Khalifa G A, Mohamed F I
Faculty of Dental Medicine for Girls, Al Azhar University, Nasr City, Cairo, Egypt.
Faculty of Dental Medicine for Girls, Al Azhar University, Nasr City, Cairo, Egypt.
Int J Oral Maxillofac Surg. 2018 Dec;47(12):1572-1580. doi: 10.1016/j.ijom.2018.06.014. Epub 2018 Jul 13.
Despite the wide uses of mandibular distraction osteogenesis (MDO), no study appears to have evaluated the use of MDO and subsequent advancement genioplasty. This study addressed lower facial third aesthetics in a consecutive series of subjects with micrognathia who underwent MDO and subsequent advancement genioplasty. Standard cephalometric measurements were performed pre-MDO, at the end of consolidation, and at 1 week, 6 months, and 12 months after genioplasty. At the end of follow-up, questionnaires were given to measure patient satisfaction. Forty patients were included, 33 of whom underwent genioplasty. The mean patient age was 22.35±1.12years. Pre-genioplasty cephalometric measurements showed that all patients had a deficient chin position and projection; they were dissatisfied with their facial aesthetics. Post-genioplasty cephalometric measurements showed that the hard and soft tissue pogonion had moved significantly: 8.4±2.3mm and 11.0±2.11mm, respectively. According to the questionnaire, the patients were satisfied with the final results. The MDO reduced the amount of chin advancement and minimized relapses; the soft tissue response of the lower facial third was more sensitive to genioplasty than isolated MDO. MDO and genioplasty lead to a modest horizontal chin movement that achieves the preferred pogonion position and projection.
尽管下颌骨牵张成骨术(MDO)应用广泛,但似乎尚无研究评估其与后续颏成形术联合使用的情况。本研究针对一系列连续的小下颌患者,探讨了下颌骨牵张成骨术及后续颏成形术对下面部三分之一美学效果的影响。在进行下颌骨牵张成骨术前、骨痂形成末期以及颏成形术后1周、6个月和12个月进行标准头影测量。随访结束时,通过问卷调查来评估患者的满意度。共纳入40例患者,其中33例接受了颏成形术。患者的平均年龄为22.35±1.12岁。颏成形术前的头影测量显示,所有患者的颏部位置和突度均不足,他们对自己的面部美学效果不满意。颏成形术后的头影测量显示,硬组织和软组织颏前点均有显著移动,分别为8.4±2.3mm和11.0±2.11mm。根据问卷调查,患者对最终结果感到满意。下颌骨牵张成骨术减少了颏部前移的幅度,并使复发最小化;下面部三分之一的软组织对颏成形术的反应比单纯下颌骨牵张成骨术更敏感。下颌骨牵张成骨术和颏成形术可使颏部产生适度的水平移动,从而达到理想的颏前点位置和突度。