Associate Professor and Head of 3D-Laboratory, University Hospital of Southern Denmark, Department of Oral and Maxillofacial Surgery & University of Southern Denmark, Faculty of Health Sciences, Department of Regional Health Research, Esbjerg, Denmark.
PhD Fellow, University of Southern Denmark, Faculty of Health Sciences, Department of Regional Health Research, University Hospital of Southern Denmark, Department of Oral and Maxillofacial Surgery, Esbjerg, Denmark.
J Oral Maxillofac Surg. 2022 Jun;80(6):1007-1017. doi: 10.1016/j.joms.2022.01.014. Epub 2022 Jan 26.
Glenoid fossa morphology may change following orthognathic surgery and may subsequently affect skeletal stability and functionality, however hardly documented. Hence, the purpose of this study was to evaluate the morphological change of the glenoid fossa 2 years after bimaxillary surgery.
A case series was performed including subjects diagnosed with maxillary and/or mandibular growth disturbances, who underwent bimaxillary surgery between March 2012 and November 2017 at the Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Esbjerg, Denmark. The study variables were gender, age, and postoperative condylar resorption. Subjects were sampled evenly within subgroups with and without postoperative condylar resorption. The outcome variable, three-dimensional morphological change of the glenoid fossa, was calculated as surface distance in mm between superimposed preoperative and postoperative (2 years) cone-beam computed tomography scans, and the glenoid fossa was spatially divided into 4 regions. Evaluation of glenoid fossa changes of more than one voxel (>0.3 mm) and comparison of subjects with and without postoperative condylar resorption were performed by one-sample and unpaired t tests, respectively.
Twenty subjects (16 women; 4 men; mean age = 27.6 years) with Class II malocclusion and maxillomandibular retrognathia were included. The glenoid fossa changes (0.36 mm) were significant (P = .021) and significantly larger in subjects with condylar resorption than in those without condylar resorption in the anterior-lateral (0.40 mm vs 0.27 mm, P = .021) and anterior-medial fossa region (0.48 mm vs 0.26 mm, P = .015).
Significant morphological fossa changes were found 2 years after orthognathic surgery, and subjects with postoperative condylar resorption showed a significantly higher degree of morphological change in the anterior glenoid fossa than subjects without postoperative condylar resorption.
在正颌手术后，肩胛盂窝形态可能会发生变化，进而影响骨骼的稳定性和功能，但几乎没有文献记录。因此，本研究旨在评估 2 年后双颌手术对肩胛盂窝形态的影响。
本研究为病例系列研究，纳入 2012 年 3 月至 2017 年 11 月期间在丹麦南丹麦大学医院口腔颌面外科诊断为上颌和/或下颌生长障碍并接受双颌手术的患者。研究变量为性别、年龄和术后髁突吸收。根据术后是否发生髁突吸收，在有髁突吸收和无髁突吸收的亚组中进行均衡采样。研究的结果变量是肩胛盂窝的三维形态变化，通过将术前和术后（2 年）锥形束 CT 扫描进行叠加，计算出表面距离（mm），并将肩胛盂窝分为 4 个区域。通过单样本 t 检验和独立样本 t 检验分别评估超过一个体素（>0.3mm）的肩胛盂窝变化和比较有髁突吸收和无髁突吸收的患者。
共纳入 20 名患者（16 名女性，4 名男性；平均年龄 27.6 岁），其中包括安氏Ⅱ类错颌和上下颌后缩。研究发现，有髁突吸收的患者（0.40mm）比无髁突吸收的患者（0.27mm）的肩胛盂窝变化更显著（P=.021），在前外侧（0.40mm vs 0.27mm，P=.021）和前内侧窝区（0.48mm vs 0.26mm，P=.015）更为明显。
在正颌手术后 2 年，发现了明显的形态学窝变化，并且术后有髁突吸收的患者在前侧肩胛盂窝的形态变化程度明显高于术后无髁突吸收的患者。
