Blomqvist J E, Isaksson S
Department of Oral and Maxillofacial Surgery, Länssjukhuset, Halmstad, Sweden.
J Oral Maxillofac Surg. 1994 Nov;52(11):1133-7. doi: 10.1016/0278-2391(94)90529-0.
To compare two different methods of rigid fixation for any difference in postoperative stability after mandibular advancement.
Thirty-eight patients with Class II malocclusion treated by bilateral sagittal split osteotomy (BSSO) and mandibular advancement were selected for this retrospective study. Group A (n = 16) had noncompressive bicortical screws inserted in the gonial area through a transcutaneous approach and Group B (n = 22) had the bone segments fixed with unicortical screws and miniplates on the lateral surface of the mandibular body. Cephalograms were taken preoperatively, 2 days postoperatively, and 6 months after the operation, and a computer program was used to superimpose the three cephalograms and register the advancement and postoperative instability.
There was a minimal difference in advancement of the mandible in the two groups. Statistical analysis showed no significant difference in postsurgical stability. However, positive correlation between the amount of advancement and the amount of postsurgical instability was demonstrated using a linear multiple regression test (P = .0002).
This study indicates that the two different methods of internal rigid fixation of the segments after surgical advancement of the mandible give equal stability postoperatively and their use is a matter of surgical choice.
比较两种不同的坚固内固定方法在下颌前徙术后稳定性方面的差异。
选取38例接受双侧矢状劈开截骨术（BSSO）及下颌前徙术治疗的安氏II类错牙合患者进行这项回顾性研究。A组（n = 16）经皮在下颌角区植入非加压双皮质螺钉，B组（n = 22）在下颌骨体外侧用单皮质螺钉及微型钢板固定骨段。术前、术后2天及术后6个月拍摄头颅侧位片，使用计算机程序对三张头颅侧位片进行叠加，并记录前徙量及术后不稳定情况。
两组下颌前徙量差异极小。统计学分析显示术后稳定性无显著差异。然而，通过线性多元回归检验发现前徙量与术后不稳定量之间呈正相关（P = .0002）。
本研究表明，下颌骨手术前徙后两种不同的骨段坚固内固定方法术后稳定性相同，其选择取决于手术方式。
