secondo su LG20 e il terzo sul gruppo di linkage LG22; ogni QTL spiegava circa l’11-13% della variazione fenotipica. Due SNP associati al MP sono stati identificati con l'analisi GWAS. I marcatori candidati sono stati individuati sul cromosoma ChrX e sul cromosoma Chr17, in stretta vicinanza ai due QTL più significativi. In particolare, il marcatore SNP su Chr17 è posizionato all'interno della regione codificante del gene Sobp, che svolge un ruolo fondamentale nello sviluppo craniofacciale. Inoltre, l’analisi dei geni differenzialmente espressi nei branzini prognati ha evidenziato lo “sviluppo del sistema nervoso" come un pathway cruciale nella formazione del MP. In particolare, Zic2, un gene chiave per la morfogenesi craniofacciale nelle specie modello, risulta significativamente sotto-espresso negli animali affetti da prognatismo. Il lavoro svolto in questo studio quindi, integrando la trascrittomica e l’analisi di marcatori molecolari sviluppati sull’intero genoma, fornisce validi risultati per comprendere meglio i meccanismi molecolari che sono alla base dell’insorgenza del prognatismo mandibolare nei branzini di allevamento.

碩士
高雄醫學大學
牙醫學研究所
89
Mandibular prognathism is characterized by excessive mandibular growth, which may compromise the masticatory function and facial appearance, and this may distort the personality of the patient. Surgical correction of mandibular prognathism will generally improve both the masticatory function and dentofacial aesthetics. This study was undertaken to examine the factors that might be responsible for skeletal stability occurring during one to two years postoperative mandibular setback. Forty-four patients, treated for absolute mandibular prognathism by modified intraoral bilateral vertical ramus osteotomy, were evaluated cephalometrically at least 1-year postoperatively. A set of 7 standardized lateral cephalograms were obtained from each subject, i.e., preoperative (T1) and immediately postoperative (T2), prior to removing the maxillomandibular fixation (T3), 3 months (T4), 6 months (T5), 1-year (T6) and 2-years postoperative (T7). There were 20 patients who underwent a 2-year follow-up with cephalograms. The mean setback of the menton was 12.3mm in the horizontal direction and 0.8mm downward in the vertical direction. Relapse was defined as forward movement of the menton during the 2-year postoperative period. The average movement for 1-year follow-up (12 of 20 patients) in the horizontal direction was as follows; 4 with 2.1mm (16% = 2.1/13.1) in forward movement and 8 with 1.6mm (12.4% = 1.6/12.9) in backward movement. The average movement during the 1-year follow-up (12 of 20 patients) in the vertical direction was 7 patients with 1.5mm in upward movement and 8 with 0.7mm in downward movement. The average movement during the 2-year follow-up (20 patients) in the horizontal direction was as follows; 14 with 2mm (16.3% = 2/12.3) in forward movement and 5 with 1.4mm (12.1% = 1.4/11.6) in backward movement. The average movement during the 2-year follow-up (20 patients) in the vertical direction was as follows; 11 patients with 1.7mm in upward movement and 8 with 1.2mm in downward movement. The variables included vertical and horizontal Me (T21) distance, Rp-Cut (distance between osteotomy point and the most posterior point of inferior ramus)(T1), and area of the pterygomasseteric sling (Rp-Cut-H ×V-T1) The multiple regression showed that the vertical amount of setback (T21) that predicated the vertical relapse (T72) was significant, whereas no significant correlations were noted between the variables and horizontal relapse (T72). In patients whose distal segments were still in the backward group 2-years postoperaviely, their osteotomy positions were anterior to the forward group. This tell us: the more anterior osteotomy position the more acceptable capacity of the pterygomasseteric sling will be created and this allow the distal segment to setback more without distend the pterygomasseteric sling. These results suggest that this technique can provide greater acceptable capacity for larger amount of distal segment setback and is feasible for the correction of severe mandibular prognathism. Key Words: Postoperative Stability, Mandibular Prognathism Modified Intraoral Vertical Ramus Osteotomy

碩士
高雄醫學大學
牙醫學研究所
86
