Bhagat Sanjay Kumar, Kannan Sankar, Babu M R Ramesh, Murugan Kanagasabapathy Thiru, Kumar Jain Manoj, Ramesh C, Radha Anu
Department of Oral and Maxillofacial Surgery, Mahatma Gandhi Post Graduate Institute of Dental Sciences Gorimedu, Pondicherry, India.
Face Max Dental and Maxillofacial Centre, 25/2 Trikuta Nager, Jammu Tawi, 180012 India.
J Maxillofac Oral Surg. 2019 Mar;18(1):93-99. doi: 10.1007/s12663-018-1099-y. Epub 2018 Mar 16.
AIMS & OBJECTIVES: To analyze the soft tissue response in patients treated by combined anterior segmental bimaxillary procedures.
A Prospective, observational and analytical study was carried out for a period of 2 years involving 37 patients with predefined inclusion and exclusion criteria; lateral cephalograms were taken by the same operator on the standardized unit immediately before and 6 months after surgery; hard and soft tissue landmarks were measured in millimeters to both horizontal and vertical reference lines; any differences in distances were recorded as a surgical change; appropriate statistical test was carried; level of significance was < 0.05.
All patients underwent anterior maxillary osteotomy with 34 anterior mandibular osteotomies, 2 advancement genioplasties and 1 reduction genioplasty. Analysis showed significant angular, horizontal and vertical change. The significant differences in skeletal variables were observed in N-Pg distance, overjet, overbite, U1-NF angle, L1-Mp angle and soft tissue variables like labiomental angle, upper-lower lip protrusion, upper-lower lip length and lower incisor to labrale inferius distance. Nasolabial angle, interlabial gap and upper incisor exposure were extremely significant.
Soft tissue response to surgery is perhaps more predictable after 6 months, so this may be a treatment modality of choice in adult bimaxillary/dentoalveolar protrusion patients who need instant esthetic facial results.
分析接受前牙区双颌联合手术治疗患者的软组织反应。
进行了一项为期2年的前瞻性、观察性和分析性研究，纳入37例符合预设纳入和排除标准的患者；由同一名操作人员在标准化设备上于手术前即刻和术后6个月拍摄头颅侧位片；以毫米为单位测量硬组织和软组织标志点到水平和垂直参考线的距离；将距离的任何差异记录为手术变化；进行适当的统计学检验；显著性水平为<0.05。
所有患者均接受上颌前部截骨术，其中34例接受下颌前部截骨术，2例接受颏前移术，1例接受颏后退术。分析显示有显著的角度、水平和垂直变化。在鼻根点至颏前点距离、覆盖、覆合、上切牙-鼻根点角、下切牙-下颌平面角等骨骼变量以及唇颏角、上下唇突度、上下唇长度和下切牙至下唇沟距离等软组织变量方面观察到显著差异。鼻唇角、唇间隙和上切牙暴露情况差异极为显著。
术后6个月软组织对手术的反应可能更具可预测性，因此对于需要即刻获得美观面部效果的成年双颌/牙牙槽前突患者而言，这可能是一种首选的治疗方式。
