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双颌正颌手术后骨骼Ⅲ类错合伴前牙开牙合的复发情况,取决于上颌后份垂直牵引和下颌逆时针旋转

Relapse of skeletal class III with anterior open bite after bimaxillary orthognathic surgery depending on maxillary posterior impaction and mandibular counterclockwise rotation.

作者信息

Kor Hok Sim, Yang Hoon Joo, Hwang Soon Jung

机构信息

Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, 28 Yeongeon-dong, Jongno-gu, Seoul 110-768, Republic of Korea.

Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, 28 Yeongeon-dong, Jongno-gu, Seoul 110-768, Republic of Korea.

出版信息

J Craniomaxillofac Surg. 2014 Jul;42(5):e230-8. doi: 10.1016/j.jcms.2013.08.013. Epub 2013 Oct 3.

Abstract

The goal of this study is to evaluate relapse after orthognathic surgery of skeletal class III with anterior open bite depending on the posterior impaction and mandibular counterclockwise rotation. Patients (n = 29) were divided into two groups according to the change of mandibular occlusal plane angle (MnOP): Group A had a clockwise change of MnOP > 0° (n = 11) and Group B had a counterclockwise change of MnOP < -2° (n = 18). Lateral cephalograms were analyzed preoperatively, and at immediate stage, six weeks, six months, and one year after surgery. One year after surgery, the stability of the maxilla was good in both groups. Upward movement of the mandible was observed six weeks after surgery due to mandibular autorotation. The amount of mean relapse was small, although a significant difference was observed horizontally between groups. Group B demonstrated more forward movement of B point, pogonion, and menton than Group A (p < 0.05). SNB angle increased in both groups (p < 0.05). At one year follow up, good occlusal stability was observed in both groups with positive overbite. Our study suggested that bimaxillary procedures with clockwise and counterclockwise rotation of mandibular occlusal planes for correction of mandibular prognathism with anterior open bite appeared to be relatively stable procedures.

摘要

本研究的目的是根据后方垂直截骨和下颌逆时针旋转,评估骨性Ⅲ类伴前牙开(牙合)正颌外科手术后的复发情况。根据下颌(牙合)平面角(MnOP)的变化将患者(n = 29)分为两组:A组MnOP顺时针变化>0°(n = 11),B组MnOP逆时针变化<-2°(n = 18)。术前以及术后即刻、6周、6个月和1年时分析头颅侧位片。术后1年,两组上颌稳定性均良好。术后6周观察到由于下颌自动旋转导致下颌向上移动。尽管两组在水平方向上存在显著差异,但平均复发量较小。B组B点、颏前点和颏下点向前移动比A组更多(p<0.05)。两组SNB角均增大(p<0.05)。在1年随访时,两组均观察到具有正覆盖的良好咬合稳定性。我们的研究表明,采用下颌(牙合)平面顺时针和逆时针旋转的双颌手术矫正下颌前突伴前牙开(牙合)似乎是相对稳定的手术。

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