Dolce Calogero, Hatch John P, Van Sickels Joseph E, Rugh John D
Department of Orthodontics, University of Florida, Box 100444, Gainesville, FL 32610, USA.
Am J Orthod Dentofacial Orthop. 2003 Sep;124(3):249-56; quiz 340. doi: 10.1016/s0889-5406(03)00446-3.
The purpose of this study was to follow the covariation of hard and soft tissue changes in Class II malocclusion subjects who received a bilateral sagittal split osteotomy. The subjects were randomized to receive wire or rigid fixation after the surgery. Subjects in the rigid group (n = 78) received 2-mm bicortical position screws, and those in the wire group (n = 49) received inferior border wires and 6 weeks of skeletal intermaxillary fixation with 24-gauge wires. Additionally, some subjects received genioplasty in both the rigid (n = 35) and the wire groups (n = 24). Soft and hard tissue profile changes were obtained from cephalometric films immediately before surgery and at various times up to 5 years postsurgery. Soft and hard tissue profile changes were referenced to a cranial-base X-Y coordinate system. Horizontal changes in mandibular incisor, lower lip, B-point, soft tissue B-point, pogonion, and soft tissue pogonion were calculated at each time. There was considerable skeletal relapse in the wire fixation group. Bivariate correlations and ratios between the hard and soft tissue changes were calculated for each time period. Hard to soft tissue correlations were the highest at the earlier times, although the ratios varied among the 4 groups. These results provide a solid basis for both short-term and long-term prediction.
本研究的目的是追踪接受双侧矢状劈开截骨术的安氏II类错颌畸形患者软硬组织变化的协同情况。患者术后被随机分为接受钢丝固定或坚固内固定两组。坚固内固定组（n = 78）使用2毫米双皮质位置螺钉，钢丝固定组（n = 49）使用下颌下缘钢丝并采用24号钢丝进行6周的颌间骨间固定。此外，部分坚固内固定组（n = 35）和钢丝固定组（n = 24）的患者还接受了颏成形术。在术前即刻以及术后长达5年的不同时间点，从头颅侧位片获取软硬组织侧貌变化情况。软硬组织侧貌变化以颅底X - Y坐标系为参照。每次均计算下颌切牙、下唇、B点、软组织B点、颏点及软组织颏点的水平变化。钢丝固定组存在相当程度的骨骼复发。计算每个时间段软硬组织变化之间的双变量相关性及比率。尽管4组之间的比率有所不同，但在早期软硬组织相关性最高。这些结果为短期和长期预测提供了坚实的基础。
