使用CBCT对面部不对称患者采用手术优先方法进行双颌手术后的骨骼稳定性。
Skeletal stability after 2-jaw surgery via surgery-first approach in facial asymmetry patients using CBCT.
作者信息
Hwang Dae Seok, Seo Jeong Seok, Choi Hong Seok
机构信息
1Dental Research Institute, Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Pusan National University Dental Hospital, Dental Research Institute, Beomeori, Mulgeum, Yangsan, Kyoungsangnamdo 50612 South Korea.
Department of Dental Clinic, Bongseng Hospital, 401, Jungang-daero, Dong-gu, Busan South Korea.
出版信息
Maxillofac Plast Reconstr Surg. 2020 Apr 9;42(1):11. doi: 10.1186/s40902-020-00253-8. eCollection 2020 Dec.
BACKGROUND
The purpose of this study is to compare the skeletal stability of two-jaw surgery via surgery-first approach with conventional two-jaw surgery in facial asymmetry patients by measuring the skeletal changes after surgery from a three-dimensional analysis. From January 2010 to January 2014, 40 patients with facial asymmetry who underwent two-jaw surgery in Pusan National University Hospital were included in this study. They were classified into experimental group ( = 20) who underwent two-jaw surgery via surgery-first approach and control group ( = 20) who underwent conventional two-jaw surgery. After selection of 24 landmarks and the construction of horizontal and sagittal, coronal reference planes, changes in 10 linear measurements and 2 angular measurements were compared between the surgery-first approach and conventional groups in the preoperative, immediate postoperative, and postoperative periods. The paired test and Student test were used for statistical analysis. The mean and standard deviation of the measurement were calculated for the experimental and control groups.
RESULTS
The statistical analysis showed that changes in skeletal measurements were similar between the surgery-first approach and conventional groups, according to each period. However, U1-SRP measurement showed statistically significant changes in surgery-first approach groups at postsurgical change (T1 to T2). Also, the mean treatment duration in the treatment group was 15.9 ± 5.48 months whereas that in the control group was 32.9 ± 14.05 months.
CONCLUSION
In facial asymmetry patients, similar results were observed in the postoperative skeletal stability when 2-jaw surgery via surgery-first approach was compared with conventional 2-jaw surgery. However, significant lateral deviation of upper incisor midline was observed. In addition, a shorter average treatment duration was observed. To stabilize the unstable occlusion after surgery, increased wearing of the stent and proactive rubber guidance will be needed.
背景
本研究的目的是通过三维分析测量面部不对称患者手术前后的骨骼变化，比较手术优先法双颌手术与传统双颌手术的骨骼稳定性。2010年1月至2014年1月，釜山国立大学医院40例接受双颌手术的面部不对称患者纳入本研究。他们被分为实验组（n = 20），接受手术优先法双颌手术；对照组（n = 20），接受传统双颌手术。在选择24个标志点并构建水平、矢状、冠状参考平面后，比较手术优先法组和传统组术前、术后即刻及术后各阶段10项线性测量和2项角度测量的变化。采用配对t检验和Student t检验进行统计学分析。计算实验组和对照组测量值的均值和标准差。
结果
统计分析表明，根据各阶段，手术优先法组和传统组骨骼测量的变化相似。然而，U1-SRP测量在手术优先法组术后变化（T1至T2）时有统计学意义的改变。此外，治疗组的平均治疗时长为15.9±5.48个月，而对照组为32.9±14.05个月。
结论
在面部不对称患者中，手术优先法双颌手术与传统双颌手术相比，术后骨骼稳定性观察到相似结果。然而，观察到上切牙中线有明显的侧向偏移。此外，观察到平均治疗时长较短。为稳定术后不稳定的咬合，需要增加支抗佩戴和积极的橡皮导板引导。
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