Francisco Inês, Guimarães Adriana, Lopes Margarida, Lucas António, Caramelo Francisco, Vale Francisco
DDS, MSc. Assistant Professor, Institute of Orthodontics, Faculty of Medicine, University of Coimbra, Portugal.
DDS, MSc. Orthodontic Postgraduate, Institute of Orthodontics, Faculty of Medicine, University of Coimbra, Portugal.
J Clin Exp Dent. 2020 Jul 1;12(7):e695-e703. doi: 10.4317/jced.56947. eCollection 2020 Jul.
Bilateral sagittal split osteotomy (BSSO) is commonly considered as the surgical technique of election for the treatment of skeletal class II with mandibular hypoplasia. After orthognathic surgery, condylar resorption can occur as a surgical relapse, which may affect the temporomandibular joint. Objective: This study aimed to summarise published systematic review that assess if orthognathic surgery with mandibular advancement performed on skeletal class II patients results in condylar form alteration.
A literature search was performed using the electronic databases PubMed, Web of Science, Cochrane Library, Embase along with several sources of grey literature. Selection Criteria: Inclusion criteria were systematic reviews published until December 2019, of skeletal class II patients aged more than 18 years old that underwent BSSO with mandibular advancement surgery. Data collection: The electronic search identified 37 publications. Four publications fulfilled the inclusion criteria and were included in this meta-analysis. Qualitative assessment of the selected studies was performed using the Assessment of Multiple Systematic Reviews - AMSTAR 2 checklist.
Four systematic reviews were included in this review. Despite its low incidence all studies reported condylar resorption. However, there were methodological limitations in all assessed articles.
The alteration of the condylar form may be a consequence of BSSO with mandibular advancement surgery. Additional high quality prospective research assisted by 3D-imaging technology is needed to allow more definite conclusions. Evidence-based orthodontics, TMJ, Class II, mandibular advancement, malocclusion, Angle class II.
双侧矢状劈开截骨术（BSSO）通常被认为是治疗下颌发育不全的骨骼Ⅱ类错合畸形的首选手术技术。正颌手术后，髁突吸收可能作为手术复发出现，这可能会影响颞下颌关节。目的：本研究旨在总结已发表的系统评价，以评估对骨骼Ⅱ类患者进行下颌前徙的正颌手术是否会导致髁突形态改变。
使用电子数据库PubMed、科学网、Cochrane图书馆、Embase以及多个灰色文献来源进行文献检索。选择标准：纳入标准为截至2019年12月发表的系统评价，研究对象为年龄超过18岁、接受BSSO及下颌前徙手术的骨骼Ⅱ类患者。数据收集：电子检索共识别出37篇出版物。4篇出版物符合纳入标准并被纳入本荟萃分析。使用多重系统评价评估-AMSTAR 2清单对所选研究进行定性评估。
本综述纳入了4篇系统评价。尽管髁突吸收发生率较低，但所有研究均有报告。然而，所有评估文章均存在方法学局限性。
髁突形态改变可能是BSSO及下颌前徙手术的结果。需要借助3D成像技术进行更多高质量的前瞻性研究，以便得出更明确的结论。循证正畸学、颞下颌关节、Ⅱ类错合畸形、下颌前徙、错牙合畸形、安氏Ⅱ类错合畸形
