Department of Oral and Maxillofacial Surgery (Head: Prof. Dr K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.
Department of Oral and Maxillofacial Surgery (Head: Prof. Dr K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.
J Craniomaxillofac Surg. 2019 Sep;47(9):1338-1342. doi: 10.1016/j.jcms.2019.06.006. Epub 2019 Jun 26.
The purpose of this study was to compare bone healing after Le Fort I osteotomy with sagittal split ramus osteotomy (SSRO) in class II and class III patients.
The subjects consisted of 46 Japanese class II and III patients. Le Fort I osteotomy was performed in combination with SSRO. They were divided into two groups (23 class II cases and 23 class III cases). Four absorbable plates (uncalcined and unsintered hydroxyapatite and poly-l-lactic acid - uHA/PLLA) and screws were used to fix the maxillary segment in all patients, in the same manner. Postoperative computed tomography (CT) was analyzed for all patients at 1 week and 1 year postoperatively. The anterior and lateral areas between the maxillary segments were measured using two-dimensional frontal and lateral views from the three-dimensional images reconstructed over a constant CT value.
There were no significant differences in the area of bone defect healing between classes II and III at 1 year postoperatively, although there were significant differences between the two groups at 1 week postoperatively (p < 0.05). Furthermore, there were no significant differences in the areas of bone defect between 1 week and 1 year postoperatively, in both groups.
Using measurements based on CT value threshold within 1 year after Le Fort I osteotomy, this study suggests that the areas of bony defect in the region of the anterior and lateral walls of the maxilla do not always decrease in both classes II and III.
本研究旨在比较 Le Fort I 截骨术与矢状劈开截骨术（SSRO）在 II 类和 III 类患者中的骨愈合情况。
本研究共纳入 46 例日本 II 类和 III 类患者。Le Fort I 截骨术与 SSRO 联合进行。将患者分为两组（23 例 II 类和 23 例 III 类）。所有患者均采用 4 块可吸收板（未煅烧和未烧结的羟基磷灰石和聚 L-乳酸 - uHA/PLLA）和螺钉以相同的方式固定上颌骨段。所有患者均在术后 1 周和 1 年进行术后计算机断层扫描（CT）分析。使用三维图像重建二维正面和侧面视图，从恒定 CT 值的三维图像上测量上颌骨段之间的前侧和外侧区域。
术后 1 年时，II 类和 III 类患者的骨缺损愈合面积无显著差异，但术后 1 周时两组间有显著差异（p < 0.05）。此外，两组患者术后 1 周和 1 年时骨缺损面积均无显著差异。
在 Le Fort I 截骨术后 1 年内，使用基于 CT 值阈值的测量方法，本研究表明，上颌骨前壁和外侧壁区域的骨缺损面积并不总是在 II 类和 III 类患者中减少。
