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骨性 III 类错颌患者双颌正颌手术后的肩胛盂窝的三维骨重塑。

Three-dimensional bone remodelling of glenoid fossa in patients with skeletal Class III malocclusion after bimaxillary orthognathic surgery.

机构信息

Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, PR China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Jiangsu, PR China.

Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, PR China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Jiangsu, PR China; Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Jiangsu, PR China.

出版信息

Int J Oral Maxillofac Surg. 2024 Feb;53(2):133-140. doi: 10.1016/j.ijom.2023.06.006. Epub 2023 Jul 11.

Abstract

This study aimed to characterize three-dimensional quantitative morphological changes of glenoid fossa in patients with skeletal Class III malocclusion treated with bimaxillary orthognathic surgery. Ninety-five eligible patients (50 male, 45 female; mean age 22.09 years) were enrolled retrospectively. Cone beam computed tomography obtained at 1 week preoperatively (T0), immediately after surgery (T1), and at ≥ 12 months postoperatively (T2) were registered based on cranial base using voxel-based registration in 3D Slicer. Glenoid fossa surface was divided spatially into four regions, and bone modelling in these regions was visualized with color maps. Our data revealed that the mean surface variations of glenoid fossa were small, with modest bone formation as a whole. No significant associations between anteroposterior or vertical mandibular displacement and overall glenoid fossa remodeling were found (P > 0.05). Moreover, bone deposition was frequently observed in the anterior-lateral region of glenoid fossa in patients with a larger mandibular movement during T0-T1 (P < 0.001). Paired bone formation in the anterior-lateral region of glenoid fossa and bone resorption in the anterior-lateral region of condylar head was frequently observed. Collectively, our results revealed that glenoid fossa underwent complex but modest bone remodeling after bimaxillary surgery in skeletal Class III patients.

摘要

本研究旨在描述接受双颌正颌手术治疗的骨性 III 类错[牙合]患者的颞下颌关节窝的三维定量形态变化。回顾性纳入 95 名符合条件的患者(50 名男性,45 名女性;平均年龄 22.09 岁)。使用 3D Slicer 中的基于体素的配准,基于颅底对术前 1 周(T0)、术后即刻(T1)和术后≥12 个月(T2)获得的锥形束 CT 进行配准。将关节窝表面空间分为四个区域,并使用彩色地图可视化这些区域的骨建模。我们的数据显示,关节窝的平均表面变化较小,整体有适度的骨形成。在前后向或垂直向下颌骨位移与整个关节窝重塑之间未发现显著相关性(P>0.05)。此外,在 T0-T1 期间下颌运动较大的患者中,关节窝的前外侧区域经常观察到骨沉积(P<0.001)。在关节窝的前外侧区域经常观察到骨形成,在髁突头部的前外侧区域经常观察到骨吸收。总之,我们的结果表明,在骨性 III 类患者的双颌手术后,关节窝经历了复杂但适度的骨重塑。

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