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下颌前徙术后的三维区域位移:一年随访

Three-dimensional regional displacements after mandibular advancement surgery: one year of follow-up.

作者信息

Motta Alexandre T, Cevidanes Lucia H S, Carvalho Felipe A R, Almeida Marco A O, Phillips Ceib

机构信息

Department of Orthodontics, Fluminense Federal University School of Dentistry, Rio de Janeiro, Brazil.

出版信息

J Oral Maxillofac Surg. 2011 May;69(5):1447-57. doi: 10.1016/j.joms.2010.07.018. Epub 2011 Jan 21.

Abstract

PURPOSE

To evaluate the association of 3-dimensional changes in the position of the condyles, rami, and chin at splint removal and 1 year after mandibular advancement surgery.

PATIENTS AND METHODS

This prospective observational study used preoperative and postoperative scans of 27 subjects presenting with a skeletal Class II jaw relationship with a normal or deep overbite. An automatic technique of cranial base superimposition was used to assess the positional and/or remodeling changes in the anatomic regions of interest. The displacements were visually displayed and quantified using 3-dimensional color maps. The positive and negative values of surface distances in the color maps indicated the direction of the displacements. Pearson correlation coefficients and a linear model for correlated data were used to evaluate the association between the regional displacements.

RESULTS

The postoperative adaptations in the chin position between splint removal and 1 year after surgery were significantly negatively correlated with changes in the borders of the posterior ramus (left, r = -0.73, P ≤ .0001; and right, r = -0.68, P = .00) and the condyles (left, r = -0.53, P = .01; and right, r = -0.46, P = .02), indicating that these structures tended to be displaced in the same direction. Even though the mean condylar displacement with surgery was less than 1 mm, individual displacements greater than 2 mm with surgery were observed for 24% of the condyles. The condylar displacements were maintained at 1 year after surgery for 17% of the condyles.

CONCLUSIONS

The surface distance displacements indicated that the postoperative adaptations at different anatomic regions were significantly related.

摘要

目的

评估下颌前伸手术拆除夹板时及术后1年髁突、下颌支和颏部位置的三维变化之间的关联。

患者与方法

这项前瞻性观察性研究对27例呈现骨骼II类颌关系且伴有正常或深覆合的受试者进行了术前和术后扫描。采用颅底自动叠加技术评估感兴趣解剖区域的位置和/或重塑变化。使用三维彩色地图直观显示并量化位移。彩色地图中表面距离的正负值表示位移方向。采用Pearson相关系数和相关数据的线性模型评估区域位移之间的关联。

结果

术后拆除夹板至术后1年颏部位置的适应性变化与下颌支后缘(左侧,r = -0.73,P≤.0001;右侧,r = -0.68,P =.00)和髁突(左侧,r = -0.53,P =.01;右侧,r = -0.46,P =.02)的变化显著负相关,表明这些结构倾向于向相同方向位移。尽管手术导致的髁突平均位移小于1mm,但24%的髁突手术时的个体位移大于2mm。术后1年,17%的髁突维持了髁突位移。

结论

表面距离位移表明不同解剖区域的术后适应性显著相关。

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Three-dimensional assessment of mandibular advancement 1 year after surgery.术后 1 年的下颌前伸三维评估。
Am J Orthod Dentofacial Orthop. 2010 Apr;137(4 Suppl):S53.e1-12; discussion S53-5. doi: 10.1016/j.ajodo.2010.01.017.
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Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Aug;106(2):179-90. doi: 10.1016/j.tripleo.2007.11.027. Epub 2008 Apr 16.
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Stability and predictability of orthognathic surgery.正颌外科手术的稳定性和可预测性。
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