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正颌手术治疗Ⅲ类牙颌面畸形后髁突的变化:一项系统评价

Condylar changes after orthognathic surgery for class III dentofacial deformity: a systematic review.

作者信息

Vandeput A-S, Verhelst P-J, Jacobs R, Shaheen E, Swennen G, Politis C

机构信息

OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium; Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.

OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium; Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.

出版信息

Int J Oral Maxillofac Surg. 2019 Feb;48(2):193-202. doi: 10.1016/j.ijom.2018.06.008. Epub 2018 Jul 12.

DOI:10.1016/j.ijom.2018.06.008
PMID:30007835
Abstract

After orthognathic surgery for class II dentofacial deformity, remodelling of the mandibular condyle will take place. In a number of cases, this may evolve towards a phenomenon of condylar resorption. Yet, studies on the occurrence of this complication after the correction of a class III deformity are scarce. A systematic review of the literature was performed with the aim of identifying reports on condylar resorption or remodelling after orthognathic surgery for class III dentofacial deformity. A search of the international databases yielded 12 eligible studies. Eight studies reported some degree of postoperative condylar remodelling, while symptoms of condylar resorption were only described in a limited group of patients. Thus, the literature may show evidence of condylar remodelling after orthognathic treatment of class III patients, and anecdotal reports of condylar resorption exist. The small sample sizes, heterogeneity in methods and outcomes, and use of two-dimensional radiographs indicate the need for updated long-term research. In the future, the use of cone beam computed tomography data for volumetric and morphological condylar analysis in combination with three-dimensional cephalometry may provide the opportunity to further elucidate this phenomenon and better characterize its aetiology.

摘要

在对II类牙颌面畸形进行正颌外科手术后,下颌髁突会发生重塑。在许多情况下,这可能会演变为髁突吸收现象。然而,关于III类畸形矫正后这种并发症发生情况的研究很少。为了确定关于III类牙颌面畸形正颌外科手术后髁突吸收或重塑的报告,我们对文献进行了系统回顾。检索国际数据库得到了12项符合条件的研究。8项研究报告了一定程度的术后髁突重塑,而只有有限的一组患者描述了髁突吸收的症状。因此,文献可能显示了III类患者正颌治疗后髁突重塑的证据,并且存在关于髁突吸收的轶事报道。样本量小、方法和结果的异质性以及二维X线片的使用表明需要更新的长期研究。未来,使用锥形束计算机断层扫描数据进行髁突体积和形态分析,并结合三维头影测量,可能会提供进一步阐明这一现象并更好地描述其病因的机会。

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