Venkategowda Pruthvi Raj Hanthur, Prakash A T, Roy E T, Shetty K Sadashiva, Thakkar Surbhi, Maurya Rajkumar
Assistant Professor, Department of Dentistry, BGS Global Institute of Medical Sciences , Bengaluru, Karnataka, India .
Professor, Department of Orthodontics, Bapuji Dental College , Davengere, Karnataka, India .
J Clin Diagn Res. 2017 Jan;11(1):ZC10-ZC14. doi: 10.7860/JCDR/2017/22455.9133. Epub 2016 Dec 22.
The restoration of normal jaw function, optimal facial aesthetics and long term stability are the goals of any orthognathic surgical procedures. During the last two decades, several cephalometric investigations have been reported on the skeletal changes following maxillary surgical procedures. The stability following LeFort I osteotomy and maxillary superior repositioning of the maxilla has not been studied extensively.
This study was aimed at determining the surgical changes brought about by superior repositioning of the maxilla by Le Fort I osteotomy and evaluate the stability of the surgical procedure one year following surgery.
Presurgical and postsurgical and one year post surgical lateral cephalograms of 10 adult patients (age group - 17 to 40 years, with a mean age of 22.2 years) who had been treated successfully by maxillary Le-Fort I osteotomy and impaction were obtained. The lateral cephalograms were grouped into three categories: T1- Presurgical, T2- Postsurgical, T3- One year postsurgical. Comparisons were made between T1-T2 and T2-T3 to assess the changes following surgery and to evaluate the stability, one year following the surgery using 5 horizontal, 5 vertical linear and 2 angular measurement. Statistical analysis was done with SPSS (Version 17). Results were expressed as mean±standard deviation. A paired t-test was used to analyze the paired observations.
The difference between T1 and T2 values of vertical changes showed that they were statistically highly significant whereas from T2 to T3 they were insignificant. The difference between T1 and T2 values of all the horizontal changes showed that they were statistically significant whereas True Vertical Line (TVL) to point Anterior Nasal Spine (ANS) was not statistically significant. The horizontal changes from T2 to T3 were statistically not significant whereas TVL to point Incisal edge of upper incisor (Is) was statistically significant. The angular changes from T1 to T2, T2 to T3 were statistically not significant.
There was a significant reduction in the facial height and significant anterior movement of maxilla after surgery. Even after one year of surgery, negligible amount of relapse was recorded except at the incisors.
恢复正常的颌功能、达到最佳面部美观效果以及实现长期稳定性是任何正颌外科手术的目标。在过去二十年中，已有多项关于上颌外科手术后骨骼变化的头影测量研究报告。LeFort I型截骨术及上颌骨上移术后的稳定性尚未得到广泛研究。
本研究旨在确定LeFort I型截骨术上颌骨上移所带来的手术变化，并评估术后一年该手术的稳定性。
获取了10例成年患者（年龄组为17至40岁，平均年龄22.2岁）术前、术后及术后一年的头颅侧位片，这些患者均成功接受了上颌LeFort I型截骨术及骨块植入术。头颅侧位片分为三类：T1 - 术前，T2 - 术后，T3 - 术后一年。对T1 - T2和T2 - T3进行比较，以评估手术后的变化，并使用5项水平、5项垂直线性及2项角度测量评估术后一年的稳定性。使用SPSS（版本17）进行统计分析。结果以均值±标准差表示。采用配对t检验分析配对观察值。
垂直变化的T1和T2值之间的差异显示具有高度统计学意义，而从T2到T3则无统计学意义。所有水平变化的T1和T2值之间的差异显示具有统计学意义，而真正垂直线（TVL）至前鼻棘（ANS）点则无统计学意义。从T2到T
