Abbasi Amir Jalal, Azadbakht Mojtaba, Mosavat Farzaneh, Bayati Mahsa
Department of Oral and Maxillofacial Surgery, Sina Hospital and Craniomaxillofacial Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
Int J Dent. 2024 Dec 31;2024:4269097. doi: 10.1155/ijod/4269097. eCollection 2024.
This study aimed to assess the changes in the position and size of articular spaces and anteroposterior and mediolateral condyle dimensions following orthognathic surgery. Additionally, it evaluated the correlation between these changes and mandibular movement during surgery. This experimental study examined 31 patients (16 with Class III and 15 with Class II malocclusions) who were candidates for orthognathic surgery. Bimaxillary orthognathic surgery was performed on 23 patients, while monomaxillary orthognathic surgery (mandible) was performed on 8 patients. Condyle positioning was achieved using the classic method. In pre- and postsurgical cone beam computed tomography (CBCT) scans, the anteroposterior and mediolateral dimensions of the condyle and spaces and the intercondylar angle were measured. The results were analyzed using the Wilcoxon signed-rank test, with a -value of less than 0.05 considered significant. The medial and lateral condyle dimensions and the upper articular space did not change significantly after orthognathic surgery in both Class II and III groups. However, the posterior articular space dimensions showed a statistically significant reduction in both groups. Although the anterior articular space dimensions increased in both groups, this increase was significant only in the Class II group. Additionally, there was a significant relationship between the extent of mandibular advancement or setback and changes in both groups' anterior and posterior articular space dimensions and the upper articular space dimensions in the Class II group. The classic method for condyle positioning is a suitable approach for orthognathic surgery. The most notable changes were observed in the anterior and posterior articular spaces, likely due to the backward force applied to the proximal part during the fixation stage. According to the evaluations and Spearman's rho, the likelihood of changes in anterior and posterior articular space dimensions increases with more significant advancement and setback.
本研究旨在评估正颌外科手术后关节间隙的位置和大小变化以及髁突前后径和内外径的变化。此外，还评估了这些变化与手术过程中下颌运动之间的相关性。这项实验性研究检查了31例正颌外科手术候选患者（16例III类错牙合和15例II类错牙合）。23例患者接受了双颌正颌手术，8例患者接受了单颌正颌手术（下颌骨）。采用经典方法实现髁突定位。在术前和术后锥形束计算机断层扫描（CBCT）中，测量髁突的前后径和内外径、间隙以及髁间角。结果采用Wilcoxon符号秩检验进行分析，P值小于0.05被认为具有显著性。II类和III类组在正颌外科手术后，髁突内外径和上关节间隙均无显著变化。然而，两组的后关节间隙尺寸均有统计学意义的减小。虽然两组的前关节间隙尺寸均增加，但仅在II类组中增加显著。此外，下颌前移或后退的程度与两组的前、后关节间隙尺寸以及II类组的上关节间隙尺寸变化之间存在显著关系。经典的髁突定位方法是正颌外科手术的一种合适方法。在前、后关节间隙观察到最显著的变化，这可能是由于在固定阶段向近端施加了向后的力。根据评估结果和Spearman相关系数，随着前移和后退程度的增加，前、后关节间隙尺寸变化的可能性增加。
