Department of Orthodontics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Int J Oral Maxillofac Surg. 2013 Jun;42(6):780-9. doi: 10.1016/j.ijom.2013.01.002. Epub 2013 Feb 8.
The purpose of this study was to apply a novel method to evaluate surgical outcomes at 1 year after orthognathic surgery for Class III patients undergoing two different surgical protocols. Fifty patients divided equally into two groups (maxillary advancement only and combined with mandibular setback) had cone beam computed tomography (CBCT) scans taken pre-surgery, at splint removal, and at 1-year post-surgery. An automatic cranial base superimposition method was used to register, and shape correspondence was applied to assess, the overall changes between pre-surgery and splint removal (surgical changes) and between splint removal and 1-year post-surgery at the end of orthodontic treatment (post-surgical adaptations). Post-surgical maxillary adaptations were exactly the same for both groups, with 52% of the patients having changes >2mm. Approximately half of the post-surgical changes in the maxilla for both groups were vertical. The two-jaw group showed significantly greater surgical and post-surgical changes in the ramus, chin, and most of the condylar surfaces (P<0.05). Post-surgical adaptation on the anterior part of the chin was also more significant in the two-jaw group (P<0.05). Regardless of the type of surgery, marked post-surgical adaptations were observed in the regions evaluated, which explain the adequate maxillary-mandibular relationship at 1-year post-surgery on average, with individual variability.
本研究旨在应用一种新方法评估接受两种不同手术方案的 III 类错[牙合]畸形患者正颌手术后 1 年的手术效果。将 50 例患者等分为两组(上颌骨仅前徙和上颌骨前徙联合下颌骨后退),分别在术前、带环去除时和术后 1 年进行锥形束 CT(CBCT)扫描。采用自动颅基底叠加方法进行注册,并应用形态对应方法评估术前与带环去除时(手术变化)以及正畸治疗结束时与术后 1 年(术后适应)之间的整体变化。两组患者的上颌骨术后适应完全相同,52%的患者变化>2mm。两组上颌骨的术后变化约一半为垂直方向。双颌组的下颌支、颏部和大部分髁突表面的手术和术后变化明显更大(P<0.05)。双颌组颏部前份的术后适应也更为显著(P<0.05)。无论手术类型如何,在评估的区域都观察到明显的术后适应性变化,这解释了平均而言术后 1 年上颌骨和下颌骨的关系良好,但存在个体差异。