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采用口内垂直升支截骨术与传统手术的正畸正颌双颌手术的长期稳定性

Long-Term Stability of Pre-Orthodontic Orthognathic Bimaxillary Surgery Using Intraoral Vertical Ramus Osteotomy Versus Conventional Surgery.

作者信息

Jeong Jeong-Hwa, Choi Sung-Hwan, Kim Kee-Deog, Hwang Chung-Ju, Lee Sang-Hwy, Yu Hyung-Seog

机构信息

Graduate Student, Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea.

Assistant Professor, Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea.

出版信息

J Oral Maxillofac Surg. 2018 Aug;76(8):1753-1762. doi: 10.1016/j.joms.2018.02.004. Epub 2018 Feb 20.

Abstract

PURPOSE

The aim of the present study was to compare the long-term stability of bimaxillary surgery using an intraoral vertical ramus osteotomy (IVRO) with and without presurgical orthodontic treatment.

MATERIALS AND METHODS

The present retrospective study included 31 consecutive patients with skeletal Class III malocclusions who had undergone bimaxillary surgery (Le Fort I osteotomy and bilateral IVRO). Patients were divided into 2 groups based on treatment type: pre-orthodontic orthognathic surgery (POGS; n = 17) and conventional surgery with presurgical orthodontic treatment (CS; n = 14). Lateral cephalograms were obtained before surgery, 1 day after surgery, 1 month after surgery, 1 year after surgery, and 2 years after surgery to evaluate skeletal and soft tissue changes between the 2 groups. Data were analyzed using χ tests, Mann-Whitney U tests, repeated-measures analyses of variance, and independent t tests.

RESULTS

There was no significant difference in skeletal or soft tissue measurements-with the exception of the angle between the sella-and-nasion plane and the occlusal plane (SN-OP; P < .001)-between the CS and POGS groups at 2 years after IVRO. The SN-OP had increased in the CS group but decreased in the POGS group at 2 years after surgery.

CONCLUSIONS

These findings suggest that POGS and CS have similar long-term stability in patients with skeletal Class III malocclusion.

摘要

目的

本研究旨在比较采用口内垂直升支截骨术(IVRO)进行双颌手术在术前是否进行正畸治疗的情况下的长期稳定性。

材料与方法

本回顾性研究纳入了31例连续接受双颌手术(Le Fort I截骨术和双侧IVRO)的骨性III类错牙合患者。根据治疗类型将患者分为两组:术前正畸正颌手术(POGS;n = 17)和术前正畸治疗的传统手术(CS;n = 14)。在手术前、手术后1天、手术后1个月、手术后1年和手术后2年获取头颅侧位片,以评估两组之间的骨骼和软组织变化。使用χ检验、Mann-Whitney U检验、重复测量方差分析和独立t检验对数据进行分析。

结果

IVRO术后2年,CS组和POGS组在骨骼或软组织测量方面(除蝶鞍-鼻根平面与咬合平面的夹角(SN-OP)外;P <.001)无显著差异。手术后2年,CS组的SN-OP增加,而POGS组的SN-OP降低。

结论

这些发现表明,POGS和CS在骨性III类错牙合患者中具有相似的长期稳定性。

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