Kim Yeon-Joo, Lee Yoonjung, Chun Youn-Sic, Kang Nara, Kim Sun-Jong, Kim Minji
Former Student, Division of Orthodontics, School of Medicine, Ewha Womans University, Seoul, Korea.
Fellow, Division of Orthodontics, School of Medicine, Ewha Womans University, Seoul, Korea.
J Oral Maxillofac Surg. 2014 Jan;72(1):145-56. doi: 10.1016/j.joms.2013.07.031. Epub 2013 Sep 24.
Postsurgical changes in the condylar position are of great importance to surgical stability, especially in asymmetric double-jaw surgery. The aims of this study were to evaluate positional changes of the condyle up to 12 months after surgery in patients with Class III malocclusion and to identify the factors affecting postsurgical condylar position.
The study included 33 adult patients diagnosed with skeletal Class III malocclusion who underwent bimaxillary surgery and had full cone-beam volumetric imaging (CBVI) records up to 1 year after surgery. The CBV images were obtained before surgery and 2 weeks, 3 months (T2), 6 months (T3), and 12 months after surgery. Condyles with deviated and nondeviated sides were examined separately regardless of the degree of asymmetry. Analyses of variance and multiple regression analysis were performed to identify factors that could affect the position of the mandibular condyles.
The condyles exhibited anterior displacement at T2, which returned to a more distal position afterward in the axial view, and an inward rotation in the coronal view up to T3. From the sagittal view, the deviated and nondeviated condylar sides rotated forward and remained stable after T2. The degree of menton deviation affected the angle of condylar rotation (horizontal angle).
The results of this study suggest that condyles tend to move in a certain direction, and this can influence postsurgical relapse up to 6 months after surgery. However, they remain relatively stable afterward.
髁突位置的术后变化对手术稳定性至关重要,尤其是在不对称双颌手术中。本研究的目的是评估Ⅲ类错牙合患者术后长达12个月时髁突的位置变化,并确定影响术后髁突位置的因素。
本研究纳入了33例诊断为骨性Ⅲ类错牙合的成年患者,这些患者接受了双颌手术,并在术后1年内有完整的锥形束容积成像(CBVI)记录。在手术前以及术后2周、3个月(T2)、6个月(T3)和12个月时获取CBV图像。无论不对称程度如何,分别检查偏斜侧和非偏斜侧的髁突。进行方差分析和多元回归分析以确定可能影响下颌髁突位置的因素。
在轴向视图中,髁突在T2时表现为向前移位,随后回到更靠后的位置,在冠状视图中直至T3时表现为向内旋转。从矢状视图来看,偏斜侧和非偏斜侧的髁突在T2后向前旋转并保持稳定。颏点偏斜程度影响髁突旋转角度(水平角)。
本研究结果表明,髁突倾向于向特定方向移动,这可能会影响术后6个月内的复发。然而,此后它们相对稳定。