Rotation of the maxillomandibular complex in orthognathic surgery: A review
AbstractIntroduction: In orthognathic surgery, maxillomandibular complex (MMC) refers to a three-dimensional dento-osseous structure consisting of the surgically-mobilized part of the maxillatogether with the distal segment (i.e., tooth bearing segment) of the mandible (either surgically mobilized or not). In fact, MMC is the skeletal part of the lower face. The size, shape and position of MMC play a major role in soft tissue esthetics of the lower face. Materials and Methods: A comprehensive review of the current data regarding effects of maxillomandibular complex rotation in sagittal plane, on “occlusal plane, TMJ, sleep apnea, paranasal soft tissues, upper lip, chin, cervicomental soft tissues” was conducted. Results: MMC rotation and translation could take place in any of the three planes of reference including sagittal, coronal, and horizontal. Any kind of changes in the position of MMC could have its own functional and esthetic consequences. In general, patients with convex facial profiles require counter clockwise rotation while patients with concave profiles require clockwise rotation. Conclusion: MMC not only has great impacts on facial esthetics, but also has significant functional effects, for example in breathing and mastication. Alteration in the position of MMC is possible by orthognathic surgery. Keywords: Maxillomandibular complex (MMC); Orthognathic surgery; Consequences of maxillomandibularcomplex rotation.
2. Reyneke JP, Bryant RS, Suuronen R, Becker PJ. Postoperative skeletal stability following clockwise and counter-clockwise rotation of the maxillomandibular complex compared to conventional orthognathic treatment. British Journal of Oral and Maxillofacial Surgery. 2007 Jan 1; 45(1):56-64.
3. Reyneke JP. Rotation the maxillomandibular complex: an alternative surgical design in orthognathic surgery [academic dissertation]. Tampere, Finland: University of Tampere, Institute of Regenerative Medicine. 2006. Figure 15a, b; p.27.
4. Wolford LM, Chemello PD, Hilliard F. Occlusal plane alteration in orthognathic surgery—Part I: Effects on function and esthetics. American Journal of Orthodontics and Dentofacial Orthopedics. 1994 Sep 1; 106(3):304-16.
5. Chemello PD, Wolford LM, Buschang PH. Occlusal plane alteration in orthognathic surgery–part II: long-term stability of results. American Journal of Orthodontics and Dentofacial Orthopedics. 1994 Oct 1; 106(4):434-40.
6. Lee SW, Cho J, Kim K, Ahn SH. Frontal changes in the lower face after clockwise rotation of the maxillomandibular complex without perisurgical orthodontic treatment in angle class I and skeletal class III women. Aesthetic plastic surgery. 2017 Jun 1; 41(3):641-9.
7. Downs WB. Analysis of the dento-facial profile. Angle Orthod 1956; 26:191-212.
8. Cottrell DA, et al. Condylar change after upward and forward rotation of the maxillomandibular complex. American journal of orthodontics and dentofacial orthopedics. 1997 Feb 1; 111(2):156-62.
9. de Sousa Miranda W, et al. Three-dimensional evaluation of superior airway space after orthognathic surgery with counterclockwise rotation and advancement of the maxillomandibular complex in Class II patients. Oral surgery, oral medicine, oral pathology and oral radiology. 2015 Oct 1; 120(4):453-8.
10. Choi JW, Park YJ, Lee CY. Posterior pharyngeal airway in clockwise rotation of maxillomandibular complex using surgery-first orthognathic approach. Plastic and Reconstructive Surgery Global Open. 2015 Aug; 3(8).
11. Reyneke JP. Rotation the maxillomandibular complex: an alternative surgical design in orthognathic surgery [academic dissertation]. Tampere, Finland: University of Tampere, Institute of Regenerative Medicine. 2006.
12. Reyneke, J. P. (2016). Rotation of the Maxillomandibular Complex. In Orthognathic Surgery (Eds F. B. Naini and D. S. Gill). doi:10.1002/9781119004370.ch31.
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