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评价口内垂直矢状劈开下颌支截骨术矫治下颌前突:一项10年的研究。

Evaluation of intraoral verticosagittal ramus osteotomy for correction of mandibular prognathism: a 10-year study.

作者信息

Hashemi Hamid Mahmood

机构信息

Department of Oral and Maxillofacial Surgery, Tehran Medical Sciences University, Tehran, Iran.

出版信息

J Oral Maxillofac Surg. 2008 Mar;66(3):509-12. doi: 10.1016/j.joms.2007.03.033.

Abstract

PURPOSE

To identify intraoperative complications, neurosensory disturbance (NSD), and horizontal relapse after surgical correction of mandibular prognathism using bilateral intraoral verticosagittal ramus osteotomy (IVSRO).

PATIENTS AND METHODS

Between 1995 and 2005, 237 Iranian patients underwent IVSRO to achieve mandibular setback. Their operation reports, cephalometric radiographs (2 weeks preoperatively and 12 months postoperatively), and neurosensory questionnaires were assessed to identify intraoperative complications, NSD of the inferior alveolar nerve (IAN), and horizontal relapse.

RESULTS

Intraoperative complications occurred in 26 cases (11%). A total of 17 patients (7.2%) reported NSD of the IAN. The mean surgical setback was 7.99 mm at the B point, and the mean horizontal relapse was 2.16 mm at the B point (after 1 year).

CONCLUSIONS

Considering our findings, the benefits of the IVSRO technique (eg, good contact between the 2 parts of the osteotomy, capacity for rigid fixation, low incidence of IAN injury) demonstrate that this technique can easily replace the intraoral vertical ramus osteotomy technique to treat mandibular prognathism and is a viable alternative to the sagittal split osteotomy technique to provide mandibular setback.

摘要

目的

采用双侧口内垂直矢状劈开下颌升支截骨术(IVSRO)对下颌前突进行手术矫正,以确定术中并发症、神经感觉障碍(NSD)和水平复发情况。

患者与方法

1995年至2005年间,237例伊朗患者接受了IVSRO以实现下颌后缩。对他们的手术报告、头影测量X线片(术前2周和术后12个月)以及神经感觉问卷进行评估,以确定术中并发症、下牙槽神经(IAN)的NSD和水平复发情况。

结果

26例(11%)发生术中并发症。共有17例患者(7.2%)报告IAN出现NSD。B点的平均手术后退量为7.99mm,B点的平均水平复发量为2.16mm(1年后)。

结论

根据我们的研究结果,IVSRO技术的优点(例如,截骨两部分之间良好的接触、坚固固定的能力、IAN损伤发生率低)表明,该技术可以轻松替代口内垂直下颌升支截骨术技术来治疗下颌前突,并且是矢状劈开截骨术技术提供下颌后缩的可行替代方法。

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