Department of Oral and Maxillofacial Surgery, Central Hospital of Central Finland, Jyväskylä, Finland.
Eur J Orthod. 2012 Apr;34(2):238-43. doi: 10.1093/ejo/cjq194. Epub 2011 Jan 17.
In adults, superior repositioning of posterior maxilla with or without mandibular surgery has become the treatment method of choice to close anterior open bite. Study aim was to examine the long-term stability of anterior open bite closure by superior repositioning of maxilla or by combining maxillary impaction with mandibular surgery. The sample comprised 24 patients who underwent anterior open bite closure by superior repositioning of maxilla (maxillary group, n = 12, mean age 29.3 years) or by maxillary impaction and mandibular osteotomy (bimaxillary group, n = 12, mean age 30.8 years). Lateral cephalograms were studied prior to surgery (T1), the first post-operative day (T2) and in the long term (T3, maxillary group mean 3.5 years; bimaxillary group mean 2.0 years). Paired and two-sample t-tests were used to assess differences within and between the groups. The vertical incisal bite relations were -2.6 and -2.2 mm at T1; 1.23 and 0.98 mm at T2; and 1.85 and 0.73 mm at T3 in the maxillary and bimaxillary groups. At T3, all subjects had positive overbite in the maxillary group, but open bite recurred in three subjects with bimaxillary surgery. For both groups, the maxilla relapsed vertically. Significant changes in sagittal and vertical positions of the mandible occurred in both groups. In the bimaxillary group, the changes were larger and statistically significant. In general, the maxilla seems to relapse moderately vertically and the mandible both vertically and sagittally, particularly when both jaws were operated on. Overbite seems to be more stable when only the maxilla has been operated on.
成人患者中,通过上颌骨高位后移或联合下颌骨手术来矫正前牙反𬌗,已成为治疗前牙开𬌗的首选方法。本研究旨在探讨上颌骨高位后移或上颌骨压入联合下颌骨截骨术矫正前牙开𬌗的长期稳定性。样本包括 24 例因前牙开𬌗接受上颌骨高位后移(上颌组,n=12,平均年龄 29.3 岁)或上颌骨压入联合下颌骨截骨术(双颌组,n=12,平均年龄 30.8 岁)的患者。在术前(T1)、术后第 1 天(T2)和长期(T3,上颌组平均 3.5 年;双颌组平均 2.0 年)拍摄侧位头颅定位片。采用配对 t 检验和两样本 t 检验比较组内和组间差异。上颌组 T1 时垂直覆𬌗关系为-2.6mm 和-2.2mm,T2 时为 1.23mm 和 0.98mm,T3 时为 1.85mm 和 0.73mm;双颌组 T1 时分别为-2.6mm 和-2.2mm,T2 时为 1.23mm 和 0.98mm,T3 时为 1.85mm 和 0.73mm。T3 时,上颌组所有患者均有正覆𬌗,但双颌组有 3 例患者出现开𬌗复发。两组上颌骨均有垂直向复发。两组下颌骨的矢状和垂直位置均发生显著变化,双颌组变化更大且具有统计学意义。总体而言,上颌骨在垂直方向上有中等程度的复发,下颌骨在垂直和矢状方向上均有复发,尤其是当上下颌骨均接受手术时。仅行上颌骨手术时,覆𬌗似乎更稳定。