Oral and Maxillofacial Surgery, Graduate School, Tokyo Medical and Dental University.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 Nov;116(5):e333-41. doi: 10.1016/j.oooo.2012.02.025. Epub 2012 Jul 24.
The aim of this study was to compare clinical results of bilateral sagittal split ramus osteotomy (BSSRO) with the use of monocortical locking plate or bicortical screw fixation.
Fifty-five patients underwent BSSRO for prognathism, using either monocortical locking plate (group A; n = 28) or bicortical screw (group B; n = 27) osseofixation. No intermaxillary fixation was done after surgery. Groups were subdivided according to presence or absence of mandibular asymmetry. Time course changes in condylar and skeletal stability were measured on lateral and posteroanterior cephalograms and axial radiographs before surgery and at 3 and 6 months after surgery.
In facial symmetry subjects, the change in angle of the longitudinal axis of the condyle in group A was significantly greater than that for group B up to 3 months after surgery, but no significant differences were found in facial asymmetry subjects.
The findings of this study suggest that monocortical fixation using the locking plate system to stabilize SSRO is as reliable as bicortical screw fixation regardless of facial asymmetry.
本研究旨在比较双侧矢状劈开截骨术（BSSRO）中使用单皮质锁定板或双皮质螺钉固定的临床结果。
55 例因下颌前突而行 BSSRO 的患者，分别采用单皮质锁定板（A 组，n = 28）或双皮质螺钉（B 组，n = 27）固定。术后不进行颌间固定。根据下颌骨是否存在不对称，将各组进一步分为有或无下颌骨不对称。在术前、术后 3 个月和 6 个月，分别在侧位和前后位头颅侧位片和轴向片上测量髁突和骨骼稳定性的时程变化。
在面部对称的患者中，A 组髁突纵轴角度的变化在术后 3 个月内明显大于 B 组，但在面部不对称的患者中，无显著差异。
本研究结果表明，无论面部是否存在不对称，使用锁定板系统固定 SSRO 的单皮质固定与双皮质螺钉固定一样可靠。
