Choi You-Sung, Yun Kyoung-In, Kim Seong-Gon
Department of Oral and Maxillofacial Surgery, Inje University, Seoul, Korea.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002 Feb;93(2):132-7. doi: 10.1067/moe.2002.121201.
The purpose of this study was to compare the long-term results of the condylotomy techniques.
Twenty-two patients (mean age, 20.8 years; occlusion: Class I in Angle's classification of malocclusion) were studied. All showed Wilkes stage II or early stage III. The Visual Analogue Scale (VAS), maximum mouth opening (MMO), and the positional change of the condylar segment were recorded preoperatively and postoperatively. The difference in each criterion according to the operative techniques was evaluated by means of a 1-way analysis of variance, and the difference between the preoperative value and the value in the long-term follow-up was evaluated by means of a paired t test.
Six patients underwent an extraoral vertical ramus osteotomy (EVRO), 6 patients underwent a sagittal split ramus osteotomy (SSRO), and 10 patients underwent an intraoral vertico-sagittal split ramus osteotomy (IVSRO). The preoperative value of the maximum mouth opening (MMO) was 33.0 +/- 8.3 mm, 46.1 +/- 7.0 mm, or 40.0 +/- 7.4 mm for patients undergoing EVRO, IVSRO, or SSRO, respectively. In the long-term follow-up period, the MMO was 49.3 +/- 14.6 mm, 47.3 +/- 3.2 mm, or 48.7 +/- 5.1 mm for patients undergoing EVRO, IVSRO, or SSRO, respectively. There were no differences in the amount of the MMO among the operative techniques (P >.05). The preoperative VAS in the operated-on joints was 3.9 +/- 2.4, 5.0 +/- 1.6, or 4.7 +/- 1.4 for patients undergoing EVRO, IVSRO, or SSRO, respectively. In the long-term follow-up period, it was 1.4 +/- 2.2, 2.5 plus minus 2.0, or 3.7 +/- 1.7 for patients undergoing EVRO, IVSRO, or SSRO, respectively. There were no differences in the VAS among the operative techniques (P >.05). When each measurement preoperation was compared with the long-term follow-up, the difference was statistically significant (P =.018 in the MMO, P =.004 in the VAS).
The curative effect of a condylotomy on the internal derangement of the temporomandibular joint was acceptable in the long-term follow-up, but the osteotomy procedure used may be only a minor contributing factor to the long-term results.
本研究旨在比较髁突切开术技术的长期效果。
对22例患者（平均年龄20.8岁；咬合：安氏错牙合分类中的I类）进行研究。所有患者均表现为威尔克斯II期或早期III期。术前和术后记录视觉模拟评分（VAS）、最大开口度（MMO）以及髁突节段的位置变化。通过单因素方差分析评估各标准在不同手术技术之间的差异，并通过配对t检验评估术前值与长期随访值之间的差异。
6例患者接受了口外升支垂直截骨术（EVRO），6例患者接受了矢状劈开截骨术（SSRO），10例患者接受了口内垂直矢状劈开截骨术（IVSRO）。接受EVRO、IVSRO或SSRO的患者术前最大开口度（MMO）值分别为33.0±8.3mm、46.1±7.0mm或40.0±7.4mm。在长期随访期间，接受EVRO、IVSRO或SSRO的患者MMO分别为49.3±14.6mm、47.3±3.2mm或48.7±5.1mm。不同手术技术之间的MMO量无差异（P>.05）。接受EVRO、IVSRO或SSRO的患者手术关节术前VAS分别为3.9±2.4、5.0±1.6或4.7±1.4。在长期随访期间，接受EVRO、IVSRO或SSRO的患者分别为1.4±2.2、2.5±2.0或3.7±1.7。不同手术技术之间的VAS无差异（P>.05）。当将每次术前测量值与长期随访值进行比较时，差异具有统计学意义（MMO中P =.018，VAS中P =.004）。
在长期随访中，髁突切开术治疗颞下颌关节内紊乱的疗效是可以接受的，但所采用的截骨手术可能只是影响长期效果的一个次要因素。
