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用于面部不对称倾斜矫正的带推进植骨块的Le Fort I型截骨术的稳定性

Stability of Le Fort I Osteotomy With Propeller Graft for Canting Correction in Facial Asymmetry.

作者信息

Lee Jae-Yeol, Kim Yong-Il, Kang Hee-Jea, Song Jae-Min, Park Soo-Byung, Kim Jong-Ryoul

机构信息

*Department of Oral and Maxillofacial Surgery †Department of Orthodontics, Pusan National University Hospital ‡Department of Oral and Maxillofacial Surgery, Barun Dental Hospital §Department of Oral and Maxillofacial Surgery, On Hospital, Busan, South Korea.

出版信息

J Craniofac Surg. 2015 Oct;26(7):2077-80. doi: 10.1097/SCS.0000000000001970.

Abstract

The aim of this study was to evaluate the maxillary stability in patients who had undergone Le Fort I osteotomy with propeller graft and mandibular sagittal split ramus osteotomy for correction of maxillary asymmetry. This was a retrospective study on 15 facial asymmetry patients (7 men, 8 women: 22.2 years) requiring surgical correction at the preoperative (T0), immediately postoperative (T1) and 6 months after surgery (T2) stages. To evaluate the skeletal stability, computed tomography (CT) superimposition was used, and skeletal landmarks were measured and compared from the superimposed images according to an x, y, z coordinate system. The skeletal changes at each stage (ΔT1-T0 and ΔT2-T1) were compared by paired t-test (P<0.05). The obtained data on the skeletal changes immediately postoperatively to 6-month follow-up (ΔT2-T1) showed that the Le Fort I osteotomy with propeller graft had effected stable maxillary skeletal stability at the maxillary measurement points (posterior nasal spine (PNS ), nasopalatine canal, U3 crown tip, U3 root apex, and U6 furcation). These results suggested that in cases of facial asymmetry where the upper tooth exposure is proper and anterior-posterior movement of the maxilla is not much required, Le Fort I osteotomy with propeller graft is an effective method for stable canting correction.

摘要

本研究的目的是评估接受了带螺旋植骨块的Le Fort I型截骨术及下颌升支矢状劈开截骨术以矫正上颌骨不对称的患者的上颌骨稳定性。这是一项针对15例面部不对称患者(7名男性,8名女性;平均年龄22.2岁)的回顾性研究,在术前(T0)、术后即刻(T1)及术后6个月(T2)阶段进行评估。为评估骨骼稳定性,采用了计算机断层扫描(CT)叠加技术,并根据x、y、z坐标系从叠加图像上测量并比较骨骼标志点。各阶段的骨骼变化(ΔT1-T0和ΔT2-T1)通过配对t检验进行比较(P<0.05)。术后即刻至6个月随访(ΔT2-T1)所获得的骨骼变化数据显示,带螺旋植骨块的Le Fort I型截骨术在上颌测量点(后鼻棘(PNS)、鼻腭管、U3牙冠顶端、U3牙根尖及U6分叉处)实现了稳定的上颌骨骨骼稳定性。这些结果表明,在上颌牙齿暴露适当且上颌骨前后移动需求不大的面部不对称病例中,带螺旋植骨块的Le Fort I型截骨术是一种有效实现稳定斜行矫正的方法。

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