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下颌正颌手术后复发的长期研究:前徙术与后退术对比

Long-Term Study of Relapse After Mandibular Orthognathic Surgery: Advancement Versus Setback.

作者信息

Sahoo N K, Agarwal Shiv Shankar, Datana Sanjeev, Bhandari S K

机构信息

Department of Oral and Maxillofcial Surgery, Armed Forces Medical College, Pune, 411040 India.

Department of Orthodontics and Dentofacial Orthopedics, Armed Forces Medical College, Pune, India.

出版信息

J Maxillofac Oral Surg. 2022 Jun;21(2):469-480. doi: 10.1007/s12663-020-01445-5. Epub 2020 Aug 31.

Abstract

BACKGROUND

Relapse is a continuing process and should be evaluated on a long rather than short term.

MATERIALS AND METHODS

Treatment records of 46 patients who underwent mandibular orthognathic surgery were divided into two groups, i.e. Group 1: Mandibular Advancement (MA) surgery ( = 26) and Group 2: Mandibular Setback (MS) surgery ( = 20). Lateral cephalograms were traced at T0 (01 week before surgery), T1 (01 week after surgery), T2 (01 year after surgery) and T3 (minimum 05 years after surgery) to study short- and long-term skeletal and dental relapse in horizontal, vertical and angular parameters selected for the study. Relapse was correlated with gender, age, amount of surgical movement and intra-operative change in mandibular plane angle to study effect of these factors on relapse.

RESULTS

All horizontal, vertical and angular parameters studied showed significant relapse at short term (from T1 to T2) which continued significantly till long-term evaluation (T2 to T3) in both groups ( value < 0.001). Horizontal relapse in all parameters, vertical relapse in all parameters (except Pog and overbite at T1-T2) and angular relapse in all parameters (except Ramus inclination at T1-T2) was significantly higher in Group 2 compared to Group 1 ( value < 0.001 for all). Relapse showed significant and positive correlation with amount of surgical movement and intra-operative change in mandibular plane angle in both groups ( value < 0.05 for all).

CONCLUSION

Both MA and MS surgeries show significant relapse on both short- and long-term evaluation which it is higher in MS as compared to MA surgeries.

摘要

背景

复发是一个持续的过程,应该从长期而非短期进行评估。

材料与方法

将46例行下颌正颌手术患者的治疗记录分为两组,即第1组:下颌前徙(MA)手术(n = 26)和第2组:下颌后退(MS)手术(n = 20)。在T0(术前1周)、T1(术后1周)、T2(术后1年)和T3(术后至少5年)拍摄头颅侧位片,以研究所选水平、垂直和角度参数的短期和长期骨骼及牙齿复发情况。将复发与性别、年龄、手术移动量和下颌平面角术中变化相关联,以研究这些因素对复发的影响。

结果

两组中所有研究的水平、垂直和角度参数在短期(从T1到T2)均显示出显著复发,并且在长期评估(T2到T3)时仍持续显著复发(P值<0.001)。与第1组相比,第2组所有参数的水平复发、所有参数(T1 - T2时的Pog和覆合除外)的垂直复发以及所有参数(T1 - T2时的升支倾斜度除外)的角度复发均显著更高(所有P值<0.001)。两组中复发均与手术移动量和下颌平面角术中变化呈显著正相关(所有P值<0.05)。

结论

MA和MS手术在短期和长期评估中均显示出显著复发,且MS手术的复发高于MA手术。

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