上颌骨腭裂牵张成骨术与正颌外科手术——哪种方法在5年内更稳定？
Cleft maxillary distraction versus orthognathic surgery--which one is more stable in 5 years?
作者信息
Chua Hannah Daile P, Hägg Margareta Bendeus, Cheung Lim Kwong
机构信息
Discipline of Oral & Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, China.
出版信息
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Jun;109(6):803-14. doi: 10.1016/j.tripleo.2009.10.056. Epub 2010 Mar 17.
OBJECTIVE
The objective of this study was to compare the long-term stability of distraction osteogenesis (DO) and conventional orthognathic surgery (CO) in patients with cleft lip and palate (CLP).
STUDY DESIGN
CLP patients requiring maxillary advancement of 4 to 10 mm were randomized and assigned to either CO or DO. In the CO group, the maxilla was fully mobilized to the preplanned position and fixed using titanium miniplates. In the DO group, the maxilla was mobilized to a limited extent and distractors were fixed on each side of the maxilla. Serial lateral cephalographs were taken for the assessment of stability at different postoperative periods up to 5 years.
RESULTS
In the CO group, the maxilla relapsed backward and upward, whereas in the DO group, it advanced more forward and downward over 5 years.
CONCLUSIONS
Distraction of the cleft maxilla can achieve better long-term skeletal stability in maintaining its advanced position than CO.
目的
本研究的目的是比较唇腭裂（CLP）患者中牵张成骨术（DO）和传统正颌外科手术（CO）的长期稳定性。
研究设计
需要上颌骨前移4至10毫米的CLP患者被随机分组并分配到CO组或DO组。在CO组中，将上颌骨完全松动至预先计划的位置并用微型钛板固定。在DO组中，上颌骨被有限度地松动，牵张器固定在上颌骨的两侧。在术后长达5年的不同时期拍摄系列头颅侧位片以评估稳定性。
结果
在CO组中，上颌骨向后上方复发，而在DO组中，在5年期间它向前下方进一步前移。
结论
与CO相比，唇腭裂上颌骨的牵张在维持其前移位置方面可实现更好的长期骨骼稳定性。
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