Department of Oral & Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA, USA.
Harvard School of Dental Medicine, Boston, MA, USA.
Int J Oral Maxillofac Surg. 2021 Sep;50(9):1203-1209. doi: 10.1016/j.ijom.2021.02.004. Epub 2021 Feb 28.
The purpose of this study was to assess skeletal stability and predictors of relapse in patients undergoing an isolated Le Fort I osteotomy. A retrospective cohort study of 92 subjects undergoing Le Fort I osteotomy for Class III malocclusion was implemented. Predictor variables were demographic and perioperative factors. The primary outcome variable was postoperative skeletal position with relapse defined as >2mm sagittal and/or vertical change at A-point on serial lateral cephalograms at immediate postoperative, 1 year, and latest follow-up time points. Mean advancement at A-point was 6.28±2.63mm and mean lengthening was 0.92±1.76mm. Eight subjects (8.70%) had relapse (>2mm) in the sagittal plane, and two subjects (2.17%) in the vertical plane. No subjects required reoperation for relapse as overbite and overjet remained in an acceptable range due to dental compensation. In regression analysis, magnitude of maxillary advancement was an independent predictor of relapse in the sagittal plane (P=0.008). There were no significant predictors of relapse in the vertical plane. This study suggests that isolated Le Fort I osteotomy for correction of skeletal Class III malocclusion is a stable procedure and that greater advancement is an independent risk factor for sagittal relapse.
本研究旨在评估接受单纯 Le Fort I 骨切开术的患者的骨骼稳定性和复发的预测因素。对 92 例行 Le Fort I 骨切开术治疗 III 类错牙合的患者进行了回顾性队列研究。预测变量为人口统计学和围手术期因素。主要结局变量为术后骨骼位置,复发定义为在即刻术后、1 年和最新随访时间点的连续侧位头颅侧位片上 A 点的矢状和/或垂直变化>2mm。A 点的平均前突为 6.28±2.63mm,平均伸长为 0.92±1.76mm。8 名患者(8.70%)在矢状面发生复发(>2mm),2 名患者(2.17%)在垂直面发生复发。由于牙齿补偿,覆颌和覆盖仍在可接受范围内,因此没有患者因复发而需要再次手术。在回归分析中,上颌前突的幅度是矢状面复发的独立预测因素(P=0.008)。垂直面复发无显著预测因素。本研究表明,单纯 Le Fort I 骨切开术治疗骨骼性 III 类错牙合是一种稳定的手术,前突增加是矢状面复发的独立危险因素。