Sakharia A, Muthusekar M R
Department of Oral and Maxillofacial Surgery, Saveetha University, Chennai, Tamil Nadu, India.
Department of Oral and Maxillofacial Surgery, Saveetha University, Chennai, Tamil Nadu, India.
Int J Oral Maxillofac Surg. 2015 Mar;44(3):343-8. doi: 10.1016/j.ijom.2014.10.014. Epub 2014 Nov 18.
Compromised maxillary perfusion following Le Fort I osteotomy is a potentially serious complication resulting in hard and/or soft tissue loss. The aim of this study was to compare the change in perfusion between two techniques of posterior maxillary disjunction by intraoperative measurement of maxillary gingival blood flow (GBF). Further, we sought to correlate the association of the movement of the maxilla and estimated blood loss as factors. The study population comprised 38 individuals, divided equally into two groups: a pterygoid disjunction group and a third molar socket disjunction group. GBF was measured using Doppler flowmetry. A P-value of <0.05 was considered significant. There was a significant drop in GBF in both groups. However, there was no significant difference between the groups based on magnitude of blood flow drop. Superior repositioning of the osteotomized maxilla caused the greatest drop in GBF, which was statistically significant. There was significantly less blood loss in the pterygoid disjunction group. In conclusion, Le Fort I osteotomy causes a significant decrease in GBF. The technique used for posterior maxillary disjunction does not influence the magnitude of drop in perfusion. There is a significant correlation of other factors such as the effect of superior repositioning of the maxilla and blood loss with the osteotomy techniques.
Le Fort I型截骨术后上颌骨灌注受损是一种潜在的严重并发症,可导致硬组织和/或软组织丧失。本研究的目的是通过术中测量上颌牙龈血流量(GBF),比较两种上颌骨后部离断技术之间的灌注变化。此外,我们试图将上颌骨移动和估计失血量之间的关联作为因素进行关联分析。研究人群包括38名个体,平均分为两组:翼突离断组和第三磨牙牙槽离断组。使用多普勒血流仪测量GBF。P值<0.05被认为具有统计学意义。两组的GBF均显著下降。然而,基于血流下降幅度,两组之间没有显著差异。截骨上颌骨的向上重新定位导致GBF下降最大,具有统计学意义。翼突离断组的失血量明显较少。总之,Le Fort I型截骨术导致GBF显著降低。用于上颌骨后部离断的技术不影响灌注下降的幅度。上颌骨向上重新定位的影响和失血量等其他因素与截骨术技术之间存在显著相关性。