Han Bing, Wang Xing, Li Zili, Yi Biao, Liang Cheng, Wang Xiaoxia
Resident, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
Professor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
J Oral Maxillofac Surg. 2018 Jul;76(7):1563.e1-1563.e18. doi: 10.1016/j.joms.2018.03.006. Epub 2018 Mar 15.
Orthognathic surgery with simultaneous condylectomy under digital guidance has been proved to be a feasible method to treat hemimandibular hyperplasia (HH). The objective of this study was to evaluate the effects and precision of correction of HH by use of this method.
This was a case-series study. Fourteen patients with HH who had undergone simultaneous bimaxillary orthognathic surgery and condylectomy from January 2016 to April 2017 were included in this study. Presurgical virtual treatment planning was performed, transferred to the operation room, and realized with the assistance of surgical navigation and 3-dimensionally printed occlusion splints. Postoperative computed tomography data were used to analyze improvement in facial symmetry and verify the accuracy of the surgical procedure.
All patients exhibited satisfactory clinical effects; facial asymmetry was corrected as expected. Postoperative validation showed that the presurgical planning had been achieved more precisely on the unaffected side than on the affected side. Moreover, bilateral mandibular proximal segments showed a tendency for outward rotation compared with the presurgical planning model. Furthermore, when we assessed facial symmetry compared with the presurgical model, deviation of all midline landmarks was less than 2 mm, occlusal-plane inclination was less than 1 mm, and the asymmetry index of paired landmarks was remarkably decreased after surgery (P < .01).
Orthognathic surgery with simultaneous condylectomy under digital guidance is a realistic and precise method for treatment of HH. Surgical results can be validated during surgery by virtual navigation. However, movement of each bone segment cannot be accurately controlled as planned before surgery.
数字引导下正颌手术同期髁突切除术已被证明是治疗半侧下颌骨增生（HH）的一种可行方法。本研究的目的是评估使用该方法矫正HH的效果和精度。
这是一项病例系列研究。本研究纳入了2016年1月至2017年4月期间接受同期双颌正颌手术和髁突切除术的14例HH患者。术前进行虚拟治疗计划，将其传输至手术室，并在手术导航和三维打印咬合板的辅助下实现。术后计算机断层扫描数据用于分析面部对称性的改善情况，并验证手术过程的准确性。
所有患者均表现出满意的临床效果；面部不对称按预期得到矫正。术后验证表明，术前规划在未受影响侧比受影响侧更精确地实现。此外，与术前规划模型相比，双侧下颌近端节段有向外旋转的趋势。此外，当我们将术后面部对称性与术前模型进行比较时，所有中线标志点的偏差均小于2毫米，咬合平面倾斜度小于1毫米，术后配对标志点的不对称指数显著降低（P <.01）。
数字引导下正颌手术同期髁突切除术是治疗HH的一种切实可行且精确的方法。手术结果可在手术过程中通过虚拟导航进行验证。然而，每个骨段的移动无法像术前计划那样准确控制。
