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矢状劈开截骨术及下颌骨闭合旋转矫正开牙合的稳定性

Stability of open bite correction with sagittal split osteotomy and closing rotation of the mandible.

作者信息

Stansbury Christopher D, Evans Carla A, Miloro Michael, BeGole Ellen A, Morris David E

机构信息

Department of Orthodontics, University of Illinois at Chicago College of Dentistry, Chicago, IL 60612, USA.

出版信息

J Oral Maxillofac Surg. 2010 Jan;68(1):149-59. doi: 10.1016/j.joms.2009.07.105.

Abstract

PURPOSE

To determine the long-term stability of bilateral sagittal split osteotomies with counterclockwise (closing) rotation of the mandible combined with rigid internal fixation in the correction of anterior open bite deformities.

MATERIALS AND METHODS

A total of 28 patients who had completed orthodontic therapy and had at least 1 year of postoperative follow-up were evaluated using cephalometric analysis for dental and skeletal changes. We evaluated 7 angular and 6 linear measurements cephalometrically at 3 points for each patient: immediately preoperatively, immediately postoperatively, and after a minimum of 1 year of postoperative follow-up.

RESULTS

Of the 28 patients, 12 exhibited some degree of opening rotation (range 1% to 64%, mean 16%), and 16 showed no open rotation or continued to experience bite closure. However, all patients had a positive overbite at 1 year of follow-up, indicating that even though skeletal relapse was observed postoperatively, dental compensation resulted in the maintenance of the occlusal relationships.

CONCLUSIONS

Bilateral sagittal split osteotomies and closing rotation of the mandible using rigid fixation is a relatively stable procedure and a viable surgical treatment option for the correction of anterior open bite in instances in which maxillary osteotomies are not indicated to improve or enhance facial esthetics.

摘要

目的

确定下颌逆时针(闭合)旋转联合坚固内固定的双侧矢状劈开截骨术在矫正前牙开颌畸形中的长期稳定性。

材料与方法

对28例完成正畸治疗且术后至少随访1年的患者进行头影测量分析,以评估牙齿和骨骼的变化。我们对每位患者在术前即刻、术后即刻以及术后至少1年随访时的3个点进行了7项角度和6项线性头影测量。

结果

28例患者中,12例出现一定程度的开口旋转(范围为1%至64%,平均16%),16例未出现开口旋转或持续出现咬合关闭。然而,所有患者在随访1年时均有正覆盖,这表明尽管术后观察到骨骼复发,但牙齿代偿导致咬合关系得以维持。

结论

对于不适合行上颌截骨术以改善或提升面部美观的前牙开颌病例,采用坚固内固定的双侧矢状劈开截骨术及下颌闭合旋转术是一种相对稳定的手术方法,也是可行的外科治疗选择。

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