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Ⅲ类错牙合畸形外科正畸矫治后的三维区域位移

Three-dimensional regional displacement after surgical-orthodontic correction of Class III malocclusion.

作者信息

Koerich L, Ruellas A C O, Paniagua B, Styner M, Turvey T, Cevidanes L H S

机构信息

International Dental Program, Virginia Commonwealth University, Richmond, VA, USA.

Department of Orthodontics, University Federal of Rio de Janeiro, Rio de Janeiro, Brazil.

出版信息

Orthod Craniofac Res. 2016 May;19(2):65-73. doi: 10.1111/ocr.12114. Epub 2015 Nov 1.

Abstract

OBJECTIVES

To investigate how displacements of maxillo-mandibular structures are associated with each other at splint removal and 1 year post-surgery following 1-jaw and 2-jaw surgeries for correction of Class III malocclusion.

SETTING AND SAMPLE POPULATION

Fifty patients who underwent surgical correction with maxillary advancement only (n = 25) or combined with mandibular setback (n = 25) were prospectively enrolled in this study.

METHODS

Cone-beam computed tomographies were taken pre-surgery, at splint removal and at 1 year post-surgery. Three-dimensional cranial base superimpositions and shape correspondence were used to measure the outcomes from pre-surgery to splint removal (surgical changes) and splint removal to 1 year post-surgery (post-surgical adaptations). Pearson's correlation coefficients were used to evaluate the association between the regional displacements.

RESULTS

Both surgery groups presented mandibular clockwise rotation with surgery and post-surgical adaptive counterclockwise rotation. In patients treated with maxillary advancement only, the surgical changes of the maxilla were significantly correlated with chin changes. The amount and direction of chin autorotation were significantly correlated with right and left ramus autorotation. Right and left condylar displacements were significantly correlated. One year post-surgery, adaptive displacements and bone remodeling of both rami were correlated with the chin and condylar changes. For the 2-jaw group, the few correlations between the positional and remodeling changes in the anatomic regions of interest observed due to the surgery were different than those observed after post-surgical adaptations, suggesting that these changes occurred independently.

CONCLUSION

Our results indicate that surgical displacements and post-surgical adaptations are often correlated in one-jaw surgery and are, in general, independent in two-jaw surgery.

摘要

目的

研究在进行单颌和双颌手术矫治III类错牙合畸形后,上颌-下颌结构移位在去除夹板时及术后1年时如何相互关联。

设置与样本量

前瞻性纳入50例仅接受上颌前徙手术(n = 25)或联合下颌后退手术(n = 25)的手术矫治患者。

方法

在术前、去除夹板时及术后1年进行锥形束计算机断层扫描。采用三维颅底叠加和形状对应来测量从术前到去除夹板时(手术变化)以及从去除夹板到术后1年时(术后适应性变化)的结果。使用Pearson相关系数评估区域移位之间的关联。

结果

两个手术组在手术时均出现下颌顺时针旋转,术后适应性逆时针旋转。仅接受上颌前徙手术的患者中,上颌的手术变化与颏部变化显著相关。颏部自身旋转的量和方向与左右下颌升支自身旋转显著相关。左右髁突移位显著相关。术后1年,双侧下颌升支的适应性移位和骨重塑与颏部及髁突变化相关。对于双颌手术组,手术引起的感兴趣解剖区域位置和重塑变化之间的相关性与术后适应性变化后观察到的不同,表明这些变化是独立发生的。

结论

我们的结果表明,单颌手术中手术移位和术后适应性变化通常相关,而双颌手术中总体上是独立的。

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