Chin cup therapy has been commonly used and widely recognized as a method for correcting malocclusion in the growing prognatic mandible. For the last 20 years, a number of clinical and experimental studies have reported that Chin cup force has several orthopedic effects: (1)redirection of mandible growth; (2)retardation of mandible growth; (3)remodelling of mandible morphology. 　　The purpose of this study was to investigate the bone morphology change or bone remodelling process in ClassⅢ malocclusion subsequent to Chin cup therapy with finite element method analysis. The finite element method analysis has several characters that can overcome some conceptual and technical constraints of customary roentgenographic cephalometric methods. FEM provide invariant descriptions of growth kinematics that are independent of their underlying, causally related, dynamics. Since FEM utilized the principles of continnum mechanics, it (i) describes the kinematics of nodal point growth behavior of any given element mesh and, (ii) provide a field result with interpolation techniques which can not be accomplished with traditiomal approach. The two attributes above suggest that FEM provides quantitative descriptions of both the functional metrices and the skeletal units enclosed within the boundaries of a given finite element mesh. 　　The subjects in this study consisted of 25 growing girls who showed anterior crossbite and Angle Class Ⅲ malocclusion before treatment. All underwent chin cup therapy from, the beginning of treatment. The duration of chin cup therapy varied but average 1.8 years. Eighteen cephalometric points on the mandible were digitized on preteatment and posttreatment lateral cephalograms of patients whose age ranged between 6 to 12 years old. By using 18 of these digitized points, the mandible were discretized into 18 triangular finite elements representing different areas of mandible. Four parameters were used to describe changes of finite elements and compare to the control groups of 18 cases without chin cup treatment. 　　The results were described as: 　　(1)The cephalometric parameters for changes in absolute mandibular length are given by mandibular ramus length and mandibular body length. Both of these values showed decrease in percentage value from the control rate of change during active therapy. 　　(2)In the FEM results, there are two elements of treatment groups on the lower border of mandible, KLM and LMR, showed increase in size ratio (p<0.05). And from the anatomic view, the mandibular body showed decrease in size ratio of treatment groups. 　　(3)In the FEM results, there are several elements of treatment groups,including ABC, CDE, EJK, GMN, ELM, LMR, OQR, OMR elements, showed significant change in form ratio. And from the anatomic view, the chin area showed significant change in form ratio of treatment groups. 　　(4)Pre end post-adolescent period can lead to FEM results different. 　　From these results on comparing the control and therapeutic changes of the mandible, it may be assumed that orthopaedic chin cup force modify normal mandibular growth and closely associate with mandibular remodelling. However, details of the mechanism about the cellular activity inducing bone resorption and deposition are still unclear and hence further investigartion with biomechanical, histological approaches will be needed in future studies.

碩士
國立臺灣大學
臨床牙醫學研究所
96
Purpose The purpose of this retrospective study was to compare post-operative changes and skeletal stability between bilateral saggital split ramus osteotomy (BSSO) and intraoral vertical ramus osteotomy (IVRO) used for mandibular setback. Factors contributing to skeletal instability were also identified. Patients and Methods The study included 48 patients with mandibular prognathism, who underwent mandibular setback surgery at the Department of Oral and Maxillo-facial Surgery, National Taiwan University Hospital (NTUH) from January 2001 to December 2006. Twenty-five of them recieved with rigid internal fixation, the remaining 23 underwent IVRO with intermaxillary fixation. Lateral cephalometric radiographs were taken within 1 month before surgery (T1), immediately after the operation (within 1 week, T2), and at the time of completion of post-op orthodontic treatment (T3). The T1,T2, and T3 radiographs were traced and superimposed with “best-fit” technique and the data were digitalized to analyze the changes at T2-T1 and T3-T2. Mann-Whitney test was used to verify the differences in post-operative changes and long-term skeletal stability between the two groups. And the linear regression model was established to find the contributing factors. Results The mean amount of horizontal setback at pogonion was 6.55 mm in BSSO group and 9.68 mm in IVRO group. The mean amount of vertical movement at menton was 0.99 mm upward in BSSO group and 0.12 mm downward in IVRO group. Long-term observation (T3-T2) showed that the chin moved upward (1.10 mm) and forward (1.48 mm) after BSSO, and moved downward (0.32 mm) and backward (1.19 mm) after IVRO. Significant differences were noted between the two procedures in horizontal skeletal instability at pogonion (T3-T2, p=.002), and vertical skeletal instability at menton (T3-T2, p=.004). In BSSO group, the horizontal soft/hard tissue ratio was 1.06 at B point, 0.88 at pogonion, 1.04 at menton. And the vertical soft/hard tissue ratio was 0.97 at B point, 1.00 at pogonion, 0.57 