Center of Craniofacial Orthodontics, Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Stomatology, China.
Shanghai Meitian Dental Clinic, China.
J Craniomaxillofac Surg. 2020 Mar;48(3):203-210. doi: 10.1016/j.jcms.2020.01.004. Epub 2020 Jan 11.
To assess postsurgical stability of mandibular advancement combined with orthodontic treatment, following functional splint therapy, in patients with idiopathic condylar resorption (ICR).
Sixteen patients who were treated with functional splint therapy followed by orthognathic surgery combined with orthodontic treatment between 2010 and 2017 were included in this retrospective study. The primary outcome variable was skeletal stability, measured on the y-axis to point B (y-axis-B). Cephalometric analysis, including measurement of temporomandibular joint spaces, was carried out on serial magnetic resonance images (MRI) prior to orthognathic surgery (T0), immediately after surgery (T1), and after at least 1 year of follow-up (T2). The differences in the data between time points were compared using statistical analyses.
All patients obtained an esthetic facial profile after orthognathic surgery, with normal occlusion as well as normal protrusive and laterotrusive excursion after treatment. Mean advancement of the mandible immediately following surgery (y-axis-B, T1 - T0) was 7.28 ± 5.79 mm. This was the only skeletal measurement that showed a sagittal positional change of the mandible. Mean backward movement (T2 - T1) was -1.04 ± 2.35 mm (p = 0.116). Thirteen out of 16 patients experienced no postsurgical relapse or less than 2 mm of mandibular backward movement (81.25%), while two out of 16 patients showed more than 2 mm of mandibular backward movement (12.5%).
Patients who underwent mandibular advancement combined with orthodontic treatment, following functional splint therapy, exhibited a stable mandibular position at the 1-year follow-up. This study indicated that functional splint therapy prior to orthognathic surgery for mandibular advancement may be a good adjuvant treatment for ICR patients.
评估特发性髁突吸收（ICR）患者接受功能夹板治疗后，行下颌前伸术联合正颌手术及正畸治疗的术后稳定性。
本回顾性研究纳入了 2010 年至 2017 年间接受功能夹板治疗后行正颌手术联合正畸治疗的 16 例患者。主要观察指标为通过点 B（y 轴-B）测量的骨骼稳定性。在正颌手术前（T0）、术后即刻（T1）和至少 1 年随访时（T2），对所有患者进行连续磁共振成像（MRI）进行头影测量分析，包括颞下颌关节间隙测量。采用统计学分析比较各时间点间数据的差异。
所有患者在接受正颌手术后均获得了美学面部轮廓，治疗后具有正常的咬合关系以及正常的前伸和侧方运动。术后即刻下颌骨平均前伸（y 轴-B，T1-T0）为 7.28±5.79mm。这是唯一显示下颌骨矢状位位置变化的骨骼测量值。平均后退运动（T2-T1）为-1.04±2.35mm（p=0.116）。16 例患者中有 13 例（81.25%）无术后复发或下颌骨后退小于 2mm，而 16 例中有 2 例（12.5%）下颌骨后退大于 2mm。
接受功能夹板治疗后行下颌前伸术联合正畸治疗的患者在 1 年随访时表现出稳定的下颌位置。本研究表明，对于接受下颌前伸术的 ICR 患者，在正颌手术前使用功能夹板治疗可能是一种很好的辅助治疗方法。
