Marewski Maya, Petto Carola, Schneider Matthias, Harzer Winfried
Department of Orthodontics, Technical University of Dresden, 01307 Dresden, Fetscherstr.74, Germany.
Department of Maxillo Facial Surgery, Technical University of Dresden, 01307 Dresden, Fetscherstr.74, Germany.
J Craniomaxillofac Surg. 2017 Apr;45(4):547-551. doi: 10.1016/j.jcms.2017.01.019. Epub 2017 Jan 25.
One third of adult patients with orthognathic surgery of a prognathic or retrognathic mandible show relapse. The sagittal split osteotomy of the mandible leads to a displacement of both parts up to 10 mm without any changes of muscle attachment. Changed mandible length needs adaptation of muscle capacity because of changed force to moment ratio. The aim of this Microarray study was to analyze the general genetic response of masseter muscle in patients with retrognathism or prognathism of the mandible six months after surgery in comparison with healthy untreated controls. We found in tissue samples from masseter muscle a reduction of different entities between patients and controls but less in retrognathic than in prognathic patients (274/429). The different entities to controls in prognathia were reduced from 1862 to 1749 but increased in retrognathia from 1070 to 1563. We have to consider that the total amount of different entities to the controls is higher in patients with prognathic mandible (7364) because of their strong genetic controlled development compared with that in patients with retrognathic mandible (4126), which is more environmentally influenced. It can be concluded that function follows form after surgical change with high inheritance. In retrognathic patients the adaptation could be delayed or the capacity of regeneration potential is not sufficient.
三分之一接受下颌前突或后缩正颌手术的成年患者会出现复发。下颌矢状劈开截骨术会导致两部分移位达10毫米,而肌肉附着无任何变化。由于力臂比改变,下颌长度的变化需要肌肉能力的适应。本微阵列研究的目的是分析下颌后缩或前突患者术后六个月咬肌的一般遗传反应,并与未接受治疗的健康对照进行比较。我们发现,在咬肌组织样本中,患者与对照之间不同实体的数量减少,但后缩患者比前突患者减少得更少(274/429)。前突患者与对照相比,不同实体从1862个减少到1749个,但后缩患者则从1070个增加到1563个。我们必须考虑到,与受环境影响更大的下颌后缩患者(4126个)相比,下颌前突患者与对照相比不同实体的总量更高(7364个),因为前者的发育受遗传控制更强。可以得出结论,手术改变后,功能随形态而变化,具有高度遗传性。在后缩患者中,适应可能会延迟,或者再生潜力不足。