评价 III 类正颌手术患者髁突位置、结构和体积状态。
Evaluation of Condylar Positional, Structural, and Volumetric Status in Class III Orthognathic Surgery Patients.
机构信息
Department of Orthodontics, Rīga Stradiņš University, Dzirciema str. 20, LV-1007 Rīga, Latvia.
Department of Oral Development and Orthodontics, University of Oulu; Medical Research Center (MRC), Oulu University Hospital, 90014 Oulu, Finland.
出版信息
Medicina (Kaunas). 2020 Dec 6;56(12):672. doi: 10.3390/medicina56120672.
BACKGROUND AND OBJECTIVES
The need to evaluate the condylar remodeling after orthognathic surgery, using three-dimensional (3D) images and volume rendering techniques in skeletal Class III patients has been emphasized. The study examined condylar positional, structural, and volumetric changes after bimaxillary or single-jaw maxillary orthognathic surgeries in skeletal Class III patients using the cone-beam computed tomography.
MATERIALS AND METHODS
Presurgical, postsurgical, and one-year post-surgical full field of view (FOV) cone-beam computed tomography (CBCT) images of 44 patients with skeletal Class III deformities were obtained. Group 1 underwent a bimaxillary surgery (28 patients: 24 females and 4 males), with mean age at the time of surgery being 23.8 ± 6.0 years, and Group 2 underwent maxillary single-jaw surgery (16 patients: 8 females and 8 males), with mean age at the time of surgery being 23.7 ± 5.1 years. After the orthognathic surgery, the CBCT images of 88 condyles were evaluated to assess their displacement and radiological signs of bone degeneration. Three-dimensional (3D) condylar models were constructed and superimposed pre- and postoperatively to compare changes in condylar volume.
RESULTS
Condylar position was found to be immediately altered after surgery in the maxillary single-jaw surgery group, but at the one-year follow-up, the condyles returned to their pre-surgical position. There was no significant difference in condylar position when comparing between pre-surgery and one-year follow-up in any of the study groups. Condylar rotations in the axial and coronal planes were significant in the bimaxillary surgery group. No radiological signs of condylar bone degeneration were detected one year after the surgery. Changes in condylar volume after surgery were found to be insignificant in both study groups.
CONCLUSIONS
At one year after orthognathic surgery, there were no significant changes in positional, structural, or volumetric statuses of condyles.
背景与目的
强调了使用三维（3D）图像和容积再现技术评估正颌手术后髁突改建的必要性，尤其是在骨骼 III 类患者中。本研究使用锥形束 CT 检查，检查了骨骼 III 类畸形患者双颌或单颌上颌正颌手术后髁突的位置、结构和体积变化。
材料与方法
获得了 44 例骨骼 III 类畸形患者的术前、术后和术后一年全视野（FOV）锥形束 CT（CBCT）图像。第 1 组行双颌手术（28 例：24 例女性，4 例男性），手术时平均年龄为 23.8±6.0 岁；第 2 组行上颌单颌手术（16 例：8 例女性，8 例男性），手术时平均年龄为 23.7±5.1 岁。正颌手术后，评估 88 个髁突的 CBCT 图像以评估其移位和骨退变的影像学征象。构建了三维（3D）髁突模型，并在术前和术后进行叠加，以比较髁突体积的变化。
结果
在单颌手术组中，手术后髁突位置立即发生改变，但在术后 1 年随访时，髁突回到术前位置。在任何研究组中，术前与术后 1 年随访时，髁突位置均无显著差异。双颌手术组中，髁突在轴向和冠状面上的旋转明显。术后 1 年未发现髁突骨退变的影像学征象。术后髁突体积的变化在两组中均不显著。
结论
正颌手术后 1 年，髁突的位置、结构或体积状态无明显变化。
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