Jamilian Abdolreza, Showkatbakhsh Abdolrahman, Gholami Dariush, Kamali Zinat
Department of Orthodontics, School of Dentistry, Islamic Azad University, Tehran, Iran.
J Craniofac Surg. 2009 May;20(3):841-3. doi: 10.1097/SCS.0b013e3181a14d8b.
Controversy exists about the relation between the amount of posterior maxillary impaction and pogonion (P) advancement. The aims of the current study were to (1) propose a formula to predict the amount of P advancement due to posterior maxillary impaction surgery, (2) predict the amount of posterior maxillary impaction by means of a formula to achieve the best facial harmony, and (3) identify the compatibility between proposed formulas and the actual resultant mandibular position after posterior maxillary impaction surgery. For obtaining the formulas, 2 cephalograms were taken from 1 patient in centric occlusion and rest position. Afterward, mandibular rotational center was obtained by superimposing the cephalograms; by the help of which the 2 formulas were obtained. To check the reliability of the formulas, 10 patients with the mean age of 21 +/- 1.5 years who had undergone posterior maxillary impaction were selected. The presurgical and postsurgical cephalograms of patients were obtained. These cephalograms were superimposed to find the center of mandibular rotation. Pearson correlation coefficient test was used to evaluate the relation between the suggested formulas and the clinical data. This test showed that there were significant correlations between maxillary impaction and P advancement in both the formulas and clinical evaluation. This correlation (r) was 0.993 (P < 0.001) based on formulas and r = 0.806 (P < 0.005) based on tracing. This study showed that the amounts of anterior facial height reduction and P advancement were almost the same, and the anterior facial height was reduced 1.5 times more than the amount of maxillary impaction.
关于上颌后部垂直向骨块移动量与颏点(P)前移之间的关系存在争议。本研究的目的是:(1)提出一个公式来预测上颌后部垂直向骨块移动手术导致的P点前移量;(2)通过一个公式预测上颌后部垂直向骨块移动量以实现最佳面部协调性;(3)确定所提出的公式与上颌后部垂直向骨块移动手术后实际的下颌位置之间的匹配度。为了获得这些公式,从1例处于正中咬合和休息位的患者拍摄了2张头颅侧位片。之后,通过叠加头颅侧位片获得下颌旋转中心;借助于此得到了2个公式。为检验公式的可靠性,选择了10例平均年龄为21±1.5岁且接受过上颌后部垂直向骨块移动手术的患者。获取了患者手术前和手术后的头颅侧位片。将这些头颅侧位片叠加以找到下颌旋转中心。采用Pearson相关系数检验来评估所提出的公式与临床数据之间的关系。该检验表明,在公式和临床评估中,上颌骨块移动与P点前移之间均存在显著相关性。基于公式,这种相关性(r)为0.993(P<0.001),基于描记法,r = 0.806(P<0.005)。本研究表明,面部高度降低量和P点前移量几乎相同,且面部高度降低量比上颌骨块移动量多1.5倍。