Department of Orthodontics and Craniofacial Biology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Int J Oral Maxillofac Surg. 2012 May;41(5):553-9. doi: 10.1016/j.ijom.2011.07.1071. Epub 2012 Feb 20.
33 patients (27 females; 6 males) were retrospectively analysed for skeletal and dental relapse before distraction osteogenesis (DOG) of the mandibular anterior alveolar process at T1 (17.0 days), after DOG at T2 (mean 6.5 days), at T3 (mean 24.4 days), and at T4 (mean 2.0 years). Lateral cephalograms were traced by hand, digitized, superimposed, and evaluated. Skeletal correction (T3-T1) was mainly achieved through the distraction of the anterior alveolar segment in a rotational manner where the incisors were more proclined. The horizontal backward relapse (T4-T3) measured -0.8mm or 19.0% at point B (p<0.001) and -1.6mm or 25.0% at incision inferior (p<0.001). Age, gender, amount and type (rotational versus translational) of advancement were not correlated with the amount of relapse. High angle patients (NL/ML'; p<0.01) and patients with large gonial angle (p<0.05) showed significantly smaller relapse rates at point B. Overcorrection of the overjet achieved by the distraction was seen in a third of the patients and could be a reason for relapse. Considering the amount of skeletal relapse the DOG could be an alternative to bilateral sagittal split osteotomy for mandibular advancement in selected cases.
33 名患者（27 名女性；6 名男性）接受了回顾性分析，以研究下颌前牙槽骨段在牵引成骨（DOG）前（T1，17.0 天）、DOG 后（T2，平均 6.5 天）、T3（平均 24.4 天）和 T4（平均 2.0 年）时的骨骼和牙齿复发情况。通过手工追踪、数字化、叠加和评估侧位头颅侧位片。骨骼矫正（T3-T1）主要通过旋转式牵引前牙槽段实现，切牙更前倾。水平向后复发（T4-T3）在 B 点测量为-0.8mm 或 19.0%（p<0.001），在切口下测量为-1.6mm 或 25.0%（p<0.001）。年龄、性别、前牙的量和类型（旋转式与平移式）与复发量无关。高角患者（NL/ML'，p<0.01）和下颌角大的患者（p<0.05）在 B 点的复发率明显较低。三分之一的患者出现了因牵引而导致的前牙覆盖过度矫正，这可能是复发的原因之一。考虑到骨骼复发的程度，在某些情况下，DOG 可以替代双侧矢状劈开截骨术来进行下颌前突。
