School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil.
Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (USP), Bauru, Brazil.
Orthod Craniofac Res. 2020 Nov;23(4):486-492. doi: 10.1111/ocr.12399. Epub 2020 Jun 28.
The purpose of this study was to evaluate the influence of a palatal splint on stability in multi-segment maxillary osteotomies.
Retrospective series of fifty-one adult patients, consecutively operated with bilateral sagittal split osteotomy (BSSO) and three-piece maxillary osteotomies, divided according to the use of a palatal splint (Group 1, n = 30) or no palatal splint (Group 2, n = 21).
Maxillary surgical casts (T1) and post-retention casts (T2), taken at least six months after discontinuation of orthodontic retention, were digitized (MicroScribe-3DX), measured and compared. Fifty-one landmarks were identified on the maxillary, transverse dimension changes and arch length were calculated. Longitudinal changes in all measurements were assessed by t test.
Post-surgical transverse instability in group 1 ranged from 0.3 ± 0.4 to -1.3 ± 0.2 mm and was statistically significantly smaller than in group 2 that ranged from -1.0 ± 0.3 to -2.5 ± 0.5 mm.
The use of a palatal splint after segmental Le Fort I maxillary osteotomy improved transverse stability in the posterior region. The post-surgical transverse instability occurred only between canine gingival points and thus suggesting no clinical relevance.
本研究旨在评估腭夹板对上颌骨多节段骨切开术稳定性的影响。
回顾性系列研究共纳入 51 例成年患者，连续行双侧矢状劈开截骨术（BSSO）和三段式上颌骨切开术，根据是否使用腭夹板（第 1 组，n=30）或不使用腭夹板（第 2 组，n=21）进行分组。
在停止正畸保持至少 6 个月后，对上颌手术模型（T1）和保持后模型（T2）进行数字化（MicroScribe-3DX）、测量和比较。在上颌骨上确定了 51 个标志点，计算了横向尺寸变化和拱长。通过 t 检验评估所有测量值的纵向变化。
第 1 组术后横向不稳定范围为 0.3±0.4 至-1.3±0.2mm，明显小于第 2 组的-1.0±0.3 至-2.5±0.5mm。
在上颌骨分段 Le Fort I 骨切开术后使用腭夹板可改善后区的横向稳定性。术后仅出现犬齿牙龈点之间的横向不稳定，因此提示无临床相关性。
