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MessagePosté le: Jeu 27 Oct - 03:10 (2016)    Sujet du message: Bilateral Sagittal Split Osteotomy Pdf Download Répondre en citant




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Bilateral Sagittal Split Osteotomy Pdf Download, nitro pdf reader free download for windows 7 32 bit


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Cases requiring large advancements, patients with poor soft tissue envelopes, and skeletally immature mandibles are better addressed with mandibular distraction osteogenesis.2 The bilateral sagittal split osteotomy is an indispensable surgical procedure for the correction of mandibular deformities. HistoryThe history of orthognathic surgery of the mandible started with Hullihen in 1846, who performed an osteotomy of the mandibular body for the correction of prognathism.3 There was little further innovation until that of Blair in the early 1900s, who performed a horizontal osteotomy of the ramus.4 The 1920s and 1930s saw further modifications by Limberg, Wassmund, and Kazanjian of external approaches to ramal osteotomies.5 All of these had difficulties with relapse. For the surgeon, the analysis must be clinically workable, simple to use, and directly relatable to the skeletal elements that can be repositioned. Surgical movements of the maxilla and mandible inherently alter the maxillary-mandibular dental occlusion, and as such, careful analysis of the dental models with the orthodontist is essential. It is important that this cut is made completely through the cortical bone along the inferior border.

Although the analysis is invaluable, it is inappropriate to focus the treatment plan solely on correcting cephalometric abnormalities. A V-shaper retractor is then placed along the external oblique ridge and all attachments to the anterior ramus are released as superior onto the coronoid as possible. It is the most commonly performed procedure for mandibular advancement and can also be utilized for a mandibular setback of small to moderate magnitude. TreatmentThere are several determinants of the optimal modification for BSSO in an individual patient, including the position of the mandibular foramen (lingual), course of the inferior alveolar nerve in the mandible, presence of the mandibular third molars, and planned direction and magnitude of distal segment movement. The incidence of hypomobility after a BSSO has declined with the use of rigid fixation, as prolonged periods of maxillomandibular fixation are not necessary. Once the pedicle is adequately protected, a channel retractor is inserted to provide lateral retraction, a Kocher is placed to provide superior retraction, and a reciprocating saw is placed medial to the ascending ramus, superior to the lingula and parallel to the occlusal plane. Numerous cephalometric analyses exist, each emphasizing particular skeletal and dental elements. Part of Springer Nature..

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