Schwartz Kristoffer, Rodrigo-Domingo Maria, Jensen Thomas
Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, AalborgDenmark.; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, AarhusDenmark.
Department of Clinical Medicine, Aalborg University, Aalborg Denmark.
J Oral Maxillofac Res. 2016 Jun 30;7(2):e5. doi: 10.5037/jomr.2016.7205. eCollection 2016 Apr-Jun.
The aim of the present study was to assess the skeletal stability after large mandibular advancement (> 10 mm) with bilateral sagittal split osteotomy and skeletal elastic intermaxillary fixation and to correlate the skeletal stability with the vertical facial type.
A total of 33 consecutive patients underwent bimaxillary surgery to correct skeletal Class II malocclusion with a mandibular advancement (> 10 mm) measured at B-point and postoperative skeletal elastic intermaxillary fixation for 16 weeks. Skeletal stability was evaluated using lateral cephalometric radiographs obtained preoperative (T1), 8 weeks postoperatively (T2), and 18 month postoperatively (T3). B-point and pogonion (Pog) was used to measure the skeletal relapse and the mandibular plane angle (MP-angle) was used to determine the vertical facial type.
The mean advancement from T1 to T2 were 11.6 mm and 13.5 mm at B-point and Pog, respectively. The mean skeletal relapse from T2 to T3 was -1.3 mm at B-point and -1.6 mm at Pog. The nineteen patients characterized as long facial types, showed the highest amount of skeletal relapse (-1.5 mm at B-point and -1.9 mm at Pog).
The present study showed a limited amount of skeletal relapse in large mandibular advancement (> 10 mm) with bilateral sagittal split osteotomy and skeletal elastic intermaxillary fixation. Bilateral sagittal split osteotomy in combination with skeletal intermaxillary fixation can therefore be an alternative to distraction osteogenesis in large mandibular advancements.
本研究旨在评估双侧矢状劈开截骨术及骨间弹性颌间固定术矫治下颌骨大幅前徙（>10mm）后的骨骼稳定性，并将骨骼稳定性与垂直面型相关联。
连续33例患者接受双颌手术，以矫治骨骼性II类错牙合畸形，下颌骨在B点处的前徙量（>10mm），术后进行16周的骨间弹性颌间固定。利用术前（T1）、术后8周（T2）及术后18个月（T3）拍摄的头颅侧位X线片评估骨骼稳定性。采用B点和颏前点（Pog）测量骨骼复发情况，采用下颌平面角（MP角）确定垂直面型。
从T1到T2，B点和Pog处的平均前徙量分别为11.6mm和13.5mm。从T2到T3，B点和Pog处的平均骨骼复发量分别为-1.3mm和-1.6mm。19例被归类为长面型的患者，骨骼复发量最高（B点为-1.5mm，Pog点为-1.9mm）。
本研究表明，双侧矢状劈开截骨术及骨间弹性颌间固定术矫治下颌骨大幅前徙（>10mm）后，骨骼复发量有限。因此，双侧矢状劈开截骨术联合骨间颌间固定术可作为下颌骨大幅前徙时牵张成骨术的替代方法。
