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正颌外科手术计划的术前重新评估

Preoperative Re-evaluation of Planned Orthognathic Surgical Procedures.

作者信息

Mutoh Mami, Nakanishi Ko, Tsuchiya Saori, Kasai Machiko, Matsushita Kazuhiro, Yamamoto Takaaki, Sato Yoshiaki

机构信息

Department of Orthodontics, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, JPN.

Department of Biomaterials and Bioengineering, Faculty of Dental Medicine, Hokkaido University, Sapporo, JPN.

出版信息

Cureus. 2025 Jun 29;17(6):e86949. doi: 10.7759/cureus.86949. eCollection 2025 Jun.

DOI:10.7759/cureus.86949
PMID:40734862
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12306516/
Abstract

OBJECTIVE

In surgical orthodontic treatment, a treatment plan is initially formulated. This plan is reviewed prior to surgery, and the surgical technique is often changed. This study aimed to provide insights into the surgical orthodontic treatment modification process.

METHODS

We included 501 patients who visited the Dental Treatment Center of Hokkaido University Hospital from April 2005 to March 2020 and underwent orthognathic surgery by March 2024. The survey items included whether the surgical technique had been changed, the details of any surgical changes, the discussion during the initial consultation, and the reasons for changing the surgical technique. The results were divided into three 5-year periods.

RESULTS

The surgical technique was changed in 138 cases (27.5%). The most common reasons for the change were jaw width, the amount of jaw movement, two occlusal planes, the amount of rotation or cant, and patient condition. Changes may also be attributed to the expanded scope of the surgical support at the time of initial planning and the introduction of insurance for anchor screws. The addition or omission of LeFort I was the most frequent surgical modification.

CONCLUSIONS

In treating jaw deformities, the initial treatment should not be strictly adhered to without a preoperative review. Surgical planning should always be considered to reduce the patient's burden and optimize the stability of the occlusion.

摘要

目的

在外科正畸治疗中，最初会制定一个治疗计划。该计划在手术前会进行审查，并且手术技术常常会改变。本研究旨在深入了解外科正畸治疗的修改过程。

方法

我们纳入了2005年4月至2020年3月期间到北海道大学医院牙科治疗中心就诊，并在2024年3月前接受正颌手术的501例患者。调查项目包括手术技术是否改变、任何手术改变的细节、初次咨询期间的讨论以及改变手术技术的原因。结果分为三个5年时间段。

结果

138例（27.5%）患者的手术技术发生了改变。改变的最常见原因是颌骨宽度、颌骨移动量、两个咬合平面、旋转或倾斜量以及患者状况。改变也可能归因于初始规划时手术支持范围的扩大以及锚固螺钉保险的引入。LeFort I截骨术的增加或省略是最常见的手术修改。

结论

在治疗颌骨畸形时，术前审查时不应严格遵循初始治疗方案。应始终考虑手术规划，以减轻患者负担并优化咬合稳定性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/dd25cdce91fa/cureus-0017-00000086949-i11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/2a9d08cc4748/cureus-0017-00000086949-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/274d7ffeb5dc/cureus-0017-00000086949-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/fd09a3f9171b/cureus-0017-00000086949-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/c650e2904770/cureus-0017-00000086949-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/576b095de5fd/cureus-0017-00000086949-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/6d0ccdb7012f/cureus-0017-00000086949-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/da3436b9ab36/cureus-0017-00000086949-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/47c486806698/cureus-0017-00000086949-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/d8112ab4211d/cureus-0017-00000086949-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/ab02a869ee66/cureus-0017-00000086949-i10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/dd25cdce91fa/cureus-0017-00000086949-i11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/2a9d08cc4748/cureus-0017-00000086949-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/274d7ffeb5dc/cureus-0017-00000086949-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/fd09a3f9171b/cureus-0017-00000086949-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/c650e2904770/cureus-0017-00000086949-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/576b095de5fd/cureus-0017-00000086949-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/6d0ccdb7012f/cureus-0017-00000086949-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/da3436b9ab36/cureus-0017-00000086949-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/47c486806698/cureus-0017-00000086949-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/d8112ab4211d/cureus-0017-00000086949-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/ab02a869ee66/cureus-0017-00000086949-i10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fd6/12306516/dd25cdce91fa/cureus-0017-00000086949-i11.jpg

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Do the stages of orthodontic-surgical treatment affect patients' quality of life and self-esteem?正畸-正颌联合治疗的阶段是否会影响患者的生活质量和自尊？
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