Lin Chenxinzi, Li Mingjuan, Zhang Jingyuan, Wang Siyuan, Zhu Chongjie, Wan Qilong
State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Orthognathic & Cleft Lip and Palate Plastic Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
J Craniomaxillofac Surg. 2025 Sep;53(9):1365-1370. doi: 10.1016/j.jcms.2025.05.006. Epub 2025 Jun 3.
This retrospective cohort study investigated the influence of differences in the pattern of lingual split on skeletal stability after bilateral sagittal split osteotomy (BSSO) in patients with skeletal Class III malocclusion. The study sample comprised patients who underwent double surgery between November 2016 and December 2024 and presented with the same type of postoperative bilateral lingual split fracture, classified according to the Lingual Split Scale (LSS). Lateral cephalograms were evaluated at three-time points: preoperative (T0), one week postoperative (T1), and six months postoperative (T2). Analyses of variance (ANOVA) and chi-square (χ) tests were employed to compare skeletal stability among the groups. The study included 159 patients, with 88 (55.35 %) in the LSS1 group, 43 (27.04 %) in the LSS2 group, and 28 (17.61 %) in the LSS3 group. Postoperative analysis revealed a counterclockwise relapse of the mandible. The maxilla showed good skeletal stability after BSSO, while the LSS2 group presented more severe forward mandibular relapse than the LSS1 and LSS3 groups (P = 0.011). Notably, the Frankfort mandibular plane angle (FMA) increased more significantly in the LSS2 group postoperatively (P = 0.003). Significant intergroup differences were observed regarding the influence of different lingual split patterns on skeletal stability after BSSO in patients with skeletal Class III malocclusions. Notably, the LSS2 group exhibited a more severe relapse compared to both the LSS1 and LSS3 groups.
这项回顾性队列研究调查了骨骼Ⅲ类错牙合畸形患者双侧矢状劈开截骨术（BSSO）后，舌侧劈开模式差异对骨骼稳定性的影响。研究样本包括2016年11月至2024年12月期间接受双颌手术且术后出现相同类型双侧舌侧劈开骨折的患者，根据舌侧劈开量表（LSS）进行分类。在三个时间点评估头颅侧位片：术前（T0）、术后1周（T1）和术后6个月（T2）。采用方差分析（ANOVA）和卡方（χ）检验比较各组间的骨骼稳定性。该研究纳入了159例患者，LSS1组88例（55.35%），LSS2组43例（27.04%），LSS3组28例（17.61%）。术后分析显示下颌骨逆时针复发。BSSO术后上颌骨显示出良好的骨骼稳定性，而LSS2组下颌骨向前复发比LSS1组和LSS3组更严重（P = 0.011）。值得注意的是，LSS2组术后法兰克福下颌平面角（FMA）增加更显著（P = 0.003）。观察到不同舌侧劈开模式对骨骼Ⅲ类错牙合畸形患者BSSO术后骨骼稳定性的影响存在显著组间差异。值得注意的是，与LSS1组和LSS3组相比，LSS2组复发更严重。
