Department of Clinical Oral Physiology, School of Dentistry, Aarhus University, Aarhus, Denmark.
J Oral Rehabil. 2010 May 1;37(5):313-21. doi: 10.1111/j.1365-2842.2010.02059.x. Epub 2010 Jan 25.
Quality control is very important in relation to invasive and lengthy treatments, such as integrated orthodontic and surgical correction of dentofacial deformities. The aim of this cross-sectional study was to compare self-reported somatosensory disturbances and quantitative sensory testing (QST) findings between two groups of patients and a healthy control group (n = 24); one group (n = 21) scheduled for bimaxillary orthognathic surgery (BOS) (pre-op) and one group (n = 24) examined 1(1/2) years after BOS (post-op). Self-reported data on pain and somatosensory disturbances were collected, and QST was performed at six trigeminal and one extratrigeminal site. Sensitivity to brush stroke, tactile stimuli, pinprick, two-point-discrimination threshold (2P-DT), pinch pain threshold (PiPT) and pressure pain threshold (PPT) was evaluated. Results were analysed with anovas, Spearman's Correlation, and chi square tests. Eight per cent of post-op patients reported intra-oral, 46% extra-oral, and 46% no somatosensory disturbances. Sensitivity to brush stroke, pinprick and 2P-DT was significantly increased at all examination sites in the post-op patients compared with healthy controls (P < 0.002). Tactile thresholds and PPT did not differ between groups (P > 0.071). Pinch pain threshold were decreased in pre-op patients compared with controls (P < 0.040). Self-reported somatosensory disturbances were not correlated with QST findings. In conclusion; 1(1/2) years after BOS, a large proportion of patients reported somatosensory disturbances and was hypersensitive to mechanical stimuli when compared with pre-op patients and healthy controls. Pre-op patients showed minor somatosensory changes. In addition to patients serving as their own control in prospective studies, a healthy control group and extratrigeminal control sites should be included in future studies.
质量控制在涉及侵入性和冗长的治疗方面非常重要,例如综合正畸和正颌外科矫正牙颌面畸形。本横断面研究的目的是比较两组患者(一组为 21 名计划接受双颌正颌手术的患者(术前),另一组为 24 名患者术后 1 年半(术后))和健康对照组(n=24)的自我报告感觉障碍和定量感觉测试(QST)结果。收集了疼痛和感觉障碍的自我报告数据,并在六个三叉神经和一个三叉神经外部位进行了 QST。评估了对刷笔触、触觉刺激、刺痛、两点辨别阈值(2P-DT)、捏痛阈值(PiPT)和压痛阈值(PPT)的敏感性。采用方差分析、Spearman 相关分析和卡方检验对结果进行分析。8%的术后患者报告口腔内有感觉障碍,46%的患者报告口腔外有感觉障碍,46%的患者报告无感觉障碍。与健康对照组相比,术后患者所有检查部位对刷笔触、刺痛和 2P-DT 的敏感性均显著增加(P<0.002)。触觉阈值和 PPT 在两组之间无差异(P>0.071)。术前患者的捏痛阈值较对照组降低(P<0.040)。自我报告的感觉障碍与 QST 结果无相关性。结论:与术前患者和健康对照组相比,BOS 术后 1 年半,大部分患者报告感觉障碍,对机械刺激敏感。术前患者表现出轻微的感觉变化。除了前瞻性研究中患者作为自身对照外,未来的研究还应包括健康对照组和三叉神经外对照部位。