Fattal Amine, Gandhi Vaibhav, Denadai Rafael, Osman Essam, Liou Eric Jein-Wein
Department of Orthodontics, University of Louisville, Louisville, KY USA.
Plastic and Cleft-Craniofacial Surgery, A&D DermePlastique, Sao Paulo, Brazil.
J Maxillofac Oral Surg. 2024 Oct;23(5):1138-1162. doi: 10.1007/s12663-023-02042-y. Epub 2023 Nov 19.
Assess the available scientific literature regarding the direction and extent of condylar positional changes during the first year of post-surgical orthodontics interventions in class III patients.
PubMed, Cochrane Library, Embase, and Google Scholar databases were searched up to March 2022 for studies involving the measurement of condylar positional changes after surgical treatment of Class III dentofacial deformity in adults with BSSO without or without Le Fort I osteotomies. The methodological index for non-randomized studies (MINORS) was utilized to assess the risk of bias and quality of non-randomized studies. Reporting of this review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Primary outcome was condyle positional changes between the following time points: T0: before treatment, T1: immediately post treatment, T2: 4, 6, or 9 months post treatment, T3: one year post treatment.
Nineteen studies were included in the systematic review. Eleven studies were deemed low quality, and the rest were of medium quality. The meta-analysis included 12 studies and showed statistically significant downward, outward positional changes at T1(Immediately after surgery). Inward Yaw rotation was significant at T1(1-4 month post-surgery) and T2(4-9 months post-surgery).
Surgically induced condylar changes tend to go back to normal within the first year after surgery, except for condylar yaw rotations.
评估关于III类患者术后正畸干预第一年髁突位置变化方向和程度的现有科学文献。
检索截至2022年3月的PubMed、Cochrane图书馆、Embase和谷歌学术数据库,以查找涉及测量接受双侧矢状劈开截骨术(BSSO)且有或无Le Fort I截骨术的成人III类牙颌面畸形手术治疗后髁突位置变化的研究。采用非随机研究方法学指数(MINORS)评估非随机研究的偏倚风险和质量。本综述的报告基于系统评价和Meta分析的首选报告项目(PRISMA)指南。主要结局是以下时间点之间的髁突位置变化:T0:治疗前,T1:治疗后即刻,T2:治疗后4、6或9个月,T3:治疗后一年。
系统评价纳入了19项研究。11项研究被认为质量低,其余为中等质量。Meta分析纳入了12项研究,结果显示在T1(手术后即刻)有统计学意义的向下、向外位置变化。在T1(手术后1 - 4个月)和T2(手术后4 - 9个月)向内偏航旋转显著。
手术引起的髁突变化在术后第一年内往往会恢复正常,但髁突偏航旋转除外。