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下颌前突畸形中下颌体前部截骨术的相关性

Relevance of anterior mandibular body ostectomy in mandibular prognathism.

作者信息

Bansal Pankaj, Singh Virender, Anand S C, Bansal Sumidha

机构信息

Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana, India.

出版信息

Natl J Maxillofac Surg. 2013 Jan;4(1):57-65. doi: 10.4103/0975-5950.117886.

Abstract

PURPOSE

We tried to find out the relevance of anterior mandibular body ostectomy in deformities of the mandible specially prognathism, which is primarily limited to anterior part only.

PATIENTS AND METHODS

Ten patients with skeletal deformity along with malocclusion, which was limited to anterior body of mandible were selected. Selected patients had proper molar interdigitation (even if class 3) and in general had anterior crossbite (except one). All patients had crossed their growth spurts and had no hormonal influence on facial deformity. Specific protocol, including cephelometric analysis cephalometry for orthognathic surgery, prediction tracing and model surgeries were devised. Pre and post-surgical orthodontics and body ostectomy were performed in all patients along with 18-month post-op follow-up.

RESULTS

There was significant reduction in prognathism and horizontal dysplasia in all ten patients. Anterior crossbite as well as axis of incisiors over mandibular plane was corrected in all patients due to decrease in length of mandibular body. All patients showed decreased facial height and better lip competence with intact posterior occlusion and no (negligible or transient) sensory loss.

CONCLUSIONS

Our study could confirm that people whose deformity is limited to the anterior part of mandible with reasonable occlusion posteriorly can get satisfactory cosmetic and functional results through body ostectomy alone rather than going for surgical procedure in the ramal area, which is liable to cause sensory and occlusal disturbances.

摘要

目的

我们试图探究下颌骨体前部截骨术在主要局限于前部的下颌骨畸形特别是前突畸形中的相关性。

患者与方法

选择10例伴有错牙合畸形的骨骼畸形患者,其畸形局限于下颌骨体前部。入选患者有正常的磨牙咬合关系(即使是Ⅲ类错牙合),且一般有前牙反牙合(除1例)。所有患者均已度过生长高峰期,且面部畸形无激素影响。制定了具体方案,包括用于正颌外科手术的头影测量分析、预测性描记和模型外科手术。对所有患者进行了术前和术后正畸治疗以及下颌骨体截骨术,并进行了18个月的术后随访。

结果

所有10例患者的前突和水平发育异常均有显著改善。由于下颌骨体长度缩短,所有患者的前牙反牙合以及切牙相对于下颌平面的轴倾度均得到矫正。所有患者面部高度降低,唇部功能改善,后牙咬合完好,且无(可忽略不计或短暂的)感觉丧失。

结论

我们的研究可以证实,对于畸形局限于下颌骨前部且后部咬合关系正常的患者,仅通过下颌骨体截骨术即可获得满意的美容和功能效果,而无需进行下颌升支区域的手术,后者容易导致感觉和咬合紊乱。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59ea/3800386/c3b4800c8e4f/NJMS-4-57-g001.jpg

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