Joss Christof Urs, Vassalli Isabella Maria
Department of Orthodontics, University of Geneva, Geneva, Switzerland.
J Oral Maxillofac Surg. 2008 Aug;66(8):1634-43. doi: 10.1016/j.joms.2008.01.046.
The purpose of this systematic review was to evaluate relapse and its causes in bilateral sagittal split setback osteotomy with rigid internal fixation.
Literature research was done in databases such as PubMed, Ovid, the Cochrane Library, and Google Scholar Beta. From the original 488 articles identified, 14 articles were finally included. Only 5 studies were prospective and 9 retrospective. The range of postoperative study records was from 6 weeks to 12.7 years.
The horizontal short-term relapse was between 9.9% and 62.1% at point B and between 15.7% and 91.3% at pogonion. Long-term relapse was between 14.9% and 28.0% at point B and between 11.5% and 25.4% at pogonion.
Neither large increase nor decrease of relapse was seen when short-term values were compared with long-term. Bilateral sagittal split osteotomy for mandibular setback in combination with orthodontics is an effective treatment of skeletal Class III and a stable procedure in the short- and long-term. The etiology of relapse is multifactorial: the proper seating of the condyles, the amount of setback, the soft tissue and muscles, remaining growth and remodeling, and gender were identified. Age did not show any correlations. To obtain reliable scientific evidence, further short- and long-term research of bilateral sagittal split osteotomy setback with rigid internal fixation should exclude additional surgery, ie, genioplasty or maxillary surgery, and include correlation statistics.
本系统评价旨在评估双侧矢状劈开后退截骨术加坚固内固定后的复发情况及其原因。
在PubMed、Ovid、Cochrane图书馆和谷歌学术测试版等数据库中进行文献研究。从最初识别出的488篇文章中，最终纳入了14篇文章。只有5项研究是前瞻性的，9项是回顾性的。术后研究记录的时间范围为6周至12.7年。
B点的水平短期复发率在9.9%至62.1%之间，颏前点在15.7%至91.3%之间。长期复发率B点在14.9%至28.0%之间，颏前点在11.5%至25.4%之间。
短期与长期值比较时，未发现复发率有大幅增减。双侧矢状劈开截骨术用于下颌后退并结合正畸治疗是治疗骨性III类错牙合的有效方法，且短期和长期效果稳定。复发的病因是多因素的：髁突的正确就位、后退量、软组织和肌肉、剩余生长与改建以及性别均已明确。年龄未显示出任何相关性。为获得可靠的科学证据，对双侧矢状劈开截骨术后退加坚固内固定的进一步短期和长期研究应排除额外手术，即颏成形术或上颌手术，并纳入相关性统计分析。
