Ueki Koichiro, Degerliyurt Kagan, Hashiba Yukari, Marukawa Kohei, Nakagawa Kiyomasa, Yamamoto Etsuhide
Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kanazawa University, Kanazawa, Japan.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Nov;106(5):656-61. doi: 10.1016/j.tripleo.2008.03.016. Epub 2008 Jul 7.
The purpose of this study was to evaluate the horizontal changes in the condylar head with bent plate fixation after sagittal split ramus osteotomy (SSRO) with and without a Le Fort I osteotomy.
Of 47 Japanese patients with mandibular prognathism, 24 underwent SSRO and 23 underwent SSRO in combination with a Le Fort I osteotomy. A 3-5-mm gap was made between the proximal and distal segments, and a bent plate was fixed with 4 screws in each side of the mandible. The angle of the condylar long axis, as well as the anteroposterior and mediolateral displacement of the condylar head were assessed preoperatively and postoperatively by computerized tomography (CT).
There was no significant difference in reduction in mandibular length between SSRO alone and SSRO with Le Fort I on the axial view of a 3-dimensional CT. There were no significant differences between pre- and postoperative horizontal changes in the condylar long axis or in the anteroposterior and mediolateral displacement of the condylar head, although the length of the proximal segment in SSRO with Le Fort I osteotomy was significantly shorter than in SSRO alone (P < .05).
These results suggest that the use of a bent plate for SSRO does not change preoperative angle or position significantly in setback surgery, regardless of the addition of Le Fort I osteotomy.
本研究旨在评估下颌升支矢状劈开截骨术（SSRO）联合或不联合Le Fort I截骨术并采用弯板固定后髁突头部的水平变化。
47例日本下颌前突患者中，24例接受了SSRO，23例接受了SSRO联合Le Fort I截骨术。在近段和远段之间形成3 - 5毫米的间隙，在下颌骨两侧用4枚螺钉固定弯板。术前和术后通过计算机断层扫描（CT）评估髁突长轴角度以及髁突头部的前后和内外侧移位情况。
在三维CT的轴向视图上，单纯SSRO与联合Le Fort I截骨术的SSRO在下颌骨长度缩短方面无显著差异。尽管联合Le Fort I截骨术的SSRO近端节段长度明显短于单纯SSRO（P <.05），但髁突长轴的术前和术后水平变化以及髁突头部的前后和内外侧移位均无显著差异。
这些结果表明，在后退手术中，无论是否增加Le Fort I截骨术，用于SSRO的弯板使用均不会显著改变术前角度或位置。
