Arpornmaeklong P, Heggie A A
Prince of Songkla University Hospital, Thailand.
Aust Orthod J. 2000 Jul;16(2):69-81.
A retrospective cephalometric study was performed to investigate the stability of 37 non-growing anterior open-bite cases using mini-plate rigid fixation. The sample was divided into two groups: Group A: maxillary repositioning alone (17 cases) and Group B: bimaxillary surgery (20 cases). Tracings were performed pre-operatively (T1), immediately post-operatively (T2) and at a minimum of one year follow-up (T3) (12-90 months). In Group A, the maxilla was advanced (3.8 +/- 2.8 mm, p < 0.01) and superiorly repositioned at PNS (2.8 +/- 2.3 mm, p < 0.001). In Group B, the maxilla was advanced (3.5 +/- 3.0 mm, p < 0.01) and superiorly repositioned at PNS (3.7 +/- 1.8 mm, p < 0.001); and the mandible (11.7 +/- 3.8 mm, p < 0.001), with no significant change in the vertical plane (p > 0.05). Late relapse due to condylar remodelling or resorption was found as a cause of large horizontal relapse (8.0 < x < 14.0 mm) in three cases (15%), the amount being associated with the amount of operative advancement (r = 0.7, r-sq = 40%, p < 0.01). It was concluded that the correction of anterior open bite by posterior repositioning of the maxilla using rigid fixation is a stable procedure during the follow-up period, and that in bimaxillary cases, post-operative stability depends largely on the stability of the mandibular advancement, which in turn relates to the amounts of advancement, the pre-operative anterior open bite and the mandibular plane angle.
进行了一项回顾性头影测量研究,以调查37例使用微型钢板坚固内固定的非生长型前牙开(牙合)病例的稳定性。样本分为两组:A组:单纯上颌骨复位(17例)和B组:双颌手术(20例)。在术前(T1)、术后即刻(T2)以及至少1年随访(T3)(12 - 90个月)时进行描记。A组中,上颌骨向前移动(3.8±2.8mm,p<0.01),在翼腭凹处向上重新定位(2.8±2.3mm,p<0.001)。B组中,上颌骨向前移动(3.5±3.0mm,p<0.01),在翼腭凹处向上重新定位(3.7±1.8mm,p<0.001);下颌骨向前移动(11.7±3.8mm,p<0.001),垂直平面无显著变化(p>0.05)。发现髁突重塑或吸收导致的晚期复发是3例(15%)水平向大复发(8.0<x<14.0mm)的原因,复发量与手术前移量相关(r = 0.7,r² = 40%,p<0.01)。研究得出结论,使用坚固内固定通过上颌骨后移矫正前牙开(牙合)在随访期是一种稳定的方法,在双颌手术病例中,术后稳定性很大程度上取决于下颌前移的稳定性,而这又与前移量、术前前牙开(牙合)及下颌平面角有关。