Tabrizi Reza, Sarrafzadeh Arash, Shafiei Shervin, Moslemi Hamidreza, Dastgir Ramtin
Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Danshjoo BLVD, Velenjak, Shahid Chamran Highway, Tehran, Iran.
Department of Oral and Maxillofacial Surgery, School of Dentistry, Arak University of Medical Sciences, Arak, Iran.
Maxillofac Plast Reconstr Surg. 2022 May 6;44(1):19. doi: 10.1186/s40902-022-00350-w.
The stability of the results remains a significant concern in orthognathic surgeries. This study aimed to assess the amount of relapse following mandibular advancement with/without maxillomandibular fixation (MMF).
A single-blind clinical trial was conducted on patients with mandibular retrognathism who underwent BSSO for mandibular advancement and Lefort I maxillary superior repositioning. Patients were randomly divided into two groups of treatment (MMF) and control (no MMF). In the treatment group, MMF was performed for 2 weeks; meanwhile, MMF was not performed in the control group, and only guiding elastics were applied postoperatively. Lateral cephalograms were obtained preoperatively (T1), immediately after surgery (T2), and at 1 year postoperatively (T3). The distance from points A and B to the X and Y plane were measured to identify the amount of vertical and horizontal relapse in 1 year as a primary outcome. An independent t-test was applied in order to find differences in outcomes between the control and treatment groups.
Fifty-eight patients were evaluated in two groups (28 patients in the MMF group and 30 in the no-MMF group). The magnitude of mandibular advancement following BSSO was 7.68±1.39 mm and 7.53±1.28, respectively, without significant difference among the groups (p= 0.68). The mean sagittal and vertical changes (relapse) at point B were significantly different between the two groups at 1-year follow-up after the osteotomy (p=0.001 and p=0.05, respectively).
According to the results of this study, patients with short-term MMF following BSSO for mandibular advancement benefit from significantly greater skeletal stability in the sagittal and vertical dimensions.
正颌手术结果的稳定性仍是一个重大问题。本研究旨在评估下颌前徙术采用/不采用颌间固定（MMF）后的复发量。
对下颌后缩患者进行单盲临床试验，这些患者接受双侧矢状劈开截骨术（BSSO）进行下颌前徙和Le Fort I型上颌骨上移术。患者被随机分为治疗组（MMF）和对照组（无MMF）。治疗组进行2周的MMF；同时，对照组不进行MMF，术后仅使用引导弹性牵引。术前（T1）、术后即刻（T2）和术后1年（T3）获取头颅侧位片。测量点A和点B到X和Y平面的距离，以确定1年内垂直和水平复发量作为主要结果。应用独立t检验以发现对照组和治疗组之间结果的差异。
两组共评估了58例患者（MMF组28例，无MMF组30例）。BSSO术后下颌前徙量分别为7.68±1.39 mm和7.53±1.28 mm，两组间无显著差异（p = 0.68）。截骨术后1年随访时，两组在点B处的矢状面和垂直面平均变化（复发）有显著差异（分别为p = 0.001和p = 0.05）。
根据本研究结果，BSSO下颌前徙术后短期进行MMF的患者在矢状面和垂直面维度上骨骼稳定性显著更高。
