Reynolds S T, Ellis E, Carlson D S
University of Michigan, Ann Arbor.
J Oral Maxillofac Surg. 1988 Dec;46(12):1077-85. doi: 10.1016/0278-2391(88)90454-5.
The purpose of this study was to provide quantitative data concerning the changes and adaptations that take place within the suprahyoid complex to larger mandibular advancements. Mandibular advancement of 6.5 mm was performed on 12 adult rhesus monkeys. Six underwent maxillomandibular fixation (MMF) using the dentition, six underwent MMF using the dentition plus skeletal suspension wires. Mandibular position and changes in the length of the various anatomic regions of the suprahyoid complex were evaluated cephalometrically with the aid of radiopaque bone, muscle, and tendon markers implanted preoperatively. Relapse of the mandible in the dental MMF animals was 27% of the advancement, whereas there was none in the dental plus skeletal MMF group. Results of adaptations within the suprahyoid complex showed that 1) the suprahyoid complex was elongated slightly less than the mandible, and 2) the major adaptations (lengthening) occurred at the muscle-bone interface, the muscle-tendon interface, and within the belly of the anterior digastric muscle. On the basis of these results, it was concluded that adaptations within the suprahyoid complex to mandibular lengthening occur first at the connective tissue attachments of the muscle, and then within the muscle belly itself. The methods of dealing with the potentially distracting forces from the stretch within the suprahyoid complex are discussed.
本研究的目的是提供有关舌骨上复合体在较大下颌前徙时发生的变化和适应性的定量数据。对12只成年恒河猴进行了6.5毫米的下颌前徙。6只使用牙列进行颌间固定（MMF），6只使用牙列加骨骼悬吊线进行MMF。借助术前植入的不透射线的骨、肌肉和肌腱标记物，通过头影测量法评估下颌位置以及舌骨上复合体各个解剖区域长度的变化。牙列MMF组动物下颌的复发量为前徙量的27%，而牙列加骨骼MMF组则没有复发。舌骨上复合体的适应性结果表明：1）舌骨上复合体的伸长略小于下颌骨；2）主要的适应性变化（伸长）发生在肌肉-骨界面、肌肉-肌腱界面以及二腹肌前腹肌腹内。基于这些结果，得出结论：舌骨上复合体对下颌骨延长的适应性变化首先发生在肌肉的结缔组织附着处，然后发生在肌腹本身。文中还讨论了处理来自舌骨上复合体拉伸产生的潜在干扰力的方法。
