Valls-Ontañón A, Triginer-Roig S, Trujillo I, Brabyn P J, Giralt-Hernando M, Hernández-Alfaro F
Institute of Maxillofacial Surgery, Teknon Medical Center Barcelona, Barcelona, Spain; Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain.
Institute of Maxillofacial Surgery, Teknon Medical Center Barcelona, Barcelona, Spain.
Int J Oral Maxillofac Surg. 2023 Mar;52(3):353-360. doi: 10.1016/j.ijom.2022.06.016. Epub 2022 Jul 22.
The main objective of this study was to compare the stability of the surgery-first and surgery-late approaches according to the standardized centre protocols, by three-dimensional evaluation after 1 year of follow-up. A retrospective study was designed that included a test group (surgery-first protocol) and a control group (surgery-late protocol), with a follow-up period of at least 1 year (average 14 months; range 12-24 months). Stability was evaluated using linear and angular measurements by superimposing cone beam computed tomography images obtained at specific points in time: preoperatively, 1 month after surgery, and at the end of the orthodontic treatment. A total of 56 patients with a mean age of 32.2 ± 11.1 years were included in the study. After surgery there were significant changes in all of the measurements in at least one dimension in both groups (except for the transverse maxillary dimension), which remained stable at the end of the treatment, with no statistically significant differences between the two groups. At the 1-year follow-up, both groups presented a SNA angle relapse; this relapse was more significant in the surgery-late group (P = 0.031) and was present only in Class III patients (P = 0.013). In conclusion, an equivalent three-dimensional stability between surgery-first and surgery-late protocols was demonstrated after 1 year of follow-up when eligibility criteria were strictly adhered to.
本研究的主要目的是根据标准化的中心方案,通过随访1年后的三维评估,比较手术优先和手术延迟方法的稳定性。设计了一项回顾性研究,包括一个试验组(手术优先方案)和一个对照组(手术延迟方案),随访期至少1年(平均14个月;范围12 - 24个月)。通过叠加在特定时间点(术前、术后1个月和正畸治疗结束时)获得的锥束计算机断层扫描图像,使用线性和角度测量来评估稳定性。共有56例平均年龄为32.2±11.1岁的患者纳入研究。手术后,两组至少在一个维度上的所有测量值均有显著变化(除上颌横向维度外),这些变化在治疗结束时保持稳定,两组之间无统计学显著差异。在1年随访时,两组均出现SNA角复发;这种复发在手术延迟组中更显著(P = 0.031),且仅在III类患者中出现(P = 0.013)。总之,当严格遵守入选标准时,随访1年后手术优先和手术延迟方案之间显示出等效的三维稳定性。