Liu Yanfei, Li Yunfeng
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Orthognathic & TMJ Surgery Center, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
J Clin Med. 2022 Nov 30;11(23):7131. doi: 10.3390/jcm11237131.
Purpose: The purpose of this study is to analyze the change and stability of mandibular morphology in patients with asymmetric mandibular prognathism after bilateral sagittal split ramus osteotomy (BSSRO). Methods: We retrospectively analyzed fifty patients with asymmetric mandibular prognathism from the West China Hospital of Stomatology, Sichuan University, between January 2018 to March 2021. The spiral CT data before surgery, within two weeks after surgery, and at more than six months after surgery of each patient were collected. According to the deflection direction of the chin, the bilateral mandibles were defined as the long side and the short side. The morphological data of the bilateral condyle, the mandibular ramus, and the mandibular body were analyzed to determine the effect and stability of BSSRO on asymmetric mandibular prognathism. Results: It was found that the long-side mandible had greater condylar volume and diameter, mandibular ramus height and volume, and mandibular body length and volume (p < 0.05) before surgery. After surgery, the volume of the mandibular ramus increased, while the length and volume of the mandibular body decreased (p < 0.05) at the long side of the mandible; the morphological changes of the mandibular ramus and body at the short side of the mandible were not statistically significant (p > 0.05). When comparing the long and short sides of the mandible, the long side still had greater height and volume of the mandibular ramus (p < 0.01). The volume difference of the mandibular body from the two sides was corrected (p > 0.05), and the length difference of the mandibular body from the two sides was overcorrected (p < 0.05). At more than six months after surgery, the volume of the mandibular ramus and body increased, while their height decreased at the long side of the mandible (p < 0.05). For the other side, or the short side, the volume of the ramus and body increased, too. However, their height decreased (p < 0.01). Conclusion: The results of this study suggested good effect and stability of BSSRO on asymmetric mandibular prognathism, except for the correction of ramus height and volume.
本研究旨在分析双侧矢状劈开下颌支截骨术（BSSRO）后不对称下颌前突患者下颌形态的变化及稳定性。方法：回顾性分析2018年1月至2021年3月四川大学华西口腔医院的50例不对称下颌前突患者。收集每位患者术前、术后两周内及术后六个月以上的螺旋CT数据。根据颏部偏斜方向，将双侧下颌骨定义为长边和短边。分析双侧髁突、下颌支和下颌体的形态学数据，以确定BSSRO对不对称下颌前突的效果和稳定性。结果：术前发现长边下颌骨的髁突体积和直径、下颌支高度和体积、下颌体长和体积更大（p<0.05）。术后，下颌支体积增加，而长边下颌骨的下颌体长和体积减小（p<0.05）；下颌骨短边的下颌支和体部形态变化无统计学意义（p>0.05）。比较下颌骨的长边和短边时，长边的下颌支高度和体积仍更大（p<0.01）。双侧下颌体的体积差异得到校正（p>0.05），双侧下颌体的长度差异过度校正（p<0.05）。术后六个月以上，长边下颌骨的下颌支和体部体积增加，而高度减小（p<0.05）。对于另一侧，即短边，下颌支和体部的体积也增加。然而，它们的高度降低（p<0.01）。结论：本研究结果表明，BSSRO对不对称下颌前突具有良好的效果和稳定性，但下颌支高度和体积的矫正除外。
