Bailey L J, Duong H L, Proffit W R
Department of Orthodontics, University of North Carolina School of Dentistry, Chapel Hill 27599-7450, USA.
Int J Adult Orthodon Orthognath Surg. 1998;13(1):35-44.
To evaluate long-term changes after surgical correction of skeletal Class III deformity, postoperative cephalometric radiographs at 1 year and 2 or more years postsurgery were digitized for 92 patients who had received either a bilateral sagittal split osteotomy for mandibular setback, Le Fort I maxillary advancement, or a combination of the two procedures. Patients' perceptions of treatment were determined by four self-administered questionnaires: satisfaction, postsurgical perception of occlusion and function, problems with facial sensation, and postsurgical perceptions. From 1 year to longest follow-up, there were almost no mean changes in landmark positions for the maxillary advancement group and minimal mean changes in the mandibular setback and two-jaw groups. In all three groups, more than 90% of the patients showed no clinically significant long-term changes, which suggests that long-term changes are less likely after Class III than Class II treatment. At long-term recall, 89% of the patients expressed satisfaction with their treatment and would recommend it to others, 74% reported improved social interaction, and 63% said their appearance changed as they expected. The predominant problems reported were altered facial sensation for 67% of the patients and surprise at the length of recovery for 52%.
为评估骨骼Ⅲ类畸形手术矫治后的长期变化，对92例接受双侧矢状劈开截骨术后退下颌、Le Fort Ