Xie Zhiyang, Yan Shunchao, Qiao Chongxu, Shi Zai, Xu Jingyi, Yan Kaili, Qu Yuming, Wang Shu, Shangguan Wensong, Wu Guoping
Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu province, China.
Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, China.
Aesthetic Plast Surg. 2025 May 12. doi: 10.1007/s00266-025-04854-4.
Previous studies have identified bone remodeling in the mandibular angle region (MAR) as a key factor influencing outcomes after mandibular angle osteotomy (MAO). This study investigates hematologic predictors-red blood cell (RBC) count and hemoglobin (Hb) levels-and their correlation with postoperative MAR bone remodeling.
A retrospective analysis was conducted on 135 patients who underwent MAO between January 2015 and December 2022. Bone remodeling was assessed using cone beam computed tomography (CBCT) imaging at two time points: T1 (immediately postoperatively) and T2 (at least 12months postoperatively). Quantification of bone remodeling was performed using Geomagic Wrap 2021. Patients were categorized into bone stability (S), bone regeneration (RG), and bone resorption (RS) groups based on MAR deviations (thresholds: > + 0.1 mm regeneration, < - 0.1 mm resorption, within ± 0.1 mm stability). Statistical analyses, including Kruskal-Wallis tests with post hoc analysis and logistic regression models, were performed to assess associations between RBC count, Hb levels, and bone remodeling outcomes.
Patients with higher preoperative RBC and Hb levels exhibited significantly greater bone remodeling than those with lower levels (p < 0.05). Remodeling was particularly evident in the mandibular angle region. Multivariate analysis confirmed RBC and Hb levels as independent predictors of favorable bone remodeling. A 1 × 10 increase in RBC count was associated with a 2.558-fold higher likelihood of postoperative bone regeneration (OR: 2.558, 95% CI: 1.098-5.958, P = 0.030), while a 1 g/L increase in Hb levels increased the probability of bone regeneration by 1.036 times (OR:1.036, 95% CI: 1.006-1.066, P = 0.017).
This study highlights RBC count and Hb levels as potential biomarkers influencing bone remodeling after MAO. These findings suggest that hematologic parameters should be considered during preoperative planning to optimize surgical outcomes and reduce the need for revision procedures.
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以往研究已确定下颌角区域（MAR）的骨重塑是影响下颌角截骨术（MAO）术后效果的关键因素。本研究调查血液学预测指标——红细胞（RBC）计数和血红蛋白（Hb）水平——及其与术后MAR骨重塑的相关性。
对2015年1月至2022年12月期间接受MAO的135例患者进行回顾性分析。使用锥形束计算机断层扫描（CBCT）成像在两个时间点评估骨重塑：T1（术后即刻）和T2（术后至少12个月）。使用Geomagic Wrap 2021对骨重塑进行量化。根据MAR偏差（阈值：再生> +0.1 mm，吸收< -0.1 mm，稳定在±0.1 mm范围内）将患者分为骨稳定（S）、骨再生（RG）和骨吸收（RS）组。进行统计分析，包括Kruskal-Wallis检验及事后分析和逻辑回归模型，以评估RBC计数、Hb水平与骨重塑结果之间的关联。
术前RBC和Hb水平较高的患者比水平较低的患者表现出明显更大的骨重塑（p <0.05）。重塑在下颌角区域尤为明显。多变量分析确认RBC和Hb水平是良好骨重塑的独立预测指标。RBC计数每增加1×10，术后骨再生的可能性高2.558倍（OR：2.558，95% CI：1.098 - 5.958，P = 0.030），而Hb水平每增加1 g/L，骨再生的概率增加1.036倍（OR：1.036，95% CI：1.006 - 1.066，P = 0.017）。
本研究强调RBC计数和Hb水平是影响MAO术后骨重塑的潜在生物标志物。这些发现表明，术前规划时应考虑血液学参数，以优化手术效果并减少翻修手术的需求。
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