Ayoub A F, Stirrups D R, Moos K F
University of Glasgow, West Scotland Regional Plastic and Maxillofacial Unit, Bearsden, Scotland.
Int J Adult Orthodon Orthognath Surg. 1995;10(3):181-92.
The effect of Le Fort I maxillary impaction on the stability of the sagittal split advancement osteotomy is debatable. The aim of this study was to compare the stability of mandibular advancement in two groups of patients: those that had simultaneous Le Fort I maxillary impaction and sagittal split advancement osteotomy and those that had only sagittal split advancement osteotomy. Lateral cephalograms taken immediately after surgery, 6 months postoperatively, and at 1-year follow-up were used in the assessment. In addition to routine cephalometric analysis, the Euclidean Distance Matrix method was also used. The magnitude of mandibular relapse was similar in both groups in the form of mandibular clockwise rotation and posterior settling. The mandible rotated by 2.2 degrees in the single-jaw surgery group and 2.5 degrees in the bimaxillary osteotomy group. The mandible settled posteriorly by 1.0 degree in the single-jaw surgery group and 1.2 degrees in the bimaxillary osteotomy group. The differences were not statistically significant. In all the patients, Le Fort maxillary osteotomy was more stable than was mandibular advancement. The counter-clockwise rotation of the distal mandibular segments and the distraction of the condylar segments during surgery were responsible for mandibular relapse.
勒福Ⅰ型上颌骨截骨术对上颌矢状劈开前徙截骨术稳定性的影响存在争议。本研究的目的是比较两组患者下颌前徙的稳定性：一组是同时进行勒福Ⅰ型上颌骨截骨术和上颌矢状劈开前徙截骨术的患者，另一组是仅进行上颌矢状劈开前徙截骨术的患者。评估采用术后即刻、术后6个月及1年随访时拍摄的头颅侧位片。除了常规的头影测量分析外，还使用了欧几里得距离矩阵法。两组患者下颌骨复发的程度相似，均表现为下颌骨顺时针旋转和向后沉降。单颌手术组下颌骨旋转了2.2度，双颌截骨术组下颌骨旋转了2.5度。单颌手术组下颌骨向后沉降了1.0度，双颌截骨术组下颌骨向后沉降了1.2度。差异无统计学意义。在所有患者中，勒福上颌骨截骨术比下颌前徙更稳定。手术过程中下颌骨远心段的逆时针旋转和髁突段的牵张是下颌骨复发的原因。
