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Connective tissue forces from mandibular advancement

E Ellis1, D P Sinn

  • 1Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, Dallas 75235-9109.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|November 1, 1994
PubMed
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Surgical mandibular advancement generates significant connective tissue forces, which are substantially reduced by periosteal stripping. Understanding these forces is crucial for optimizing surgical outcomes in mandibular lengthening procedures.

Area of Science:

  • Oral and Maxillofacial Surgery
  • Orthodontics
  • Biomechanical Engineering

Background:

  • Mandibular lengthening procedures, such as sagittal ramus osteotomy, are common in treating dentofacial deformities.
  • Connective tissues surrounding the mandible can exert forces that influence surgical outcomes.
  • Quantifying these forces is essential for predicting and managing treatment results.

Purpose of the Study:

  • To measure the forces generated by connective tissues during surgical mandibular advancement.
  • To assess the impact of periosteal and connective tissue stripping on these forces.

Main Methods:

  • Sixty-three patients undergoing mandibular advancement via sagittal ramus osteotomy were studied.
  • Force measurements were taken before and after stripping perimandibular tissues.

Related Experiment Videos

  • A spring gauge measured the force required to achieve a Class I incisor relationship.

    • Main Results:

    • Preoperative overjet averaged 6 mm.
    • Mean force decreased from 1,498 g before stripping to 787 g after stripping (P < .001).
    • Significant correlations were found between overjet and force levels, and between pre- and post-stripping forces.

    Conclusions:

    • Perimandibular connective tissues generate significant orthopedic forces after mandibular advancement.
    • Periosteal stripping effectively reduces these forces.
    • Further research is needed to evaluate the effect of these forces on the temporomandibular joint.