Islam I, Lim A A T, Wong R C W
Discipline of Oral and Maxillofacial Surgery, National University Hospital, Singapore; Faculty of Dentistry, National University of Singapore, Singapore.
Discipline of Oral and Maxillofacial Surgery, National University Hospital, Singapore; Faculty of Dentistry, National University of Singapore, Singapore.
Int J Oral Maxillofac Surg. 2017 Jun;46(6):746-755. doi: 10.1016/j.ijom.2017.01.012. Epub 2017 Feb 13.
Patients requesting treatment for mandibular prognathism seek functional and aesthetic improvements. Improvements in bite force and efficiency are generally used as measures of better function. It is unclear what effect the surgical correction of mandibular prognathism will have on the patient's occlusal forces. The literature was searched using medical subject heading (MeSH) and key word terms 'bite force', 'osteotomy', 'orthognathic surgery', and 'prognathism'. A total of 17 articles were included in this review. These included a total of 697 patients, who ranged in age from 15 to 44 years. Male patients outnumbered female patients in only one study. Five hundred and thirty-two patients underwent bilateral sagittal split osteotomy, 108 patients underwent intraoral vertical ramus osteotomy, and 24 patients underwent extraoral vertical ramus osteotomy (approach unspecified). In general, masticatory efficiency at 3 months after surgery was greater than that found pre-surgically; the increase was significant at 6 months after surgery. The occlusal contact area and points tended to increase from 3 months after surgery, and there was a significant increase at 12 months after surgery. Occlusal forces, although improved, will be lower in corrected prognathic patients than in normognathic patients even at 2 years after surgery.
因下颌前突而寻求治疗的患者期望功能和美观都能得到改善。咬合力和咀嚼效率的提高通常被用作衡量功能改善的指标。目前尚不清楚下颌前突手术矫正对患者咬合力会产生何种影响。我们使用医学主题词（MeSH）以及关键词“咬合力”“截骨术”“正颌外科手术”和“前突”对文献进行了检索。本综述共纳入17篇文章。这些文章共涉及697例患者，年龄在15至44岁之间。只有一项研究中男性患者数量超过女性患者。532例患者接受了双侧矢状劈开截骨术，108例患者接受了口内垂直升支截骨术，24例患者接受了口外垂直升支截骨术（手术入路未明确）。总体而言，术后3个月的咀嚼效率高于术前；术后6个月时这种提高具有显著性。咬合接触面积和接触点从术后3个月开始趋于增加，术后12个月时有显著增加。即使在术后2年，矫正后的前突患者的咬合力虽有所改善，但仍低于正常咬合患者。
