Ismail I N, Leung Y Y
Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong.
Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong.
Int J Oral Maxillofac Surg. 2017 Jun;46(6):766-773. doi: 10.1016/j.ijom.2017.02.1275. Epub 2017 Mar 18.
A retrospective cohort study was conducted to analyze the relapse rate of anterior open bite (AOB) correction comparing Le Fort I osteotomy with and without anterior segmentation. The risk factors that might contribute to relapse were also assessed. Lateral cephalograms obtained at six different times were analyzed. A total of 81 patients with AOB were recruited. Thirty-five patients underwent Le Fort I osteotomy without anterior segmentation and 46 patients underwent anterior segmentation. Le Fort I osteotomy with anterior segmentation resulted in significantly more AOB relapse when compared to that without anterior segmentation at 7 weeks postoperative (15.2% vs. 0%, P=0.016). During the early postoperative period, factors that contributed to AOB relapse in Le Fort I osteotomy with anterior segmentation were AOB closure ≥4mm and inferior positioning of the anterior segment >2mm. Over the long term, AOB closure ≥4mm and intraoral vertical ramus osteotomy as the only mandibular procedure were factors identified as causing more AOB relapse in those treated by Le Fort I osteotomy with anterior segmentation. In conclusion, Le Fort I osteotomy without anterior segmentation was found to be more stable in the surgical correction of AOB in the early and late postoperative periods.
进行了一项回顾性队列研究，以分析比较有和无前部节段性切开的Le Fort I截骨术矫正前牙开（AOB）的复发率。还评估了可能导致复发的危险因素。分析了在六个不同时间获得的头颅侧位片。共招募了81例AOB患者。35例患者接受了无前部节段性切开的Le Fort I截骨术，46例患者接受了前部节段性切开。与术后7周时无前部节段性切开的情况相比，有前部节段性切开的Le Fort I截骨术导致AOB复发明显更多（15.2%对0%，P=0.016）。在术后早期，有前部节段性切开的Le Fort I截骨术中导致AOB复发的因素是AOB闭合≥4mm以及前部节段向下移位>2mm。从长期来看，AOB闭合≥4mm以及仅进行口内垂直升支截骨术作为唯一的下颌手术是在接受有前部节段性切开的Le Fort I截骨术治疗的患者中导致更多AOB复发的因素。总之，发现在术后早期和晚期，无前部节段性切开的Le Fort I截骨术在AOB手术矫正中更稳定。
