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比较两种不同内固定方法在下颌双侧矢状劈开升支骨切开术后 III 类女性患者的最大张口度。

Comparison of Maximum Mouth Opening Following Mandibular Bilateral Sagittal Splitting Ramus osteotomies in Class III Females Using Two Different Osteosynthesis Methods.

机构信息

Oral and Maxillofacial Surgery, Department of Oral Patho-biological Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan.

Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.

出版信息

J Oral Rehabil. 2020 Oct;47(10):1242-1246. doi: 10.1111/joor.13059. Epub 2020 Aug 2.

Abstract

BACKGROUND

Limitation of mouth opening is a common complaint following orthognathic surgery.

OBJECTIVES

This investigation reports on the progress of maximum incisal opening following orthognathic surgery and compares the impact of two different osteosynthesis methods on mouth opening in female patients with Class III dentofacial deformities.

METHODS

Forty cases of skeletal class III malocclusion were divided into twenty cases treated using the conventional single miniplate osteosynthesis method (P1) and twenty cases using the additional L-shaped miniplate osteosynthesis method (P2). No significant differences in pre-operative clinical status were detected between the P1 and P2 group, and all patients were managed with elastics in the post-operative period. Independent mouth opening exercises were initiated seven days after surgery, and inter-incisal distance was measured as maximum mouth opening (MMO) at 1 week, 2 weeks, and 1, 2, 3, 6 months. Statistical analysis was performed in order to analyse differences in MMO between the P1 and P2 groups (Prism 7 GraphPad software, San Diego, CA). Values of P < .05 were considered to be significant.

RESULTS

MMO significantly increased from 2 weeks after surgery in both groups. The MMO of P2 was significantly larger than that of P1 in all experimental periods after surgery. MMO was statistically improved in P2 at 2 months after surgery, while MMO in P1 was significantly smaller than the pre-operative MMO, even at 6 months post-operative. A minimum MMO of 40 mm was achieved by all patients.

CONCLUSION

L-shaped miniplate osteosynthesis was more useful for early limitation of mandibular opening improvement than conventional single miniplate osteosynthesis.

摘要

背景

张口受限是正颌手术后常见的主诉。

目的

本研究报告了正颌手术后最大切牙开口的进展,并比较了两种不同的骨内固定方法对女性 III 类牙颌面畸形患者张口度的影响。

方法

40 例骨骼 III 类错畸形患者分为采用传统单微型板骨内固定法(P1)治疗的 20 例和采用附加 L 形微型板骨内固定法(P2)治疗的 20 例。P1 和 P2 组患者术前临床状况无显著差异,所有患者术后均使用弹性橡皮圈。术后 7 天开始进行独立的张口练习,测量切牙间距离作为最大张口度(MMO),分别在术后 1 周、2 周和 1、2、3、6 个月进行测量。使用 Prism 7 GraphPad 软件(San Diego,CA)对 P1 和 P2 组之间的 MMO 差异进行统计学分析(P<0.05)。

结果

两组患者术后 2 周 MMO 均显著增加。术后所有实验期 P2 的 MMO 均明显大于 P1。术后 2 个月 P2 的 MMO 显著改善,而 P1 的 MMO 甚至在术后 6 个月仍明显小于术前 MMO。所有患者均达到了最小 MMO 为 40mm。

结论

L 形微型板骨内固定术比传统单微型板骨内固定术更有助于早期改善下颌开口受限。

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