Politis Constantinus, Lambrichts Ivo, Sun Yi, Vrielinck Luc, Schepers Serge, Agbaje Jimoh Olubanwo
J Craniofac Surg. 2014 Nov;25(6):2121-6. doi: 10.1097/SCS.0000000000001091.
This study was aimed to investigate a modified buccal osteotomy technique and whether the integrity of the lingual part of the lower border influences the attachment of the neurovascular bundle to the proximal segment of the mandible during a sagittal split osteotomy without increasing the number of bad splits. The presence of self-reported sensibility disturbance in the lower lip at the last follow-up visit was assessed. This study included 220 and 133 patients with bilateral sagittal split osteotomy undergoing the classical and the new modified buccal osteotomy techniques, respectively. In the new technique, the lower border is divided into a lingual fragment that remains incorporated in the tooth-bearing fragment and a buccal fragment that comes with the proximal fragment (buccal plate). In the classical technique, the inferior alveolar nerve was attached to the proximal segment of the mandible in more than one third of operation sites (36.36% on the right and 40.91% on the left) compared with less than one fourth of the operation sites using the new technique (9.73% on the right and 23.01% on the left). The overall figure of self-reported changed sensibility was 09.40% (12/128) in the new technique compared to 15.12% in the classical technique. We present a suitable improvement to the classical buccal osteotomy technique that allows less manipulation and injury of the inferior alveolar nerve with consequent reduction in self-reported postoperative changes in lower lip sensation
本研究旨在探讨一种改良的颊侧截骨技术，以及在下颌骨矢状劈开截骨术中，下颌下缘舌侧部分的完整性是否会在不增加不良劈开数量的情况下，影响神经血管束与下颌近端的附着。评估了最后一次随访时患者自述下唇感觉障碍的情况。本研究分别纳入了220例接受经典颊侧截骨技术和133例接受新改良颊侧截骨技术的双侧矢状劈开截骨患者。在新技术中，下颌下缘被分为仍与含牙骨段相连的舌侧骨块和与近端骨段（颊侧骨板）相连的颊侧骨块。在经典技术中，超过三分之一的手术部位（右侧为36.36%，左侧为40.91%）下牙槽神经附着于下颌近端骨段，而使用新技术的手术部位不到四分之一（右侧为9.73%，左侧为23.01%）。新技术中患者自述感觉改变的总体比例为09.40%（12/128），而经典技术为15.12%。我们对经典颊侧截骨技术提出了一种合适的改进方法，该方法可减少下牙槽神经的操作和损伤，从而降低患者自述的术后下唇感觉变化
