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 Oct;47(10):1498-1503. doi: 10.1016/j.jcms.2019.07.027. Epub 2019 Jul 29.
The purpose of this study was to compare the stability of the chin between absorbable plate and screws with a template device and titanium plate after advancement genioplasty in class II patients.
The subjects consisted of 22 Japanese class II patients who underwent genioplasty advancement in combination with bi-maxillary surgery. After genioplasty horizontal osteotomy, the template plate and screws were fixed at the central region of the chin temporarily. Then, two absorbable bi-cortical screws (uncalcined and unsintered hydroxyapatite and poly-l-lactic acid: uHA/PLLA) were used and fixed bilaterally. After removal of the template plate and screws, one absorbable plate and screws were added to fix the segment in the advancement genioplasty (n = 14). The remaining 8 patients underwent genioplasty advancement surgery with the conventional titanium plate. For all patients, lateral cephalograms were obtained pre- and immediately after surgery and at 1 year after surgery. Change in the Pogonion (Pog) and Menton (Me) points and the corresponding soft tissue points (PogS and MeS) were evaluated.
Although there were no significant differences in the change from before to immediately after surgery between the absorbable and titanium groups, there were significant differences in the Pog (Y) (P = 0.0379) and PogS (Y) (P = 0.0379) from immediately after surgery to after 1 year between both groups.
This study shows that predicted advancement of the chin in the absorbable group could be achieved by using a template and screws, and likewise in the titanium group. However, this study suggested that vertical relapse to the inferior site or resorption at the antero-superior edge of the segment could occur in the absorbable group.
本研究旨在比较使用模板装置和钛板固定在颏部的可吸收板和螺钉与 II 类患者颏成形术推进后的稳定性。
研究对象为 22 名接受双颌手术联合颏成形术推进的日本 II 类患者。在颏部水平骨切开术后，模板板和螺钉暂时固定在颏部中央区域。然后，使用 2 个可吸收双皮质螺钉（未煅烧和未烧结的羟基磷灰石和聚左旋乳酸：uHA/PLLA）并双侧固定。去除模板板和螺钉后，在推进的颏成形术中添加 1 个可吸收板和螺钉以固定颏部段（n=14）。其余 8 例患者接受常规钛板颏成形术推进手术。所有患者均在术前、术后即刻和术后 1 年获得侧位头颅侧位片。评估颏顶点（Pog）和颏下点（Me）以及相应的软组织点（PogS 和 MeS）的变化。
虽然可吸收组和钛组从术前到术后即刻的变化没有统计学差异，但两组之间在术后即刻到术后 1 年的 Pog（Y）（P=0.0379）和 PogS（Y）（P=0.0379）的变化有统计学差异。
本研究表明，使用模板和螺钉可以实现可吸收组颏部的预测推进，钛板组也是如此。然而，本研究表明，可吸收组可能会发生颏部向下的垂直复发或前段的吸收。
