Posnick J C, Choi E, Chang R P
Posnick Center for Facial Plastic Surgery, Georgetown University, Washington, DC, USA; School of Dentistry, University of Maryland, Baltimore, MD, USA; Howard University College of Dentistry, Washington, DC, USA.
Oral and Maxillofacial Surgery, Howard University Hospital, Washington, DC, USA.
Int J Oral Maxillofac Surg. 2016 Jul;45(7):904-13. doi: 10.1016/j.ijom.2016.02.009. Epub 2016 Mar 10.
The purpose of this study was to evaluate the results of osseous genioplasty with bimaxillary orthognathic surgery. A retrospective consecutive case series of patients treated by a single surgeon between 2004 and 2013 was studied. All underwent Le Fort I, sagittal ramus osteotomies, septoplasty, inferior turbinate reduction, and osseous genioplasty. The outcome variables included the presenting chin dysmorphology, complications, and assessment of morphologic change. A Steiner analysis was completed for each subject's interval cephalogram. Two hundred sixty-two subjects met the inclusion criteria. Their mean age at operation was 25 (range 13-63) years. Chin osteotomy complications included one wound infection (0.4%), and two of the 1572 mandibular anterior teeth at risk sustained a pulpal injury. None of the subjects required revision. For subjects undergoing chin advancement, the mean change was +3.5 (range +3 to +6) mm. A majority also underwent counterclockwise rotation of the mandible (62%). For those undergoing chin lengthening, the mean change was +5 (range +3 to +12mm) mm, and for those undergoing vertical shortening, the mean change was -3.5 (range -3 to -7) mm. Osseous genioplasty is confirmed to be a safe method to reshape the chin. When osseous genioplasty is performed in conjunction with bimaxillary orthognathic surgery, only a modest horizontal change is required to achieve the preferred pogonion projection.
本研究的目的是评估骨性颏成形术联合双颌正颌手术的效果。对2004年至2013年间由单一外科医生治疗的一系列连续回顾性病例进行了研究。所有患者均接受了Le Fort I型手术、矢状劈开截骨术、鼻中隔成形术、下鼻甲缩小术和骨性颏成形术。结果变量包括颏部畸形表现、并发症以及形态学变化评估。对每位受试者的间隔头颅侧位片进行了Steiner分析。262名受试者符合纳入标准。他们手术时的平均年龄为25岁（范围13 - 63岁）。颏部截骨术并发症包括1例伤口感染（0.4%），1572颗下颌前牙中有2颗有牙髓损伤风险。所有受试者均无需翻修。对于颏部前移的受试者，平均变化为 +3.5（范围 +3至 +6）mm。大多数受试者还进行了下颌逆时针旋转（62%）。对于颏部加长的受试者，平均变化为 +5（范围 +3至 +12）mm，对于颏部垂直缩短的受试者，平均变化为 -3.5（范围 -3至 -7）mm。骨性颏成形术被证实是一种重塑颏部的安全方法。当骨性颏成形术与双颌正颌手术联合进行时，仅需适度的水平变化即可达到理想的颏前点投影。
