Bouwman J P, Tuinzing D B, Kostense P J, van Teeseling R A, Mokhtari H
Department of Oral and Maxillofacial Surgery, Kennemer Gasthuis, Iocatie EG, Haarlem, The Netherlands.
Mund Kiefer Gesichtschir. 1997 Nov;1(6):311-5. doi: 10.1007/BF03043574.
The objective of this study was to evaluate retrospectively the stability of mandibular advancement via bilateral sagittal split osteotomies. Two fixation methods were compared: intermaxillary fixation (IMF) and rigid internal fixation (RIF). The hypothesis was that, in patients with a low to normal mandibular plane angle (MPA) in retrognathia, the bilateral sagittal split osteotomy (BSSO) to advance the mandible is a predictable and stable procedure and that no significant changes occur after 1 year. Twelve patients with mandibular deficiency with a low to normal MPA (mean 24.7 degrees, range 20.3 degrees-30.7 degrees) underwent BSSO with IMF. The follow-up period was at least 5 years (mean 6.3, range 5-9.1 years). Cephalometric analysis using a commercial software package was performed on radiographs that were taken immediately preoperatively (T0), within 6 weeks postoperatively (T1), 1 year postoperatively (T2), and at least 5 years postoperatively (T3). The average advancement at B point was 4.7 mm (range: 3-7 mm). The assessment of B point in regard to relapse showed no significant change. One patient showed a relapse due to condylar resorption. Forty-five consecutive patients were treated with RIF. Radiographs were taken preoperatively (T0), 6 weeks postoperatively (T1), and 1 year postoperatively (T2). This group had a mean MPA of 26.2 degrees, range 10 degrees-32 degrees. The average B-point advancement was 4.4 mm (range 1-10 mm). No patient showed a clinically significant relapse at T2.
本研究的目的是回顾性评估经双侧矢状劈开截骨术实现的下颌前徙的稳定性。比较了两种固定方法：颌间固定（IMF）和坚固内固定（RIF）。假设是，对于下颌后缩且下颌平面角（MPA）低至正常的患者，通过双侧矢状劈开截骨术（BSSO）前徙下颌是一种可预测且稳定的手术，术后1年不会发生显著变化。12例下颌后缩且MPA低至正常（平均24.7度，范围20.3度 - 30.7度）的患者接受了采用颌间固定的双侧矢状劈开截骨术。随访期至少5年（平均6.3年，范围5 - 9.1年）。使用商业软件包对术前即刻（T0）、术后6周内（T1）、术后1年（T2）以及术后至少5年（T3）拍摄的X线头颅侧位片进行头影测量分析。B点的平均前徙量为4.7毫米（范围：3 - 7毫米）。关于复发的B点评估显示无显著变化。1例患者因髁突吸收出现复发。连续45例患者接受了坚固内固定治疗。在术前（T0）、术后6周（T1）和术后1年（T2）拍摄X线头颅侧位片。该组的平均MPA为26.2度，范围10度 - 32度。B点的平均前徙量为4.4毫米（范围1 - 10毫米）。在T2时，没有患者出现临床上显著的复发。
