Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands.
Department of Oral and Maxillofacial Surgery, University Hospital of Wroclaw, Borowska 213, 50-556 Wroclaw, Poland.
J Craniomaxillofac Surg. 2017 Nov;45(11):1835-1841. doi: 10.1016/j.jcms.2017.08.023. Epub 2017 Aug 31.
To quantify the postoperative changes of the dental show and chin projection following SARME using 3D CBCT imaging.
78 patients with transversal maxillary hypoplasia and mandibular hypoplasia who underwent SARME were enrolled into the study. A cone beam computed tomography (CBCT) scan was acquired preoperatively and at least 1 year postoperatively. 3D postoperative changes in the dental show and pogonion position were measured based on soft tissue and hard tissue landmarks.
68 patients (87%) exhibited a postoperative increase in the dental show. The dental show was increased by a mean of 2.2 ± 2.0 mm (p < 0.01). The mean horizontal and vertical displacement of the chin (pogonion) following SARME was 1.6 ± 2.5 mm posteriorly and 1.6 ± 2.0 mm inferiorly (p < 0.01). An inferior displacement of the maxilla and maxillary tooth as well as a consequent clockwise pitch of the mandible seemed to play a role in inducing these postoperative changes.
An increase in dental show and a posterior and inferior displacement of the chin should be considered prior to SARME to prevent undesirable postoperative changes of the facial esthetics.
通过三维锥形束 CT（CBCT）成像定量研究上颌横向发育不足伴下颌横向发育不足患者行上颌骨矢状劈开截骨术（SARME）后的牙显露和颏部突度的术后变化。
纳入 78 例接受 SARME 的上颌横向发育不足伴下颌横向发育不足患者，获取术前和术后至少 1 年的锥形束 CT 扫描。基于软组织和硬组织标志点测量术后牙显露和颏顶点位置的三维变化。
68 例（87%）患者术后牙显露增加。牙显露平均增加 2.2±2.0mm（p<0.01）。SARME 后颏（颏顶点）的水平和垂直位移平均分别为向后 1.6±2.5mm 和向下 1.6±2.0mm（p<0.01）。上颌和上颌牙齿的向下移位以及下颌的顺时针旋转似乎在诱导这些术后变化中起作用。
在行 SARME 前应考虑牙显露增加和颏部向后和向下移位，以防止术后面部美观发生不良变化。
