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正颌手术是否会影响下颌髁突位置?一项回顾性研究。

Does orthognathic surgery affect mandibular condyle position? A retrospective study.

机构信息

Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Comenius University and University Hospital Bratislava, Bratislava, Slovakia.

Department of Stomatology and Maxillofacial Surgery, Faculty of Medicine, Comenius University, Oncologic Institute of St Elisabeth, Bratislava, Slovakia.

出版信息

Oral Maxillofac Surg. 2024 Jun;28(2):639-643. doi: 10.1007/s10006-023-01181-3. Epub 2023 Sep 23.

Abstract

PURPOSE

The aim of this study is to analyze mandibular condyle position changes after bilateral sagittal split osteotomy (BSSO) and bimaxillary orthognathic surgery in patients operated at a single department by two surgeons in 2013-2022. Compared were groups of mandibular advancement vs setback and bimaxillary vs BSSO.

METHODS

Ninety-nine subjects were included. Inclusion criteria were patients who underwent one of the BSSO or bimaxillary surgery and had CT scans performed before and after surgery. Preoperative CT scans were performed 1 day before surgery and postoperative CT scans 6-12 months afterwards. Changes in mandibular condyle position were measured in axial and sagittal planes.

RESULTS

CT condylar position measurements indicated significant postoperative changes in AB angle bilaterally (p =  < 0.001). In mandibular advancement and setback comparison, values were significantly lower in ABL angle values in the setback group (p = 0.011326) and significantly higher in FDR in the advancement group (p = 0.005795). There were no statistically significant changes found in BSSO and bimaxillary group comparison.

CONCLUSION

Within the limitations of this study, it can be concluded that orthognathic surgery does have a moderate effect on position of the condyles, especially condylar rotation in transversal axis.

摘要

目的

本研究旨在分析 2013 年至 2022 年间由两位外科医生在单一科室为患者行双侧矢状劈开截骨术(BSSO)和双颌正颌手术时,下颌髁突位置的变化。对比了下颌前伸与后退组和双颌组与 BSSO 组。

方法

共纳入 99 名患者。纳入标准为接受 BSSO 或双颌手术且术前术后均行 CT 检查的患者。术前 CT 检查在手术前 1 天进行,术后 CT 检查在术后 6-12 个月进行。测量了下颌髁突位置在矢状面和冠状面的变化。

结果

CT 髁突位置测量表明双侧 AB 角术后有显著变化(p<0.001)。在下颌前伸和后退的对比中,后退组的 ABL 角值显著降低(p=0.011326),而前伸组的 FDR 值显著升高(p=0.005795)。BSSO 和双颌组比较无统计学显著变化。

结论

在本研究的限制范围内,可以得出结论,正颌手术确实对髁突位置有一定影响,特别是在横轴上的髁突旋转。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cd9/11144676/8d42fa9bbc06/10006_2023_1181_Fig1_HTML.jpg

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