Telha Wael, Abotaleb Bassam, Zhang Jie, Bi Rui, Zhu Songsong, Jiang Nan
State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China.
Clin Oral Investig. 2023 Mar;27(3):1035-1042. doi: 10.1007/s00784-022-04665-w. Epub 2022 Aug 11.
This study aimed to find out the correlation between different anatomical parameters of the mandible and the occurrence of a bad split in patients who had undergone bilateral split sagittal ramus osteotomy (BSSRO).
At both the distal roots of the first molar (1) and the retromolar area (2), we measured the distance from the buccal margin of the inferior dental canal (IDC) to the buccal margin of the cortical bone (MCBC), the thickness of both buccal cortical (WBCB) and cancellous bone (WBCA), distance from the superior border of IDC to the alveolar crest (MCAC), buccolingual thickness (BLT), and thickness of cancellous bone (WCA). At the ramus, the distances between the sigmoid notch to the upper part of the lingula (SL) and the inferior border of the mandible (SIBM), the thickness of the ramus at the level of the lingula (BLTR), and the anteroposterior width of the ramus (APWR) were measured. The paired and independent t-tests were used when applicable, and a P-value < 0.05 was considered significant.
MCBC1 showed a significant difference between bad and non-bad split sides (P = 0.037). Both WBCA1 and WBCA2 show the same significant difference (P = 0.023, 0.024). Similarly, WCA1 and WCA2 showed a statistical difference between the bad and non-bad split sides (P = 0.027, 0.036). There were no statistically significant differences between the compared sides of WBCB1, WBCB2, MCAC1, MCAC2, SIBM, APWR, SL, and BLTR.
Narrow space between IDC and the buccal cortical margin, along with the decrease in the thickness of both buccal cancellous bone and total cancellous bone at the inferior border of the mandible along the course of SSRO, has been implicated in the occurrence of bad split intraoperatively.
本研究旨在找出接受双侧矢状劈开下颌支截骨术（BSSRO）患者下颌骨不同解剖参数与不良劈开发生之间的相关性。
在第一磨牙远中根（1）和磨牙后区（2），我们测量了下颌管（IDC）颊侧边缘至皮质骨颊侧边缘（MCBC）的距离、颊侧皮质骨（WBCB）和松质骨（WBCA）的厚度、IDC上缘至牙槽嵴的距离（MCAC）、颊舌厚度（BLT）以及松质骨厚度（WCA）。在升支，测量了乙状切迹至舌骨上缘（SL）和下颌骨下缘（SIBM）之间的距离、舌骨水平处升支的厚度（BLTR）以及升支的前后宽度（APWR）。适用时采用配对和独立t检验，P值<0.05被认为具有统计学意义。
MCBC1在不良劈开侧与非不良劈开侧之间存在显著差异（P = 0.037）。WBCA1和WBCA2均显示出相同的显著差异（P = 0.023，0.024）。同样，WCA1和WCA2在不良劈开侧与非不良劈开侧之间存在统计学差异（P = 0.027，0.036）。WBCB1、WBCB2、MCAC1、MCAC2、SIBM、APWR、SL和BLTR的比较侧之间无统计学显著差异。
术中不良劈开的发生与下颌管和颊侧皮质边缘之间的狭窄间隙以及沿矢状劈开下颌支截骨术过程中下颌骨下缘颊侧松质骨和总松质骨厚度的减小有关。
