Orthodontics, Oral Health Centre of Western Australia, School of Dentistry, The University of Western Australia, 17 Monash Avenue, Nedlands, WA, 6009, Australia.
Private Practice in Orthodontics, 5 Khartoum Avenue, Gordon, NSW, 2072, Australia.
Prog Orthod. 2024 Feb 26;25(1):8. doi: 10.1186/s40510-023-00507-x.
The aim of this retrospective study was to firstly assess the stability of surgical advancement using inter-molar mandibular distraction osteogenesis (IMDO) and secondly to assess the impact of the surgical intervention on subsequent mandibular growth in patients with residual growth.
The sample consisted of 17 (13F and 4M) consecutively treated patients who underwent IMDO and orthodontic treatment. Cephalometric analysis was performed at three time points: T0 prior to distraction; T1 post-distraction immediately prior to surgical removal of the distractors; and T2 following completion of orthodontic treatment when the final lateral cephalogram was taken (0.86-4.37 years after T1). Statistical comparison of lower facial height, mandibular length, growth, condylar position and anterior mandibular rotation was performed.
No association was found between changes in any of the cephalometric measurements and the length of the follow-up interval. The anterior mandibular segment underwent clockwise rotation during distraction and recovered to near its pre-distraction angulation during remodelling. An increase in the lower facial height of 1.88 ± 2.81mm also occurred during distraction (T0-T1) and was maintained during the follow-up period (T1-T2). Post-distraction (T1-T2) growth of lower facial height (p value 0.872) and mandibular length (p value 0.251) showed no association when compared to an untreated control group and an overall reduction in growth was reported.
IMDO was highly stable within a follow-up period of 2.3 ± 0.9 years; however, growth appears to have been inhibited.
本回顾性研究的目的首先是评估使用下颌骨间距牵引成骨术（IMDO）进行手术前伸的稳定性，其次是评估手术干预对有残留生长的患者随后下颌生长的影响。
该样本由 17 名（13 名女性和 4 名男性）连续接受 IMDO 和正畸治疗的患者组成。在三个时间点进行头影测量分析：T0 在牵引前；T1 在牵引后立即手术取出牵引器之前；T2 在完成正畸治疗后拍摄最终侧位头颅片时（T1 后 0.86-4.37 年）。对下面部高度、下颌长度、生长、髁突位置和下颌前旋转进行了比较。
在任何头影测量指标的变化与随访间隔的长度之间均未发现相关性。下颌前牙段在牵引时发生顺时针旋转，并在重塑过程中恢复到接近牵引前的角度。在下颌骨高度也在牵引过程中增加了 1.88 ± 2.81mm（T0-T1），并在随访期间保持不变（T1-T2）。与未治疗对照组相比，牵引后（T1-T2）下脸部高度（p 值 0.872）和下颌长度（p 值 0.251）的生长无相关性，并且报告了生长总体减少。
IMDO 在 2.3 ± 0.9 年的随访期内高度稳定；然而，生长似乎受到抑制。
