Latar Belakang: Deviasi atau ketidakseimbangan proporsi fasial serta hubungan gigigeligi yang menggangu fungsi, estetika dan profil wajah. Bedah ortognatik bertujuan memperbaiki ketidakharmonisan dan estetika wajah bekerjasama dengan perawatan ortodonti. Sagital split osteotomy merupakan reposisi segmen mandibula yang dilakukansecara bilateral. Perubahan posisi kondilus mandibula serta stabilitas skeletal pada pasien BSSO mempengaruhi asimetri kondilus mandibula yang dikaitkan dengan adanya resiko terjadinya TMD.Tujuan: Mengetahui perbedaan kondilus mandibula pada pasien pra bedah dan pasca bedah BSSO di Divisi Bedah Mulut dan Maksilofasial RSCM, Jakarta dengan perhitungan indeks simetri dan asimetri kondilus mandibula. Material dan Metode: Penelitian retrospektif melalui radiografik panoramik pra bedah, pasca bedah dan 1 tahun pasca bedah BSSO prosedur setback mandibula di Divisi Bedah Mulut danMaksillofasial, RSCM, Januari 2001 hingga Desember 2017 sesuai kriteria inklusi dan eksklusi dan didapatkan 16 sampel. Setiap sampel dilakukan pengukuran pada radiografi panoramiknya dengan menggunakan teknik Habets dan teknik Kjellberg.Hasil Penelitian: Haasil uji Repeated ANOVA, didapatkan hasil kemaknaan p = 0.389 maka p>0.05 pada indeks asimetri Habets pada saat pra bedah, pasca bedah dan 1 tahun pasca bedah,. Sedangkan uji Repeated ANOVA kelompok indeks simetri Kjellberg, didapatkan hasil kemaknaan p = 0.297 maka p>0.05 pada indeks asimetri Kjellberg pada saat pra bedah, pasca bedah dan 1 tahun pasca bedah.Kesimpulan: Hasil penelitian indeks asimetri Habets dan indeks simetri Kjellberg menunjukkan tidak ada perbedaan signifikan pada hasil pengukuran simetri dan asimetri mandibula. Orientasi kodilus terhadap fossa glenoid dan manuver posisi kondilus merupakan langkah terpenting yang harus dilakukan dalam BSSO.sehingga tujuan pokokBSSO yaitu perbaikan fungsi, estetik dan stabilitas dapat tercapai.
Background: Deviations or imbalances in facial proportions and occlusions that interfere with facial function, aesthetics and profile. Orthognathic surgery aims to correct the disharmony and facial aesthetics in collaboration with orthodontic treatment. Sagittal splitosteotomy is repositioning of the bilateral mandible segment. Changes in mandibular condyle position and bone stability in BSSO affect mandibular condyle asymmetry related to TMD risk.Objective: To determine the differences in mandibular condyle in pre-surgical and postBSSO patients in the Oral and Maxillofacial Surgery Division, RSCM, by calculating the symmetry index and asymmetry of the mandibular condyle.Materials and Methods: Retrospective studies through preoperative, postoperative and 1 year post-BSSO mandibular setback procedures panoramic radiographs in the Oral and Maxillofacial Surgery Division, RSCM, January 2001 to December 2017 according to inclusion and exclusion criteria and obtained 16 samples. Each sample was measured on its panoramic radiography using the Habets technique and the Kjellberg technique.Result: The results of repeated ANOVA test obtained significance p = 0.389 then p> 0.05 in the Habet asymmetry index during pre-surgery, post-surgery and 1 year post-surgery. Whereas the Repeated ANOVA test from the Kjellberg symmetry index group, the result of significance was p = 0.297, then p> 0.05 on the Kjellberg asymmetry index during presurgery, post-surgery and 1 year post-surgery.Conclusion: The results of the Habets asymmetry index and the Kjellberg symmetry index showed no significant differences in the results of measurements of mandibular symmetry and asymmetry. Condyle orientation to the glenoid fossa and condyle position maneuver are the most important steps that must be done in BSSO. So that the main objectives of BSSO are improvement of function, aesthetics and stability can be achieved. |
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