Skoczylas L J, Ellis E, Fonseca R J, Gallo W J
University of Michigan, Ann Arbor.
J Oral Maxillofac Surg. 1988 Dec;46(12):1056-64. doi: 10.1016/0278-2391(88)90451-x.
This study examines the short-term stability of bimaxillary surgery following Le Fort I impaction with simultaneous bilateral sagittal split osteotomies and mandibular advancement using two standard techniques of postsurgical fixation. Fifteen adults had skeletal plus dental maxillomandibular fixation, and fifteen adults had rigid internal fixation using bone plates in the maxilla and bicortical bone screws between the proximal and distal segments in the mandible. The group with rigid internal fixation did not undergo maxillomandibular fixation. Radiographic cephalograms were analyzed during the postsurgical period to evaluate skeletal and dental stability. There was no statistical difference in postsurgical stability with rigid internal fixation or skeletal plus dental maxillomandibular fixation other than the vertical position of the maxillary molar; the skeletal plus dental maxillomandibular fixation group had a significant amount of postsurgical intrusion of the maxillary molar when compared with the rigid internal fixation group. Although the other measures showed no statistically significant difference between the experimental groups, the amount of variability in postsurgical stability in the group with skeletal plus dental maxillomandibular fixation was greater than that found in the group with rigid internal fixation.
本研究采用两种标准的术后固定技术,探讨在Le Fort I型截骨术同时行双侧矢状劈开截骨术及下颌前徙术后双颌手术的短期稳定性。15名成年患者采用骨骼加牙间颌间固定,另外15名成年患者在上颌使用骨板、在下颌近远心段之间使用双皮质骨螺钉进行坚固内固定。采用坚固内固定的组未进行颌间固定。在术后期间分析头颅X线侧位片,以评估骨骼和牙齿的稳定性。除上颌磨牙的垂直位置外,坚固内固定与骨骼加牙间颌间固定在术后稳定性方面无统计学差异;与坚固内固定组相比,骨骼加牙间颌间固定组的上颌磨牙在术后有明显的垂直移位。尽管其他测量结果显示实验组之间无统计学显著差异,但骨骼加牙间颌间固定组术后稳定性的变异性大于坚固内固定组。