Lai Steven Sheng-Tsung, Tseng Yu-Chuan, Huang I-Yueh, Yang Yi-Hsin, Shen Yee-Shyong, Chen Chun-Ming
Department of Oral Maxillofacial Surgery, Kaohsiung Medical University, No. 100, Shih-chuan 1st Road, Kaohsiung 807, Taiwan.
J Plast Reconstr Aesthet Surg. 2007;60(2):139-45. doi: 10.1016/j.bjps.2006.04.001. Epub 2006 Jun 23.
Orthognathic surgery is widely used to correct congenital and acquired dentofacial discrepancies. Various surgical procedures have been advocated for correction of mandibular prognathism. In this study, a modified intraoral vertical ramus osteotomy has been developed for surgical correction of mandibular prognathism. The aim of this study is to identify contributing factors to skeletal change by analysing cephalometric changes after modified intraoral vertical ramus osteotomy.
Forty-one patients, treated for absolute mandibular prognathism by bilateral modified intraoral vertical ramus osteotomy, were evaluated cephalometrically with reference to the menton point. A set of four standardised lateral cephalograms were obtained from each subject preoperatively (T1) and immediately postoperatively (T2), prior to removal of maxillomandibular fixation (T3), and at 1-year postoperatively (T4). The mean setback of the menton was 12.4 mm in the horizontal direction. Relapse was defined as forward movement of the menton during the 1-year follow-up.
The highly significant backward movements in a horizontal direction were observed during the maxillomandibular fixation period (T3-T2). Moreover, highly significant forward movement was observed following the maxillomandibular fixation period (T4-T3). After 1-year follow-up (T4-T2), the mean changes of the menton were 0.1 mm backward in the horizontal direction.
In this series, the mean skeletal change compared with the amount of setback was less than 1% (0.1/12.4 mm) in backward movement. The results suggest that the modified intraoral vertical ramus osteotomy technique is useful and the more stable approach for correction of severe mandibular prognathism.
正颌外科手术广泛用于矫正先天性和后天性牙颌面畸形。针对下颌前突的矫正,人们提出了各种手术方法。在本研究中,我们开发了一种改良的口内垂直升支截骨术用于下颌前突的手术矫正。本研究的目的是通过分析改良口内垂直升支截骨术后的头影测量变化来确定影响骨骼变化的因素。
对41例接受双侧改良口内垂直升支截骨术治疗绝对下颌前突的患者,以颏下点为参照进行头影测量评估。从每位受试者术前(T1)、术后即刻(T2)、去除颌间固定前(T3)和术后1年(T4)获取一组四张标准化的侧位头影测量片。颏下点在水平方向的平均后缩量为12.4 mm。复发定义为在1年随访期间颏下点向前移动。
在颌间固定期(T3 - T2)观察到水平方向高度显著的向后移动。此外,在颌间固定期之后(T4 - T3)观察到高度显著的向前移动。经过1年随访(T4 - T2),颏下点在水平方向的平均变化为向后0.1 mm。
在本系列研究中,与后缩量相比,平均骨骼变化在向后移动中小于1%(0.1 / 12.4 mm)。结果表明,改良口内垂直升支截骨术技术对于矫正严重下颌前突是有用且更稳定的方法。