Shanmugasundaram S, Sneha P, Prasad T Guru, Raja V B Krishnakumar
Department of Oral and Maxillofacial Surgery, SRM Dental College Ramapuram, Chennai, India.
J Maxillofac Oral Surg. 2022 Dec;21(4):1291-1295. doi: 10.1007/s12663-022-01782-7. Epub 2022 Sep 22.
To assess the efficacy of sagittal split plate with adjustable slider for intra-operative correction of condylar sag after bilateral sagittal split osteotomy.
Patients reporting for correction of mandibular skeletal deformities for correction with sagittal split osteotomy (SSRO) were enrolled in the study. Simple randomization method was followed for patient allocation. Patients in group A had undergone fixation sagittal split fix plates; in group B, miniplate fixation with monocortical screws was used. Occlusion was the key indicator of condylar sage that was checked at different time frames (intra-operatively T0, immediate T1, 6 months postoperatively T2). Preoperative, immediate and late postoperative (at 6 months and 1-year interval) and lateral cephalometric assessment was used to assess their stability.
Thirty-three patients were enrolled and 20 patients were included in the study. One patient of group A presented with central condylar sag that was identified intra-operatively and addressed immediately. All the patients in group B presented with type 2 peripheral condylar sag that was addressed by inter-maxillary elastics and orthodontics. Two patients in group A presented with mild degree of relapse at 6 months, which was comparable to the control group indicating good stability.
Sagittal split plates appear to be efficacious for intra-operative identification and correction of condylar sag is associated with SSRO.
The online version contains supplementary material available at 10.1007/s12663-022-01782-7.
评估带可调节滑块的矢状劈开接骨板在双侧矢状劈开截骨术后术中矫正髁突矢状移位的疗效。
纳入因下颌骨骨骼畸形需行矢状劈开截骨术(SSRO)矫正而前来就诊的患者。采用简单随机化方法进行患者分组。A组患者采用矢状劈开固定接骨板固定;B组患者采用单皮质螺钉微型接骨板固定。咬合是髁突移位的关键指标,在不同时间点(术中T0、即刻T1、术后6个月T2)进行检查。术前、即刻及术后晚期(6个月和1年时)采用头颅侧位片评估其稳定性。
共纳入33例患者,最终20例患者纳入研究。A组1例患者术中发现中央髁突移位并立即进行了处理。B组所有患者均出现2型周围髁突移位,通过颌间弹力牵引和正畸治疗进行处理。A组2例患者在6个月时出现轻度复发,与对照组相当,表明稳定性良好。
矢状劈开接骨板似乎对术中识别和矫正与SSRO相关的髁突移位有效。
网络版包含可在10.1007/s12663-022-01782-7获取的补充材料。