Department of Cranio-Maxillofacial Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1 Gebäude W30, 48149, Muenster, Germany.
Department of Periodontology, State University of Maringá, Maringá, A. Colombo, 5790, 87020-900, Brazil.
Odontology. 2023 Jan;111(1):201-206. doi: 10.1007/s10266-022-00721-9. Epub 2022 Jun 23.
The purpose of this prospective study was to evaluate whether the surgical protocol involving marginal incision and Le Fort I osteotomy affects the periodontal outcome. Twenty-nine patients requiring surgical correction of maxillary dysgnathia were selected for this study. Periodontal conditions of maxillary anterior teeth were assessed prior to the surgery (T), one month (T), and 6 months (T) after the surgical procedure. Interdental papillae loss, periodontal parameters and aesthetic outcomes in the anterior zone were assessed. Statistical analysis was performed with Friedman´s test and within ANOVA (p ≤ 0.05) followed by post-hoc tests. Papilla height decreased from T to T (p = 0.003), followed by an increase from T to T (p = 0.040). PPD (T = 1.72 ± 0.46; T = 2.13 ± 0.43) and CAL (T = 1.24 ± 0.55; T = 1.99 ± 0.70) increased after 6 months. There were statistically significant differences in aesthetic score among T, T and T. Periodontal changes after orthognathic surgery were within acceptable biological levels. Although a change in papillae height was reported after the surgery, initial values were recovered after 6 months. Surgical incision design might improve the outcome of Le-Fort I osteotomy. Anterior aesthetic zone may benefit from a marginal incision design, as it respects vascularization principle and may ensure a wound healing without complications.
本前瞻性研究旨在评估涉及边缘切口和 Le Fort I 截骨术的手术方案是否会影响牙周结局。选择 29 例需要上颌骨畸形矫正的患者进行本研究。在手术前（T）、手术后 1 个月（T）和 6 个月（T）评估上颌前牙的牙周状况。评估前牙区的牙周附着丧失、牙周参数和美学效果。采用 Friedman 检验和组内方差分析（p≤0.05）进行统计学分析，然后进行事后检验。牙间乳头高度从 T 期到 T 期下降（p=0.003），然后从 T 期到 T 期增加（p=0.040）。PPD（T=1.72±0.46；T=2.13±0.43）和 CAL（T=1.24±0.55；T=1.99±0.70）在 6 个月后增加。T、T 和 T 之间的美学评分存在统计学差异。正颌手术后的牙周变化在可接受的生物学范围内。尽管手术后牙间乳头高度发生变化，但 6 个月后恢复到初始值。截骨术的手术切口设计可能会改善 Le-Fort I 截骨术的结果。在前美学区，边缘切口设计可能会受益，因为它尊重血管化原则，并确保无并发症的伤口愈合。
