Department of Oral and Maxillofacial surgery, Centre Hospitalier Universitaire (CHU) de Québec, Pavillon Hôpital de l'Enfant-Jésus, Université Laval, Québec (Québec), Canada.
Int J Oral Maxillofac Surg. 2013 May;42(5):592-6. doi: 10.1016/j.ijom.2012.10.034. Epub 2012 Nov 29.
The purpose of this study was to evaluate the accuracy of surgical splints and an external reference point to reposition the maxilla during orthognathic surgery. Before surgery, a radiological marker was inserted inside the orthodontic bracket of the first right maxillary molar. A surgical splint was utilized to reposition the maxilla in the sagittal and coronal planes after the osteotomy. The vertical position was established by measuring the distance between a Kirschner wire inserted at bony nasion and the orthodontic wire. Preoperative and postoperative cephalometric radiographs were obtained and manually traced. The radiological marker and the tip of the right maxillary incisor were used as specific landmarks. Their displacement on the pre- and postoperative radiographs was measured. The actual surgical movement of the maxilla was compared to the initial surgical planning. 23 patients met the inclusion criteria to participate in the study. The mean difference between the planned and executed movements of the maxilla was 0.1mm (p=0.71). The difference was not statistically significant for any given movements of the maxilla. The use of surgical splints made from model surgery combined with an external reference point at bony nasion is accurate methods for repositioning the maxilla during orthognathic surgery.
本研究旨在评估手术夹板和外部参考点在正颌手术中重新定位上颌骨的准确性。在手术前，将一个放射性标记物插入第一右上颌磨牙的正畸托槽内。在截骨术后，使用手术夹板在矢状面和冠状面重新定位上颌骨。通过测量骨性鼻根处插入的克氏针与正畸线之间的距离来确定垂直位置。获取术前和术后头颅侧位片并进行手动描记。将放射性标记物和右上颌切牙的尖端用作特定的标志点。测量它们在术前和术后 X 光片上的位移。将上颌骨的实际手术移动与初始手术计划进行比较。23 名患者符合纳入标准参与研究。上颌骨计划和执行运动之间的平均差异为 0.1mm（p=0.71）。对于上颌骨的任何给定运动，差异均无统计学意义。使用来自模型手术的手术夹板结合骨性鼻根处的外部参考点是正颌手术中重新定位上颌骨的准确方法。
