Gerressen Marcus, Stockbrink Gereon, Smeets Ralf, Riediger Dieter, Ghassemi Alireza
Department of Oral, Maxillofacial and Plastic Facial Surgery, Universitätsklinikum der RWTH Aachen, Aachen, Germany.
J Oral Maxillofac Surg. 2007 Jul;65(7):1297-302. doi: 10.1016/j.joms.2006.10.026.
The goal of this retrospective study was to investigate whether utilization of condylar positioning devices in comparison to the manual positioning technique has a favorable influence on skeletal stability after bilateral sagittal split osteotomy.
Lateral cephalometric radiographs of 49 patients who had undergone bilateral sagittal split osteotomy or bimaxillary surgery at the Universitiy Hospital of Aachen between 1993 and 2003 were evaluated with the aid of analysis software (Adda Keph version 3.0, JR - datentechnik, Leipzig, Germany). As a criterion for skeletal stability the postoperative changes of SNB angle and Wits appraisal were determined. In 10 of 28 patients with mandibular advancement and in 10 of 21 individuals with mandibular setback, the Luhr positioning device was used intraoperatively to reproduce the condylar position. Mandibular joints of the remaining patients were positioned manually. The results were statistically worked up by means of unrelated t test at P = .05.
Neither in advancement nor in setback surgery did the positioning device technique result in better outcomes for postoperative changes of SNB angle and Wits appraisal. The confidence intervals rather suggest equivalence of the data in both groups.
The use of positioning appliances does not lead to an improvement of skeletal stability. With the manual technique, equally stable results can be attained in advancement as well as in setback surgery.
本回顾性研究的目的是调查与手动定位技术相比，髁突定位装置的使用对双侧矢状劈开截骨术后的骨骼稳定性是否有有利影响。
借助分析软件（Adda Keph版本3.0，JR - datentechnik，德国莱比锡）对1993年至2003年期间在亚琛大学医院接受双侧矢状劈开截骨术或双颌手术的49例患者的头颅侧位X线片进行评估。将术后SNB角和Wits评估的变化作为骨骼稳定性的标准。在28例下颌前徙患者中的10例以及21例下颌后退患者中的10例中，术中使用Luhr定位装置来重现髁突位置。其余患者的下颌关节采用手动定位。通过独立样本t检验对结果进行统计学处理，P = 0.05。
无论是前徙手术还是后退手术，定位装置技术在SNB角和Wits评估的术后变化方面均未产生更好的结果。置信区间反而表明两组数据相当。
使用定位器械并不能提高骨骼稳定性。采用手动技术，在前徙手术和后退手术中均可获得同样稳定的结果。
