Ying B, Ye N, Jiang Y, Liu Y, Hu J, Zhu S
State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Stomatology, Ningbo First Hospital, Ningbo, China.
Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Int J Oral Maxillofac Surg. 2015 Nov;44(11):1330-6. doi: 10.1016/j.ijom.2015.05.012. Epub 2015 Jul 17.
The facial asymmetry associated with vertical maxillary excess and mandibular prognathism is one of the more complicated types in the field of oral and maxillofacial surgery. The purpose of this study was to investigate the efficacy of combined orthognathic surgeries, together with guiding templates and splints fabricated by rapid prototyping technique, for the correction of facial asymmetry. Fourteen patients with facial asymmetry associated with vertical maxillary excess and mandibular prognathism were included. A maxillary Le Fort I osteotomy, a sagittal split ramus osteotomy on the shorter side of the face, and an intraoral vertical ramus osteotomy on the longer side of the face were performed with the aid of guiding templates and splints fabricated by rapid prototyping technique. Parameters reflecting maxillary canting, ramal inclination, mandibular deviation, and chin inclination were measured before surgery, 7 days after surgery, and 1 year after surgery, and compared. Significant differences in these parameters were found between the two sides preoperatively, whereas no differences were observed postoperatively. Facial asymmetry was corrected in all patients with satisfactory outcomes. In conclusion, combined orthognathic surgery and guiding templates and splints can offer improvements in accuracy, complexity, and duration over traditional procedures for the correction of facial asymmetry associated with vertical maxillary excess and mandibular prognathism.
与垂直上颌骨过长和下颌前突相关的面部不对称是口腔颌面外科领域中较为复杂的类型之一。本研究的目的是探讨正颌联合手术,以及通过快速成型技术制作的导板和夹板对矫正面部不对称的疗效。纳入了14例与垂直上颌骨过长和下颌前突相关的面部不对称患者。借助快速成型技术制作的导板和夹板,进行了上颌Le Fort I截骨术、在面部较短侧进行矢状劈开下颌支截骨术以及在面部较长侧进行口内垂直下颌支截骨术。在术前、术后7天和术后1年测量反映上颌倾斜、下颌支倾斜、下颌偏斜和颏部倾斜的参数,并进行比较。术前两侧这些参数存在显著差异,而术后未观察到差异。所有患者的面部不对称均得到矫正,效果满意。总之,与传统手术相比,正颌联合手术以及导板和夹板在矫正与垂直上颌骨过长和下颌前突相关的面部不对称方面,在准确性、复杂性和手术时长方面均有改善。