State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
J Stomatol Oral Maxillofac Surg. 2023 Oct;124(5):101526. doi: 10.1016/j.jormas.2023.101526. Epub 2023 Jun 2.
The mandible's ongoing development presents a contraindication for combined orthodontic-orthognathic treatment. The aim of this study was to evaluate the mandibular stability before and after preoperative orthodontic treatment in late adolescent patients with skeletal Class III malocclusion and to investigate the most appropriate time to start preoperative orthodontic treatment.
The study population consisted of 58 adolescents, aged between 15 and 21 years, with skeletal Class III malocclusion; the adolescents underwent CT scans at the beginning (T1) and the end (T2) of preoperative orthodontic treatment. The CT data were analyzed using ITK-SNAP and 3D Slicer software, and the effects of age and gender on mandibular development were investigated.
In these 58 patients, there were no significant local bone alterations in the condyle and anterior chin point between T1 and T2 and no significant changes in the mandibular branch height, mandibular body length, condylar distance, and mandibular angle distance (p>0.05). The mandibular growth at the angel of mandible was statistically significant (p<0.05), but it was not clinically significant because the mean value of the growth was small (right: 0.416±0.986 mm, left: 0.328±0.886 mm). No effect of age and gender on mandibular development was observed.
The mandibular morphology was stable during preoperative orthodontic treatment in patients at the late adolescent stage. This study provides evidence for the possibility of early implementation of preoperative orthodontics.
下颌骨的持续发育是联合正畸-正颌治疗的禁忌症。本研究旨在评估骨骼 III 类错畸形的青少年晚期患者术前正畸治疗前后的下颌稳定性,并探讨开始术前正畸治疗的最佳时间。
研究人群由 58 名年龄在 15 至 21 岁之间的骨骼 III 类错畸形青少年组成;这些青少年在术前正畸治疗开始时(T1)和结束时(T2)接受 CT 扫描。使用 ITK-SNAP 和 3D Slicer 软件分析 CT 数据,并研究年龄和性别对下颌骨发育的影响。
在这 58 名患者中,T1 和 T2 之间髁突和前颏点没有明显的局部骨质改变,下颌支高度、下颌体长度、髁突距离和下颌角距离均无明显变化(p>0.05)。下颌角的下颌生长有统计学意义(p<0.05),但由于生长值较小,无临床意义(右侧:0.416±0.986mm,左侧:0.328±0.886mm)。年龄和性别对下颌发育无影响。
在青少年晚期患者的术前正畸治疗期间,下颌形态稳定。本研究为早期实施术前正畸提供了证据。