at menton. In IVRO group, the horizontal soft/hard tissue ratio was 1.03 at B point, 0.88 at pogonion, 1.01 at menton. And the vertical soft/hard tissue ratio was 0.91 at B point, 1.00 at pogonion, 2.07 at menton. No significant difference was found in the soft/hard tissue ratio. In BSSO group, the significant predictor for the horizontal skeletal instability was age and rotation of condylar axis. For vertical skeletal instability, it was significantly correlated to change of mandibular plane angle. In IVRO group, the significant predictors for horizontal skeletal instability were gender, openbite, and jaw deviation. And vertical skeletal instability was significantly correlated to age, amount of horizontal setback, grade of openbite, and follow-up period. Discussion The patterns of post-operative instability are significantly different between BSSO and IVRO. The key factors contributing to this difference was considered be the change in condylar axis and the application of RIF or IMF. In BSSO, the tooth-bearing segment was rigidly fixed with the bilateral condylar segments. Therefore, the chin moves upward and forward as the condylar axis rotates counter-clockwise post-operatively. But in IVRO, osseous remodeling takes place at the osteotomy site. The chin may not move while the condylar axis rotates counter-clockwise post-operatively. Moreover, the application of IMF will lead to an increase of lower facial height. Thus, the chin moves downward and backward after the surgery.

碩士
長庚大學
顱顏口腔醫學研究所
95
Purpose: The purpose of this study were to evaluate the difference in the surgical changes and post-surgical changes between bi-cortical osteosynthesis (BCO) and mono-cortical osteosynthesis (MCO) in the correction of skeletal class III malocclusion with bilateral sagittal split osteotomy (BSSO) in three dimension (frontal and lateral views). Materials and methods: Fifty-seven patients who underwent BSSO to setback the mandible with complete lateral and postero-anterior cephalometric radiographs, taken at the timings of before surgery, one week after surgery, and at least 6 months post-operatively (mean, 9.9 months). Of these patients, 25 patients were in BCO group, and 32 patients were in MCO group. The cephalograms were traced and measured to determine the surgical and post-surgical changes. T-test was performed to see the difference between BCO and MCO, and correlation analyses were performed to evaluate the factors related to the sagittal, vertical, and transverse changes of the mandible. Results: The sagittal relapse rate was 20.4% in BCO group and 24.8% in MCO group. There were no significant differences in sagittal and vertical changes between BCO and MCO during surgery and in post-surgical period. However, the inter-gonial width of BCO group was increased more than that of MCO group in surgical and overall changes. Conclusions: The study suggested that both methods of skeletal fixation had similar post-operative stability by 9.9 months. The choice of skeletal fixation technique therefore depends on the preference of the individual operator. The difference of transverse (width) change of mandible between two fixation methods should be concerned.

碩士
長庚大學
顱顏口腔醫學研究所
104
Background/Purpose: The purpose of this study was to determine the position of the mandibular canal in relation to the buccal cortical bone in Chinese patients with the three dentofacial relationships: normal dentition, retrognathism, and prognathism. Methods: Cone-beam computed tomography and lateral cephalograms of patients with normal dentation, retrognathism, and prognathism (n = 32 each group) were reviewed. Measurements of the shortest distance from the outer/buccal edge of the mandibular canal to the inner surface of the buccal cortex, and the distance from the lingula of the ramus to the distal root of the first molar were recorded. One-way ANOVA was performed to compare the three groups. Results: No significant difference was observed between the three groups in the distribution of contact or fusion of the mandibular canal, or in the course of the mandibular canal on the right or left side. When the shortest distance at the lingula on the left side was > 2.1 mm, no instances of contact or fusion were observed. On the right side, 100% of the patients had no contact or fusion when the shortest distance was > 2.7 mm at the lingual. The mandibular canal was nearest the cortical bone at the point halfway between the lingula and the anterior ramus border. Conclusions: The shortest distance from the outer/buccal edge of the mandibular canal to the inner surface of the buccal cortex, measured at the lingual, can predict contact or fusion. During sagittal split ramus osteotomy, surgeons should be very careful at the point halfway between the lingula and the anterior ramus border where the mandibular canal is nearest the cortical bone.

