Yu Chung-Chih, Bergeron Leonard, Lin Cheng-Hui, Chu Yong-Ming, Chen Yu-Ray
Taipei, Taiwan From the Craniofacial Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University.
Plast Reconstr Surg. 2009 Sep;124(3):879-886. doi: 10.1097/PRS.0b013e3181b03842.
Despite the most meticulous preoperative planning and execution, intraoperative soft-tissue response to dentoskeletal changes is often different from those statistically predicted, especially when midline asymmetry is present. A "single-splint" technique for bimaxillary surgery, with intraoperative adjustments and checkpoints, was developed in an attempt to overcome these limitations. The purpose of this study was therefore to determine whether this technique can improve the midline symmetry of facial soft tissues.
Forty-five patients who underwent at least a Le Fort I and a bilateral sagittal split osteotomy of the mandible were identified in the authors' patient database. Standardized frontal photographs were used to measure the change in midfacial, intercommissural, chin to midface, and chin to ideal facial midline angles. The facial midline symmetry index, an overall score of facial symmetry, was also calculated.
This study demonstrates that there is a statistically significant improvement of the four angles measured and of the facial midline symmetry index.
These findings demonstrate that the single-splint technique with its intraoperative checkpoints can successfully maintain or improve facial midline symmetry. Thus, the single-splint technique is a useful alternative to the classic two-splint technique for bimaxillary surgery.
尽管术前进行了最为细致的规划与实施，但术中软组织对牙颌面变化的反应往往与统计预测的情况不同，尤其是存在中线不对称时。为克服这些局限性，开发了一种用于双颌手术的“单夹板”技术，术中可进行调整并设置检查点。因此，本研究的目的是确定该技术是否能改善面部软组织的中线对称性。
在作者的患者数据库中确定了45例至少接受了下颌骨双侧矢状劈开截骨术和Le Fort I型截骨术的患者。使用标准化的正面照片测量面中部、口角间、颏部至面中部以及颏部至理想面部中线角度的变化。还计算了面部中线对称指数，即面部对称性的综合评分。
本研究表明，所测量的四个角度以及面部中线对称指数在统计学上有显著改善。
这些发现表明，带有术中检查点的单夹板技术能够成功维持或改善面部中线对称性。因此，对于双颌手术，单夹板技术是经典双夹板技术的一种有用替代方法。
