State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
Department of Plastic and Aesthetic Surgery, Hospital of Stomatology, Jilin University, Changchun 130000, China.
Br J Oral Maxillofac Surg. 2021 Jul;59(6):678-682. doi: 10.1016/j.bjoms.2020.08.107. Epub 2020 Aug 28.
To identify the potential risk factors for bad splits, we calculated the incidence of bad splits from 484 patients with 964 cases of sagittal split ramus osteotomy (SSRO) and investigated the association between the occurrence of bad splits and risk factors such as gender, patients' age, class of occlusion, unimaxillary or bimaxillary surgery, presence of the lower third molar, thickness of the ascending ramus, and the distance from the mandibular canal to the buccal cortical bone. The results showed that 40 sides (4.149%) with bad splits occurred in 36 patients (7.438%). The mean (SD) gap width from the canal to the buccal cortex for the bad split group, at 4.02 (1.20)mm, was narrower (p=0.003; OR=0.689; 95% CI=0.538 to 0.882) than the normal split group 4.80 (1.72)mm. On the contrary, no statistical significance (p>0.05) was detected between the patients with bad splits and those with normal splits for the other factors. In conclusion, SSRO patients with narrower distances from the mandibular canal to the buccal cortex were more prone to bad splits. More attention should be paid to patients with this risk factor during future surgeries.
为了确定不良劈裂的潜在危险因素，我们对 484 例患者的 964 例矢状劈开下颌支（SSRO）进行了不良劈裂的发生率计算，并调查了不良劈裂的发生与性别、患者年龄、咬合类型、单颌或双颌手术、下颌第三磨牙存在、升支厚度以及下颌管到颊侧皮质骨的距离等危险因素之间的关系。结果显示，36 例患者（7.438%）的 40 侧（4.149%）出现不良劈裂。不良劈裂组的颊侧皮质骨到管之间的平均（标准差）间隙宽度为 4.02（1.20）mm，明显小于正常劈裂组的 4.80（1.72）mm（p=0.003；OR=0.689；95%CI=0.538 至 0.882）。相反，在其他因素方面，不良劈裂患者与正常劈裂患者之间未检测到统计学意义（p>0.05）。总之，下颌管到颊侧皮质骨距离较窄的 SSRO 患者更容易发生不良劈裂。在未来的手术中，应更加关注具有这种危险因素的患者。