Introdução: A maloclusão Classe III de Angle caracteriza-se por uma alteração intermaxilar manifestada por um posicionamento mais anterior da mandíbula em relação à maxila e causada pelo crescimento anormal de uma ou ambos os maxilares. Pode ser devido a modificações esqueléticas e dentoalveolares que são representadas por retrognatia maxilar, prognatismo mandibular ou uma combinação de ambos. Objetivo: Contribuir para um maior conhecimento da malocclusão Classe III assim como uma melhor compreensão dos seus factores etiológicos e dos seus vários tratamentos. Metodologia: Realizou-se uma pesquisa bibliográfica, recorrendo à base de dados PubMed e Elsivier, com os termos “mandibular prognathism”, “Class III maloclusion” e o operador boleano AND com os termos : “Etiology”, “Orthodontic treatment”, “genetica” e “mastigatory muscles”, publicados nos últimos 50 anos. Conclusão: A etiologia da Classe III é multifactorial devido a influências genéticas, físicas ou ambientais. O conhecimento destes factores permite uma melhor compreensão da maloclusão e o estabelecimento precoce dos tratamentos que promovem a recuperação em pessoas com maloclusão de Classe III. A presença dos diferentes tratamentos, que já mostraram a sua eficácia ou que apareceram recentemente, mostra que a abordagem da maloclusão de Classe III está em constante evolução.
Introduction: Angle Class III malocclusion is characterized by an intermaxillary change manifested by a more anterior positioning of the mandible relative to the maxilla and caused by abnormal growth of one or both maxillae. It can be due to skeletal and dentoalveolar changes that are represented by maxillary retrognathia, mandibular prognathism or a combination of both. Objective: Contribute to a greater knowledge of Class III malocclusion as well as a better understanding of its etiological factors and its various treatments. Methodology: A literature search was conducted using the PubMed and Elsivier databases for human and animals studies, with the terms "mandibular prognathism", "Class III malocclusion" combined using the Boolean term AND with the terms: "Etiology", "Orthodontic treatment", "genetics" and "masticatory muscles". published in the last 50 years. Conclusion: The etiology of Class III is multifactorial due to genetic, physical or environmental influences. Knowledge of these factors allows a better understanding of malocclusion and the early establishment of treatments that promote recovery in people with Class III malocclusion. The presence of the various treatments, which have already shown their efficacy or have appeared recently, shows that the approach to Class III malocclusion is in constant evolution.

碩士
高雄醫學大學
牙醫學研究所
89
Mandibular prognathism due to excessive growth of mandible, varies in facial characteristics and incidences amoung the different ethnic proups. People who are seeking management of mandibular prognathism are usually disturbed by prominent lower third of the face, poor chewing function and psychological factors. In Taiwan, the high incidences and more severely dentofacial deformity in mandibular prognathism was noted and the problem could only be solved by combined orthodontic treatment and surgery. The purpose of this study was to investigate the changes in gonial region and the factors contributing to skeletal stability in mandibular prognathism treated by modified intraoral vertical ramus osteotomy. Thirty-two patients( 9 males and 23 females ), treated for absolute mandibular prognathism by modified intraoral vertical ramus osteotomy, were evaluated cephalometrically at least two-years postoperatively. A set of three standardized lateral cephalograms were obtained from each subject, i.e., preoperative (A), immediately postoperative (B1) and two-years postoperatively (B6). Some cephalometric landmarks were used for evaluating the positional and angular change postoperatively. The results showed that (1). In stability, during the postoperative period, the Me moved forward with 1.9mm in 22 patients( group I ) whose mean setback of Me was 13.96mm, and the relapse was 13.61%. In other group, the Me moved backward with 2.46mm in 10 patients( group II ) whose mean setback of Me was 11.31mm, and the