Assistant Professor, Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Clinical Fellow, Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2020 May;129(5):447-452. doi: 10.1016/j.oooo.2019.10.014. Epub 2019 Nov 5.
The aim of this study was to investigate postoperative horizontal relapse of the mandible in terms of the effects of the magnitude of mandibular setback movement and ramus inclination after LeFort I osteotomy and sagittal split ramus osteotomy.
A retrospective study of patients who underwent orthognathic surgery for mandibular prognathism was performed. Postoperative relapse at point B was analyzed with regard to the magnitude of mandibular setback and the ramus inclination. Serial cephalograms were used to measure surgical changes and evaluate postoperative relapse.
Nineteen men and 31 women (mean age 23.1 years) were retrospectively enrolled. Mean surgical backward movement of the mandible at point B was 8.2 mm, mean ramus inclination was 3.56 degrees, and mean relapse 1 year postoperatively was 0.95 mm (11.6%). Horizontal relapse of the mandible was significantly correlated with the magnitude of mandibular setback (r = -0.52; P = .007) and ramus inclination (r = 0.48; P = .014).
Increased horizontal mandibular relapse after bimaxillary surgery was associated with greater mandibular setback movement and increased proximal segment clockwise rotation. Mandibular relapse after bimaxillary surgery may be minimized via adequate control of intraoperative clockwise rotation of the proximal segment.
本研究旨在探讨 LeFort I 截骨术和矢状劈开截骨术后下颌骨后退幅度和下颌支倾斜度对下颌骨术后水平复发的影响。
对接受正颌手术治疗下颌前突的患者进行回顾性研究。分析下颌骨后退幅度和下颌支倾斜度与术后 B 点复发的关系。使用连续头颅侧位片测量手术变化并评估术后复发。
共纳入 19 名男性和 31 名女性(平均年龄 23.1 岁)。B 点下颌骨的平均手术后退距离为 8.2mm,平均下颌支倾斜度为 3.56 度,术后 1 年的平均复发量为 0.95mm(11.6%)。下颌骨的水平复发与下颌骨后退幅度(r=-0.52;P=0.007)和下颌支倾斜度(r=0.48;P=0.014)显著相关。
双颌手术后面下部水平复发增加与下颌骨后退幅度增大和近中端顺时针旋转增加有关。通过术中对近中端顺时针旋转的适当控制,可使双颌手术后的下颌骨复发最小化。