Efendiyeva Ruchengiz, Aydemir Halise, Karasu Hakan, Toygar-Memikoğlu Ufuk
a Research Assistant, Department of Orthodontics, University of Ankara, Faculty of Dentistry, Ankara, Turkey.
Angle Orthod. 2014 Sep;84(5):773-81. doi: 10.2319/072213-534.1. Epub 2014 Mar 7.
(1) To determine the effect of bimaxillary orthognathic surgery on pharyngeal airway, hyoid bone, and craniocervical posture in Class III bimaxillary surgery patients. (2) To evaluate short-term and long-term results. (3) To compare short- and long-term values.
Twenty-six Class III adult patients treated with bimaxillary surgery were included in the study. Cephalometric records were taken before treatment (T1), before surgery (T2), and 5 months (T3), 1.4 years (T4), 3 years (T5), and 5 years (T6) postsurgery.
No significant differences were identified in craniocervical angulation between time intervals. There was a significant superior movement of hyoid bone at postsurgery (T3; P < .05); however, adaptation occurred to the normal position in the long term. A nonsignificant decrease occurred at the oropharyngeal middle pharyngeal distance parameter; however, this was compensated with a significant increase between T5 and T6 (P < .001). A significant decrease was observed in the hypopharyngeal Go-P parameter between T3 and T1 (P < .01), but it recovered with a nonsignificant increase in the long term. A significant increase in nasopharyngeal area was observed between T3 and T1 (P < .05). The hypopharyngeal area significantly increased between T5 and T6, and PNS-R significantly increased between T3 and T1 (P < .05).
The pharyngeal areas adversely affected after surgery recover at long-term follow-up; thus, adaptation occurs after bimaxillary surgery.
(1)确定双颌正颌手术对Ⅲ类双颌手术患者咽气道、舌骨和颅颈姿势的影响。(2)评估短期和长期结果。(3)比较短期和长期数值。
本研究纳入了26例接受双颌手术治疗的Ⅲ类成年患者。在治疗前(T1)、手术前(T2)以及术后5个月(T3)、1.4年(T4)、3年(T5)和5年(T6)进行了头影测量记录。
各时间间隔之间的颅颈角度未见显著差异。术后舌骨有显著的向上移动(T3;P <.05);然而,长期来看会适应至正常位置。口咽中部咽距参数出现了不显著的下降;然而,这在T5和T6之间通过显著增加得到了补偿(P <.001)。下咽Go-P参数在T3和T1之间观察到显著下降(P <.01),但长期来看通过不显著的增加而恢复。T3和T1之间观察到鼻咽面积显著增加(P <.05)。下咽面积在T5和T6之间显著增加,PNS-R在T3和T1之间显著增加(P <.05)。
手术后受到不利影响的咽部区域在长期随访中恢复;因此,双颌手术后会出现适应性变化。