Gil Ariane P S, Machado-Fernández Agustin, Guijarro-Martínez Raquel, Hernández-Alfaro Federico, Haas Orion L, de Oliveira Rogério B
Oral and Maxillofacial Surgery PhD Student at Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil.
Oral and Maxillofacial Surgery PhD Student at Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil.
J Craniomaxillofac Surg. 2022 Feb;50(2):107-113. doi: 10.1016/j.jcms.2021.11.009. Epub 2021 Nov 14.
The aim of this study was to evaluate the nasolabial soft tissues effects in three different Le Fort I osteotomy techniques using cone beam computed tomography (CBCT) evaluation of three-dimensional (3D) volume surfaces. A retrospective study was designed, and three groups were evaluated: group 1, patients who underwent conventional Le Fort I osteotomy; group 2, patients who underwent subspinal Le Fort I osteotomy; and group 3, patients who underwent conventional Le Fort I osteotomy with ANS recontouring or removal. CBCT evaluation was performed at two time points: T0, 1 week before surgery; T1, 6 months after surgery. A total of 90 patients were enrolled in this study (group 1: 30; group 2: 30; group 3: 30). Mean maxillary advancement was 4.26 mm. For group 1, mean change in inter-alar width was 2.29 ± 1.57 mm (minimum -2mm; maximum 6.1 mm; for group 2 it was 1.20 ± 1.56 mm (minimum -1.7 mm; maximum 5.9 mm), and for group 3 was 1.84 ± 1.76 mm (minimum -2.3 mm; maximum 5.9 mm). For group 1, mean change in alar base width was 1.69 ± 2.32 mm (minimum -4.8 mm; maximum 6,1 mm); in group 2 it was 0.85 ± 2.08 mm (minimum -4mm; maximum 6 mm), and group 3 was 1.21 ± 1.83 mm (minimum -2mm; maximum 5 mm). Results showed statistically significant differences in nasolabial area (P < 0.001). Within the limitations of the study it seems that subspinal Le Fort I osteotomy should be preferred when the priority is to avoid changes to the nasolabial region.
本研究旨在通过锥形束计算机断层扫描（CBCT）对三维（3D）体积表面进行评估，来评价三种不同的Le Fort I型截骨术对鼻唇软组织的影响。设计了一项回顾性研究，并对三组患者进行了评估：第1组，接受传统Le Fort I型截骨术的患者；第2组，接受经棘突下Le Fort I型截骨术的患者；第3组，接受伴有前鼻棘重塑或切除的传统Le Fort I型截骨术的患者。在两个时间点进行CBCT评估：T0，术前1周；T1，术后6个月。本研究共纳入90例患者（第1组：30例；第2组：30例；第3组：30例）。平均上颌前移量为4.26mm。对于第1组，鼻翼间宽度的平均变化为2.29±1.57mm（最小值-2mm；最大值6.1mm）；对于第2组，为1.20±1.56mm（最小值-1.7mm；最大值5.9mm）；对于第3组，为1.84±1.76mm（最小值-2.3mm；最大值）。对于第1组，鼻翼基底宽度的平均变化为1.69±2.32mm（最小值-4.8mm；最大值6.1mm）；第2组为0.85±2.08mm（最小值-4mm；最大值6mm）；第3组为1.21±1.83mm（最小值-2mm；最大值5mm）。结果显示鼻唇区域存在统计学上的显著差异（P<0.001）。在本研究的局限性范围内，当优先考虑避免鼻唇区域发生变化时，似乎应首选经棘突下Le Fort I型截骨术。
