Brockmeyer Phillipp, Hahn Wolfram, Fenge Stefan, Moser Norman, Schliephake Henning, Gruber Rudolf Matthias
Department of Oral and Maxillofacial Surgery, University Medical Centre Goettingen, Robert-Koch-Str. 40, 37075, Goettingen, Germany,
Oral Maxillofac Surg. 2015 Sep;19(3):301-7. doi: 10.1007/s10006-015-0499-0. Epub 2015 Apr 25.
This clinical trial aimed to test the hypothesis that piezosurgery causes reduced nerval irritations and, thus, reduced somatosensory impairment when used in orthognathic surgery of the mandible.
To this end, 37 consecutive patients with Angle Class II and III malocclusion were treated using bilateral sagittal split osteotomies (BSSO) of the mandible. In a split mouth design, randomized one side of the mandible was operated using a conventional saw, while a piezosurgery device was used on the contralateral side. In order to test the individual qualities of somatosensory function, quantitative sensory testings (QSTs) were performed 1 month, 6 months and 1 year after surgery.
A comparison of the data using a two-way analysis of variance (ANOVA) revealed a significant reduction in postoperative impairment in warm detection threshold (WDT) (P = 0.046), a decreased dynamic mechanical allodynia (ALL) (P = 0.002) and a decreased vibration detection threshold (VDT) (P = 0.030) on the piezosurgery side of the mandible as opposed to the conventionally operated control side. In the remaining QSTs, minor deviations from the preoperative baseline conditions and a more rapid regression could be observed.
Piezosurgery caused reduced somatosensory impairment and a faster recovery of somatosensory functions in the present investigation.
本临床试验旨在验证以下假设：在进行下颌骨正颌手术时，压电手术可减少神经刺激，从而减少体感障碍。
为此，对37例连续的安氏II类和III类错牙合患者采用下颌骨双侧矢状劈开截骨术（BSSO）进行治疗。采用双侧对照设计，随机选择一侧下颌骨使用传统锯进行手术，而对侧使用压电手术设备。为了测试个体的体感功能质量，在术后1个月、6个月和1年进行定量感觉测试（QST）。
使用双向方差分析（ANOVA）对数据进行比较后发现，与传统手术对照侧相比，下颌骨压电手术侧的术后热觉阈值（WDT）损伤显著降低（P = 0.046），动态机械性异常性疼痛（ALL）降低（P = 0.002），振动觉阈值（VDT）降低（P = 0.030）。在其余的QST中，可以观察到与术前基线条件的微小偏差以及更快的恢复。
在本研究中，压电手术导致体感障碍减少，体感功能恢复更快。
