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使用改良L形单皮质骨板的下颌支矢状劈开截骨术后节段间移位的评估:锥形束计算机断层扫描叠加法

Evaluation of Intersegmental Displacement After Mandibular Setback Split Ramus Osteotomy Using Modified L-Shaped Monocortical Plate: Cone-Beam Computed Tomography Superimposition.

作者信息

Hwang Dae Seok, Lee Hyeong Geun, Shin Sang Hun, Kim Uk Kyu

机构信息

Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, South Korea.

出版信息

J Craniofac Surg. 2018 May;29(3):655-660. doi: 10.1097/SCS.0000000000004161.

Abstract

PURPOSE

The purpose of the current study is to compare intersegmental displacements after mandibular setback sagittal split ramus osteotomy (SSRO) using 4 types of osteosynthesis methods.

PATIENTS AND METHODS

This is a retrospective study of 53 subjects who presented underwent bilateral setback SSRO at Pusan National University Hospital from January 2009 to December 2013. The subjects were divided into 4 groups according to the osteosynthesis method applied: group A-modified L-type monocortical plate; B-conventional miniplate; group C-bicortical screws; group D-metal and absorbable screws. To obtain the intersegmental displacement, the mean of the differences of the 3-dimensional from T0 (2 days after surgery) to T1 (6 months after surgery) was calculated for the right and left condylar heads (condylion, Cd) and the right and left coronoid processes (Cps) using 3-dimensional imaging software (Ondemand 3D; Cybermed Co, Seoul, Korea).

RESULTS

For the condylion in the x, y, z coordinate system, in group A, there were significant differences in the y-axis for the right and left Cd; in group B, significant differences in the y-axis for the right Cd and in the y- and z-axes for the left Cd; in group C, no significant differences in the axis for the Cd; and in group D, there were significant differences in the y- and z-axes for the right Cd and in the x- and y-axes for the left Cd. For the Cps, the results are not much different from the condylion movement in all group.

CONCLUSION

In the current study, group C manifested the greatest displacement for the healing period. Group A did not show the significant difference to group B. In view of these results, modified L-shaped monocortical plate can be applied for osteosynthesis effectively.

摘要

目的

本研究旨在比较下颌矢状劈开截骨术(SSRO)后退下颌后,使用4种不同接骨方法后的节段间移位情况。

患者与方法

本研究为回顾性研究,对2009年1月至2013年12月在釜山国立大学医院接受双侧后退式SSRO手术的53例患者进行分析。根据所采用的接骨方法,将患者分为4组:A组——改良L型单皮质板;B组——传统微型钢板;C组——双皮质螺钉;D组——金属与可吸收螺钉。使用三维成像软件(Ondemand 3D;韩国首尔Cybermed公司)计算从T0(术后2天)至T1(术后6个月)期间,左右髁突头部(髁顶点,Cd)以及左右冠状突(Cps)三维差异的平均值,以获取节段间移位情况。

结果

在x、y、z坐标系中,对于髁顶点,A组左右Cd的y轴存在显著差异;B组右侧Cd的y轴以及左侧Cd的y轴和z轴存在显著差异;C组Cd各轴均无显著差异;D组右侧Cd的y轴和z轴以及左侧Cd的x轴和y轴存在显著差异。对于Cps,所有组的结果与髁顶点的移动情况差异不大。

结论

在本研究中,C组在愈合期的移位最大。A组与B组无显著差异。鉴于这些结果,改良L形单皮质板可有效应用于接骨。

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