backward instability rate was 21.75%( 2.46/11.31). (2). The Go moved backward with 1.35mm and upward with 1.90mm in group I, the gonial angle increased for 3.69°, and angle between palatal plane and mandibular plane was increased for 5.00°; In group II, the Go moved backward with 1.85mm and upward with 3.32mm , the gonial angle increased for 4.06°, and angle between palatal plane and mandibular plane was increased for 5.22°. Both in group I and II, there was a tread for clockwise rotation of mandibular corpus. The length of pterygomasseteric sling was mild increased due to the backward movement of Go. (3). The displacement of condylar process( forward or backward ) didn’t influence the stability, but the condyle could not return to its original position completely. The position of condyle may be controlled by bone remodeling. (4). The results of multiple regression showed that the postoperative stability was only correlated with amount of mandibular setback, and rotation of mandibualr corpus and amount of displacement of condyle could not influence the stability. The amount of Go backward movement depends on two factors, one is the position of osteotomy site in distal segment, and the other is the position of osteotomy site in distal segment immediately postoperative. The more horizontal distance between Go and osteotomy site, the less tread of posterior movement of Go postoperatively. When the distal segment setback to ideal position of occlusion and the osteotomy site was behind to Go, the more distance between osteotomy site and Go, the more tread of posterior movement of Go postoperatively. But when the osteotomy site was before to Go, we found that the horizontal position of Go postoperatively was unchanged nearly. The pterygomasseteric sling could be lengthened and distorted under the limitation and it has potential to recover the original length and position if the stretch was larger then the upper limitation. In our study, there was no relationship between the stability and positional change of Go postoperatively. But in group II, we found the distance between the Rp and osteotomy site was larger then amount of mandibular setback. We suspected that the backward movement of Me was caused by loosening the pterygomasseteric sling or other else. It needs more study cases for further examination.

Uma das questões centrais da ortodontia moderna é: como as descobertas na área da genética afetarão diretamente conceitos e abordagens no tratamento ortodôntico e de que forma os fatores genómicos e epigenéticos podem ser manipulados e introduzidos no tratamento individual de cada paciente. O objetivo deste trabalho é demonstrar a importância da genética na previsão do crescimento mandibular. Esta dissertação é de índole teórica, estando desta forma isenta de qualquer tipo de trabalho prático experimental. Trata-se de uma revisão sistemática de trabalhos que estudaram o tema. A ortodontia baseada no genoma usa a informação genética para melhorar o diagnóstico e tratamento de distúrbios dentários e deformidades dentofaciais. Nos últimos 20 anos houve uma convergência de princípios e conceitos entre a genética e a ortodontia que levará a um avanço significativo dos tratamentos ortodonticos, contudo a sua aplicação prática não será imediata.
The central question in orthodontics in this millennium is: how discoveries in the field of genetics will directly affect concepts and approaches in orthodontic treatment and how genomic and epigenetic factors can be manipulated and introduced into the individual treatment of each patient. The aim of this study is to demonstrate the importance of genetics in the prediction of mandibular growth. This dissertation is of a theoretical nature, being thus exempt of any type of practical experimental work. This is a systematic review of papers that have studied the theme. Genome based orthodontics uses genetic information to improve the diagnosis and treatment of dental disorders and dentofacial deformities. In the last 20 years there has been a convergence of principles and concepts between genetics and orthodontics that will lead to a significant advance in orthodontic treatments, however, its practical application will not be immediate.

