PhD student, Resident, School of Stomatology, Jiangxi Medical College, Nanchang University Jiangxi Province Key Laboratory of Oral Biomedicine, Jiangxi Province Clinical Research Center for Oral Diseases, Jiangxi, China.
Master student, Resident, School of Stomatology, Jiangxi Medical College, Nanchang University Jiangxi Province Key Laboratory of Oral Biomedicine, Jiangxi Province Clinical Research Center for Oral Diseases, Jiangxi, China.
J Oral Maxillofac Surg. 2024 Sep;82(9):1052-1066.e1. doi: 10.1016/j.joms.2024.05.013. Epub 2024 Jun 3.
Assessing condyle position postorthognathic surgery is pivotal for optimizing surgical accuracy, sustaining postoperative stability, and ensuring predictable treatment outcomes.
The aim of this study was to analyze the changes of condyle position after orthognathic surgery with different types of jaw deformity and to analyze whether the changes of condyle position are different.
STUDY DESIGN, SETTING, SAMPLE: A retrospective cohort study was designed and conducted, involving adults who underwent orthognathic surgery for jaw deformities at the affiliated Stomatological Hospital of Nanchang University between 2019 and 2022. Patients with incomplete computerized tomography data were excluded.
PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE: The primary predictor variable was time (preoperative and postoperative) and types of jaw deformities (skeletal Class III, skeletal Class II, and mandibular deviation).
MAIN OUTCOME VARIABLE(S): The main outcome variables were the three-dimensional linear and rotational positional changes of the condyle.
Evaluated covariates included sex and age.
MIMICS 20.0 software measured all data, and SPSS 22.0 software facilitated statistical analyses. Intragroup and intergroup correlation analyses employed paired t-tests and independent t-tests, with statistical significance set at P < .05.
The study sample was composed of 32 subjects with a mean age of 22.43 ± 1.6 and 9 were male. The analysis of changes of condylar position from virtual surgical planning to the immediate postoperative period showed that the maximum condylar displacement was 1.74 mm and the maximum angular change was 3.92°. The analysis of changes in condylar position from the immediate postoperative period to 1 year postoperatively showed no statistically significant changes for the same type of jaw deformity. But patients with Class II malocclusion exhibited distinct condylar displacement and rotation patterns compared to those with Class III malocclusion and mandibular deformity.
The application of virtual surgical planning in orthognathic surgery ensures a high degree of consistency in achieving the desired condylar position. Moreover, no significant change in condylar position was observed after orthognathic surgery for the same type of jaw deformity. However, patients with Class II deformities exhibited a higher susceptibility to rotational displacement of the condyles compared to those with other types of jaw deformities.
评估正颌手术后髁突的位置对于优化手术准确性、维持术后稳定性以及确保可预测的治疗结果至关重要。
本研究旨在分析不同类型颌骨畸形患者正颌手术后髁突位置的变化,并分析这些变化是否存在差异。
研究设计、地点和样本:本研究为回顾性队列研究,纳入 2019 年至 2022 年期间在南昌大学附属口腔医院因颌骨畸形接受正颌手术的成年人患者。排除了计算机断层扫描数据不完整的患者。
预测因子/暴露因素/自变量:主要预测变量是时间(术前和术后)和颌骨畸形类型(骨性 III 类、骨性 II 类和下颌偏斜)。
主要结局变量是髁突的三维线性和旋转位置变化。
评估的协变量包括性别和年龄。
MIMICS 20.0 软件测量所有数据,SPSS 22.0 软件进行统计分析。采用配对 t 检验和独立 t 检验进行组内和组间相关性分析,以 P<.05 为统计学显著性标准。
研究样本由 32 名平均年龄为 22.43±1.6 岁的患者组成,其中 9 名为男性。从虚拟手术规划到术后即刻,髁突位置变化的分析显示最大髁突位移为 1.74mm,最大角度变化为 3.92°。术后即刻至术后 1 年髁突位置变化的分析显示,对于同一类型的颌骨畸形,没有统计学意义上的变化。但与骨性 III 类畸形和下颌偏斜患者相比,骨性 II 类错畸形患者的髁突位移和旋转模式存在明显差异。
虚拟手术规划在正颌手术中的应用可确保实现预期髁突位置的高度一致性。此外,对于同一类型的颌骨畸形,正颌手术后髁突位置没有明显变化。然而,与其他类型的颌骨畸形相比,骨性 II 类畸形患者的髁突更容易发生旋转位移。