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正颌手术后髁突位置的准确性和稳定性:一项回顾性研究。

Accuracy and stability of the condyle position after orthognathic surgery: A retrospective study.

机构信息

Department of Oral and Maxillofacial Surgery, Odense University Hospital, Denmark.

Consultant Surgeon & Head of Research, Department of Oral and Maxillofacial Surgery, Odense University Hospital, Oral and Maxillofacial Research Department, Clinical Institute, University of Southern Denmark, Denmark.

出版信息

J Craniomaxillofac Surg. 2024 Feb;52(2):240-245. doi: 10.1016/j.jcms.2023.12.008. Epub 2023 Dec 28.

Abstract

The purpose of this study was to evaluate the accuracy and stability of condylar positioning in patients treated with bimaxillary procedures compared with patients treated with maxillary procedures alone. All patients had undergone treatment at Odense University Hospital and were treated with inferior maxillary procedures. The primary outcome was changes in condyle position and the primary predictor variable was time: pre-operative (T) measurements to 1-week post-operative (T) and 1-year post-operative (T) measurements. Condyle movement was measured using dual voxel-based alignment. Sixteen patients were included. Seven patients underwent solitary maxillary procedure and 9 patients bimaxillary procedure. Bimaxillary procedures overall showed a condyle positional change in pitch from T to T and T to T compared to maxillary procedures alone. Condylar translation was stable despite large differences in positioning. Compared to solitary maxillary procedures, bimaxillary procedures showed a statistically significant anterocranial rotation at 1-week follow-up movement (3.95° vs. -0.95°; SD 3,74 vs 1,05; P value = 0.000) and an additional statistically significant anterocranial movement at 1 year after surgery (4.89° vs 0.60°; SD 3,82 vs 0,92; P value = 0.000). In conclusion a need for greater anterocranial stability of the sagittal split osteotomy than that provided by 3 bicortically fixated screws alone might be indicated.

摘要

本研究旨在评估接受双颌手术治疗的患者与仅接受上颌手术治疗的患者在髁突定位方面的准确性和稳定性。所有患者均在奥登塞大学医院接受治疗,并接受了下颌骨手术。主要结局是髁突位置的变化,主要预测变量是时间:术前(T)测量到术后 1 周(T)和术后 1 年(T)测量。使用双体素基于对齐的方法测量髁突运动。共纳入 16 名患者。7 名患者接受了单纯上颌手术,9 名患者接受了双颌手术。与单纯上颌手术相比,双颌手术总体上显示髁突在俯仰方向上的位置变化,从 T 到 T 和 T 到 T。尽管定位存在较大差异,但髁突的平移是稳定的。与单纯上颌手术相比,双颌手术在术后 1 周的运动中表现出明显的前颅旋转(3.95°与-0.95°;SD 3,74 与 1,05;P 值=0.000),并且在术后 1 年时还存在明显的前颅运动(4.89°与 0.60°;SD 3,82 与 0.92;P 值=0.000)。总之,可能需要比单纯使用 3 个皮质固定螺钉提供的矢状劈开截骨术更大的前颅稳定性。

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