碩士
長庚大學
機械工程研究所
92
The aims of the project was useing Computer Aided Surgery (CAS) and 3C/3R (CAD, CAE, CAM / RE, RP, RT ) technology applied to surgical operation dormain. This study will be proceeded by dividing into two parts, the first part was 『The Stability Analysis and In Vitro Experiment of Various Screw Rigid Intraoral Fixation for Bilateral Sagittal Split Osteotomy of Mandibular Prognathism』；the second part was 『Measuring Fixator Design for Long Bone Corrective Osteotomy』. In the first part of this study, a high proportion of normal population have been observed to have malocclusion and 5 to 10 % of them are mandibular prognathism in Taiwan. Orthognathic surgery with bilateral sagittal split osteotomy (BSSO) and setback is the treatment of choice. Rigid Intraoral Fixation (RIF) is applied using screws in different numbers and locations. This study employs techniques of finite element (FE) method and CAD system to evaluate the stability of the Rigid Intraoral Fixation methods. Computed tomography (CT) data were obtained from patients with prognathism. The data were reconstructed to display 3-dimensional imaging. A computer model was created using the morphometric characteristics of the osseous tissue, i.e., cortical vs. cancellous bone. Bilateral sagittal split osteotomy on the imaging model was performed simulating realistic operating procedure according to the planning. Six types of fixation methods for the osseous segments were applied using two to three screws on different locations avoiding injury to the inferior alveolar nerve. Detailed stress distribution of screws and alveolar bone were calculated in FE package (ANSYS). The von Mises stress values on and surrounding the screws were the least among the methods when three screws were inserted in a triangular shape across the inferior alveolar nerve. When the screws were aligned in linear setting, the stress values were 4 times higher, implying a significantly elevated loading onto the screws. A triangular shape of the screw position across the nerve presented less stress loading than the linear configuration, and hence providing better stability as the preferred fixation method for bilateral split osteotomy of the mandible. In the second part of this study, treatment for bone deformities secondary to malunited fractures usually require corrective osteotomies, and high incidence of surgical failure rates have been reported. Inaccurate corrections and loss of reductions are among the most common causes, and these technical errors ought to be improved. A new measuring fixator for humeral supracondylar corrective osteotomies in children were designed and used in clinical application. Several surgical trials were performed in vitro using rapid prototype models to simulate different bony deformities. Two patient who had sustained cubitus varus following malunited humeral supracondylar fracture were performed using proposed measuring fixtor. The results of the clinical trial showed the angle of correction was accurated, and the procedure could be carried out by the surgeon himself without additional help, with an average of 1.3 penetration of the physis per each fixating Kirschner wire ( 8 times in 6 K-wire ). The surgical time was reduced, as well as the radiation exposure.

碩士
長庚大學
顱顏口腔醫學研究所
101
Abstract Purpose: The purpose of this study was to assess alterations in three-dimensional (3D) position of condyles evaluated by cone-beam computed tomography (CBCT) images in the patients receiving LeFort I osteotomy and bilateral sagittal split mandibular osteotomy (BSSO). Subjects and Methods: CBCT scans were taken from 25 patients (12 male, 13 female, mean age= 20.9±3.53 years ) one week before and one month after orthognathic surgery. They were skeletal Class III malocclusion and underwent LeFort I osteotomy and BSSO. The CBCT images were standardized in the same head position and were measured the angles and distances of the condyles to surrounding anatomy structures. The Student paired t test was used to evaluate the difference of condylar position after the surgery. The preorperative and postoperative symptoms of temporomandible joint (TMJ) were also recorded. Results: In the axial view The right condyle went inward by 0.18±0.21mm and rotated inward by 1.11±1.0°. The left condyle went outward by 0.87±0.29mm and rotated outward by 0.75±0.86°. The intercondylar distance increased by 0.7±0.39mm. But, significant difference was only found in outward displacement of left condyle. In the sagittal view The right condyle went backward by 0.54±0.31mm and rotated backward by 3.58±0.81°. The left condyle went backward by 0.6±0.27mm and rotated backward by 3.66±1.15°. But, significant difference was found in backward displacement of left condyle and backward rotation of both condyles. In the coronal view The right condyle went inward by 0.43±0.43mm, and rotated inward by 2.85±0.66°. The left condyle went inward by0.14± 0.58mm and rotated inward by 1.76±0.76°. The intercondylar distance decreased by 0.3±0.97mm. But, significant difference was found in inward rotation of both condyles. Symptoms of TMJ were not found preoperatively and postoperatively. Conclusion: After surgery: In the axial view, the left condyle significantly went outward by 0.87±0.29mm. In the sagittal view, the right condyle significantly rotated backward by 3.58±0.81°. The left condyle went backward by 0.6±0.27mm and rotated backward by 3.66±1.15°. In coronal view, right and left condyles significantly rotated inward by 1.76±0.76° and 2.85±0.66°, respectively. In our study, the positional change of condyle occurred after surgery. Patient did not complain of TMJ symptoms before and after surgery. The changes of condylar position were within the range of self-adaptation.