Xi Tong, Vinayahalingam Shankeeth, Bergé Stefaan, Maal Thomas, Kwon Tae-Geon
Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands.
3D Imaging Lab, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands.
Maxillofac Plast Reconstr Surg. 2023 Aug 9;45(1):27. doi: 10.1186/s40902-023-00393-7.
This study aimed to compare the skeletal structures between mandibular prognathism and retrognathism among patients with facial asymmetry.
Patients who had mandibular asymmetry with retrognathism (Group A) in The Netherlands were compared with those with deviated mandibular prognathism (Group B) in Korea. All the data were obtained from 3D-reformatted cone-beam computed tomography images from each institute. The right and left condylar heads were located more posteriorly, inferiorly, and medially in Group B than in Group A. The deviated side of Group A and the contralateral side of Group B showed similar condylar width and height, ramus-proper height, and ramus height. Interestingly, there were no inter-group differences in the ramus-proper heights. Asymmetric mandibular body length was the most significantly correlated with chin asymmetry in retrognathic asymmetry patients whereas asymmetric elongation of condylar process was the most important factor for chin asymmetry in deviated mandibular prognathism.
Considering the 3D positional difference of gonion and large individual variations of frontal ramal inclination, significant structural deformation in deviated mandibular prognathism need to be considered in asymmetric prognathism patients. Therefore, Individually planned surgical procedures that also correct the malpositioning of the mandibular ramus are recommended especially in patients with asymmetric prognathism.
本研究旨在比较面部不对称患者中下颌前突与下颌后缩之间的骨骼结构。
将荷兰下颌后缩伴下颌不对称的患者(A组)与韩国下颌前突偏斜的患者(B组)进行比较。所有数据均来自各机构的三维重建锥形束计算机断层扫描图像。B组左右髁突头部比A组更靠后、更低且更靠内侧。A组的偏斜侧和B组的对侧显示出相似的髁突宽度和高度、升支高度以及升支长度。有趣的是,升支高度在组间没有差异。在伴有下颌后缩的不对称患者中,不对称的下颌体长与颏部不对称最显著相关,而在偏斜的下颌前突患者中,髁突的不对称伸长是颏部不对称的最重要因素。
考虑到下颌角的三维位置差异以及升支前缘倾斜度的个体差异较大,在不对称前突患者中,偏斜的下颌前突存在明显的结构变形需要考虑。因此,尤其对于不对称前突患者,建议采用个体化的手术方案,同时纠正下颌升支的错位。