Larson Brent E, Lee Nam-Ki, Jang Moon-Jung, Yun Pil-Young, Kim Jong-Wan, Kim Young-Kyun
Associate Professor, Division of Orthodontics, School of Dentistry, University of Minnesota, Minneapolis, MN.
Associate Professor, Department of Orthodontics, Seoul National University Bundang Hospital, Seongnam, South Korea.
J Oral Maxillofac Surg. 2017 Jun;75(6):1240-1248. doi: 10.1016/j.joms.2017.01.020. Epub 2017 Jan 30.
The aim of this study was to compare treatment time and skeletal stability between mandibular setback surgery (MS) and 2-jaw surgery (2J) with minimal presurgical orthodontics (MPO) in patients with skeletal Class III.
One hundred ninety-five patients who underwent orthognathic surgery were enrolled in this retrospective cohort study. Consecutive patients were selected based on standardized inclusion criteria: Class III malocclusion with mandibular prognathism, surgery type, and presurgical orthodontics with non-extraction for less than 6 months (MPO). Lateral cephalograms were taken before surgery (T0), 1 month after surgery (T1), and at debonding (T2). To evaluate surgical changes (T0 to T1) and postsurgical changes (T1 to T2) in skeletodental tissue, linear, angular, and dental measurements were analyzed using paired t test and independent t test.
Thirty-one patients were allocated to the MS-MPO group (n = 16) and the 2J-MPO group (n = 15). The 2J-MPO group showed a shorter duration of postsurgical orthodontic and total surgical and orthodontic treatment than the MS-MPO group. Although the 2J-MPO group exhibited advancement and superior impaction of the maxilla from T0 to T1, posterior movement with clockwise rotation of the mandible between the 2 groups did not show a statistical difference. In addition, from T1 to T2, the MS-MPO and 2J-MPO groups presented forward and upward movement and counterclockwise rotation of the mandible, but no intergroup difference was found.
The MS-MPO and 2J-MPO groups showed similar horizontal and vertical mandibular stability. However, the 2J-MPO group presented a shorter surgical and orthodontic treatment time than the MS-MPO group.
本研究旨在比较骨骼Ⅲ类患者在进行下颌后缩手术（MS）和双颌手术（2J）并采用最小化术前正畸（MPO）治疗时的治疗时间和骨骼稳定性。
195例行正颌手术的患者纳入本回顾性队列研究。根据标准化纳入标准选择连续的患者：Ⅲ类错颌畸形伴下颌前突、手术类型以及术前正畸不拔牙且时间少于6个月（MPO）。在术前（T0）、术后1个月（T1）和拆除矫治器时（T2）拍摄头颅侧位片。为评估骨骼牙组织的手术变化（T0至T1）和术后变化（T1至T2），采用配对t检验和独立t检验分析线性、角度和牙齿测量数据。
31例患者被分配至MS-MPO组（n = 16）和2J-MPO组（n = 15）。2J-MPO组术后正畸及手术和正畸总治疗时间比MS-MPO组短。虽然2J-MPO组从T0到T1上颌有前移和更显著的压低，但两组之间下颌向后移动并顺时针旋转未显示出统计学差异。此外，从T1到T2，MS-MPO组和2J-MPO组下颌均有向前向上移动和逆时针旋转，但组间未发现差异。
MS-MPO组和2J-MPO组在下颌水平和垂直稳定性方面相似。然而，2J-MPO组的手术和正畸治疗时间比MS-MPO组短。
