Department of Orthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
J Oral Rehabil. 2023 Jul;50(7):596-616. doi: 10.1111/joor.13447. Epub 2023 Apr 6.
One of the main goals of orthognathic surgery is to improve the masticatory performance in patients with maxillofacial deformities.
The aim of this study was to evaluate the literature on assessing masticatory performance before, after orthognathic surgery and normal occlusion.
An electronic search was performed via Pubmed, Scopus, LILACs and Web of Science without any restrictions until June 2022. The articles assessing masticatory performance using a comminution assay, bite force or occlusal contact area in patients undergoing orthognathic surgery with or without comparing controls were included. The risk of bias of the selected articles was assessed using the appropriate tools according to the study design.
Of the 2507 records identified, 21 studies were included in the qualitative evaluation and 17 studies in the meta-analysis. Nine articles were cohort studies, and the other eight were before-after studies. Moderate to high risks of bias were found among the articles. Comparing the values before and after surgery, the meta-analysis revealed a significant improvement in the bite force and occlusal contact area at 1- and 2-year post-surgery. However, regardless of the assessed parameters, the masticatory performance in patients with normal occlusion was significantly greater than those in patients undergoing orthognathic surgery at all evaluated time points.
Although combined surgical orthodontic treatment can improve impaired masticatory function, assessed by the comminution method, bite force and occlusal contact area, the improvement may not reach that of normal occlusion.
正颌手术的主要目标之一是改善颌面畸形患者的咀嚼性能。
本研究旨在评估正颌术前、术后和正常咬合患者咀嚼性能评估的文献。
通过 Pubmed、Scopus、LILACs 和 Web of Science 进行电子检索，无任何限制，检索时间截至 2022 年 6 月。纳入使用粉碎试验、咬合力或咬合接触面积评估正颌手术患者（无论是否与对照组比较）咀嚼性能的文章。根据研究设计，使用适当的工具评估所选文章的偏倚风险。
在 2507 条记录中，有 21 篇文章进行了定性评价，17 篇文章进行了荟萃分析。9 篇文章为队列研究，其余 8 篇为前后对照研究。文章存在中高度偏倚风险。荟萃分析显示，无论评估参数如何，与术前相比，术后 1 年和 2 年均显著提高了咬合力和咬合接触面积，但与正常咬合患者相比，正颌手术患者的咀嚼性能无论在任何评估时间点均显著降低。
尽管联合外科正畸治疗可以改善咀嚼功能受损患者的咀嚼功能，如粉碎试验、咬合力和咬合接触面积，但改善程度可能不如正常咬合。
