Stroster T G, Pangrazio-Kulbersh V
Department of Orthodontics, University of Detroit Mercy, School of Dentistry, Michigan.
Int J Adult Orthodon Orthognath Surg. 1994;9(1):55-63.
In this study, 53 patients who underwent a bilateral sagittal split ramus osteotomy to advance the mandible were examined radiographically to assess condylar position presurgically, postsurgically, and posttreatment. Subjects were separated into two groups, 29 patients who received wire fixation and 24 who received rigid internal fixation. Condylar position changes were measured on tracings of submentovertex and transcranial radiographs at the time periods mentioned. Differences in condylar position were evaluated in two defined time intervals--T1, presurgical to postsurgical, and T2, postsurgical to posttreatment. Right and left sides were evaluated independently. No correlation between amount of advancement and condylar position change was identified within or between the fixation groups at T1 and T2. No correlation between change in mandibular plane angle and change in condylar position was identified within or between the groups at T1 and T2. Statistically significant differences were identified between the fixation groups in the degree of condylar change measured on the tracings of both submentovertex and transcranial radiographs both right and left sides, at time T1. There was also a significant difference in the change in mandibular plane angle at T1 between the fixation groups. It appears from this study that use of rigid internal fixation following bilateral sagittal split ramus osteotomy results in a statistically significantly greater condylar displacement than does wire fixation. Further research is required to determine whether these changes in condylar position are clinically significant.
在本研究中，对53例行双侧下颌升支矢状劈开截骨术以前移下颌骨的患者进行了影像学检查，以评估术前、术后及治疗后的髁突位置。将受试者分为两组，29例接受钢丝固定，24例接受坚固内固定。在上述时间段，在颏下顶点位和经颅X线片的描图上测量髁突位置变化。在两个确定的时间间隔内评估髁突位置的差异——T1，术前至术后；T2，术后至治疗后。左右两侧分别进行评估。在T1和T2时，固定组内或固定组间，前移量与髁突位置变化之间均未发现相关性。在T1和T2时，组内或组间，下颌平面角变化与髁突位置变化之间均未发现相关性。在T1时，在颏下顶点位和经颅X线片的描图上测量的左右两侧髁突变化程度，固定组之间存在统计学显著差异。在T1时，固定组之间下颌平面角的变化也存在显著差异。从本研究看来，双侧下颌升支矢状劈开截骨术后使用坚固内固定导致的髁突移位在统计学上显著大于钢丝固定。需要进一步研究以确定这些髁突位置变化是否具有临床意义。
