Proffit W R, Bailey L J, Phillips C, Turvey T A
Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill 27599-7450, USA.
Angle Orthod. 2000 Apr;70(2):112-7. doi: 10.1043/0003-3219(2000)070<0112:LTSOSO>2.0.CO;2.
Skeletal changes greater than those observed in untreated adults have been noted beyond 1 year post-surgery in adult patients who had surgical correction of a long face deformity. The stability of skeletal landmarks and dental relationships from 1 to >3 years post-surgery was examined in 28 patients who had undergone surgery of the maxilla only, and in 26 patients who had undergone 2-jaw surgery to correct >2 mm anterior open bite. Although the average changes in almost all landmark positions and skeletal dimensions were less than 1 mm, point B moved down >2 mm and face height increased >2 mm in one-third of the maxilla-only group and in 40% of the 2-jaw group (>4 mm in 10% and 22% respectively). Overbite decreased 2-4 mm in only 7% of the maxilla-only and 12% of the 2 groups, with no changes >4 mm, because in three-fourths of the patients with an increase in anterior face height, further eruption of the incisors maintained the overbite relationship. In the maxilla-only group, mandibular length (Co-Pg) showed >2 mm long-term change in 45% of the patients, two-thirds of whom showed an increase rather than a decrease in length. In the 2-jaw group, no patients showed a decrease in Co-Pg length and one-third had an increase. For both groups, changes in overjet were smaller and less frequent than changes in mandibular length.
在接受长脸畸形手术矫正的成年患者中，术后1年以上出现的骨骼变化比未治疗的成年人更为明显。对28例仅接受上颌手术的患者和26例接受双颌手术以矫正超过2mm前牙开牙合的患者，研究了术后1至3年以上骨骼标志点和牙关系的稳定性。尽管几乎所有标志点位置和骨骼尺寸的平均变化小于1mm，但仅上颌组三分之一的患者和双颌组40%的患者（分别有10%和22%的患者变化超过4mm）中，B点向下移动超过2mm，面高增加超过2mm。仅上颌组7%的患者和两组中12%的患者覆牙合减少2 - 4mm，没有超过4mm的变化，因为四分之三的患者前面部高度增加，切牙的进一步萌出维持了覆牙合关系。在仅上颌组中，45%的患者下颌长度（Co - Pg）出现超过2mm的长期变化，其中三分之二的患者长度增加而非减少。在双颌组中，没有患者Co - Pg长度减少，三分之一的患者长度增加。对于两组，覆盖的变化比下颌长度的变化更小且更不频繁。
