Dept. of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Beomeori, Mulgeum, Yangsan, Kyoungsangnamdo, 50612, South Korea.
Dept. of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Beomeori, Mulgeum, Yangsan, Kyoungsangnamdo, 50612, South Korea; Institute of Translational Dental Sciences and Dental Research Institute, Pusan National University, Beomeori, Mulgeum, Yangsan, Kyoungsangnamdo, 50612, South Korea.
J Craniomaxillofac Surg. 2018 Oct;46(10):1828-1833. doi: 10.1016/j.jcms.2018.08.003. Epub 2018 Aug 11.
To evaluate maxillary stability following Le Fort I osteotomy using postero-superior movement after pterygoid plate fracture. Additionally the authors sought to analyze the postoperative changes at the intentional pterygoid plate fracture site.
Thirty-six patients with class III deformities treated with total maxillary setback at the Lefort I level were enrolled in a retrospective cohort study. Relative changes in measurement points were identified on cone-beam computed tomographic scans (CBCT) as well as lateral cephalograms. The outcome variables were determined as changes at measurement points obtained preoperatively, immediately postoperatively, and 6 months after surgery.
The average posterior repositioning of ANS in the 36 patients was 1.78 mm and the mean superior repositioning at PNS was 2.78 mm. The maximal recurrence rate was less than 10% at the 6 months postoperative time point. The intentional fracture site of the pterygoid plates healed with a linear pattern. There were no major complications such as airway edema, hemorrhage and nerve damage reported over the 6-month follow-up period.
Intentional fracture of the pterygoid plates has a role in the retropositioning of the maxilla with good healing at the fracture site, little relapse and satisfactory postoperative stability.
评估翼突板骨折后后上移位的 Le Fort I 截骨术后上颌骨稳定性。此外，作者还分析了翼突板骨折部位的术后变化。
回顾性队列研究纳入 36 例接受 Le Fort I 水平全上颌后退治疗的 III 类畸形患者。通过锥形束 CT（CBCT）和侧位头颅侧位片确定测量点的相对变化。测量指标为术前、术后即刻和术后 6 个月的测量点变化。
36 例患者中，ANS 的平均后移位为 1.78mm，PNS 的平均上移位为 2.78mm。术后 6 个月时最大复发率小于 10%。翼突板的有意骨折部位以线性愈合。在 6 个月的随访期间，没有出现气道水肿、出血和神经损伤等主要并发症。
翼突板的有意骨折在将上颌骨向后复位方面具有作用，骨折部位愈合良好，复发少，术后稳定性满意。
