Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
Department of Orthodontics, Arthur Dugoni School of Dentistry, University of the Pacific, San Francisco, CA, USA.
Oral Maxillofac Surg. 2024 Jun;28(2):935-943. doi: 10.1007/s10006-023-01174-2. Epub 2023 Jul 24.
The aim of this study was to assess the accuracy of maxillary repositioning surgery in teaching hospitals using conventional model surgery.
A total of 73 patients undergoing single-piece LeFort I osteotomies in the maxilla and bilateral sagittal split osteotomies in the mandible were included in the study. Preoperative and immediate postoperative cone-beam CT were compared in computer software (Dolphin3D©). Maxillary landmarks relative to the vertical and horizontal reference lines were evaluated. The difference between the planned and achieved maxillary positions was measured. Distance error in millimeters and achievement ratio (achieved displacement/planned displacement*100) were calculated for different maxillary movements.
Midline correction and advancement were the most accurate movements with an overall mean distance error of 0.53 mm and 0.63 mm respectively while posterior impaction and setback were the least accurate movements with 1.38 mm and 1.76 mm mean discrepancies, respectively. A significant difference was observed only in setback movement regarding the discrepancy value (P < .05). Although setback and down-graft movements tended to under-correction, all other movements were overcorrected. As the magnitude of maxillary movements increases, the accuracy decreases. In severe displacements (≥ 8 mm), the accuracy declines significantly (P < .05).
Classic cast surgery and manually fabricated intermediate splints in teaching hospitals yield accurate and acceptable results in the majority of cases (84.6%). The accuracy of maxillary repositioning decreases as the magnitude of displacement increases.
本研究旨在评估教学医院使用传统模型手术进行上颌骨复位手术的准确性。
共纳入 73 例接受上颌一次性 LeFort I 截骨术和双侧下颌矢状劈开截骨术的患者。在计算机软件（Dolphin3D©）中比较术前和即刻术后的锥形束 CT。评估上颌标志相对于垂直和水平参考线的位置。测量计划和实现的上颌位置之间的差异。计算不同上颌运动的毫米距离误差和实现比（实现位移/计划位移*100）。
中线校正和前突是最准确的运动，总平均距离误差分别为 0.53 毫米和 0.63 毫米，而后倾和后退是最不准确的运动，平均差异分别为 1.38 毫米和 1.76 毫米。仅在后倾运动中观察到差异值有显著差异（P <.05）。虽然后倾和下旋运动倾向于矫正不足，但所有其他运动都存在过矫正。随着上颌运动幅度的增加，准确性降低。在严重位移（≥ 8 毫米）的情况下，准确性显著下降（P <.05）。
在教学医院中，经典铸造手术和手工制作的中间夹板在大多数情况下（84.6%）可获得准确且可接受的结果。随着位移幅度的增加，上颌复位的准确性降低。
