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不对称性下颌前突患者正颌手术中,根据不同截骨技术下颌近远心段之间的干扰情况

Interferences between mandibular proximal and distal segments in orthognathic surgery for patients with asymmetric mandibular prognathism depending on different osteotomy techniques.

作者信息

Yang Hoon Joo, Lee Woo Jin, Yi Won Jin, Hwang Soon Jung

机构信息

Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Jul;110(1):18-24. doi: 10.1016/j.tripleo.2009.12.049. Epub 2010 Apr 9.

Abstract

OBJECTIVE

The aim of this study was to evaluate, using computer simulation, the amount of interference between the proximal and distal segments of the mandible incurred by 3 different osteotomy methods.

STUDY DESIGN

With the 3-dimensional facial computerized tomography data of 20 patients showing mandibular prognathism with asymmetry, simulation surgeries of conventional sagittal split ramus osteotomy (SSRO), intraoral vertical ramus osteotomy (IVRO), or short lingual osteotomy (SLO) was performed. The distal segments were moved backward (3, 6, or 9 mm) and rotated (2 degrees, 4 degrees, or 6 degrees). The amounts of interference between the proximal and distal segments of the mandible were measured and statistically analyzed.

RESULTS

Conventional SSRO demonstrated the greatest interference between the proximal and distal segments of the mandibles (P < .01), followed by IVRO and SLO. SLO showed less interference than IVRO in mild asymmetry cases (P < .05), but no difference was noted in severe prognathism and asymmetry cases.

CONCLUSION

SLO is the most favorable osteotomy method for reducing displacement of the proximal segment in mandibular prognathism with asymmetry.

摘要

目的

本研究旨在通过计算机模拟评估3种不同截骨方法在下颌骨近端和远端节段之间产生的干扰量。

研究设计

利用20例显示下颌前突伴不对称的患者的三维面部计算机断层扫描数据,进行传统矢状劈开下颌支截骨术(SSRO)、口内垂直下颌支截骨术(IVRO)或短舌侧截骨术(SLO)的模拟手术。将远端节段向后移动(3、6或9毫米)并旋转(2度、4度或6度)。测量并统计分析下颌骨近端和远端节段之间的干扰量。

结果

传统SSRO在下颌骨近端和远端节段之间表现出最大的干扰(P <.01),其次是IVRO和SLO。在轻度不对称病例中,SLO显示出比IVRO更少的干扰(P <.05),但在严重前突和不对称病例中未发现差异。

结论

对于减少下颌前突伴不对称患者近端节段的移位,SLO是最有利的截骨方法。

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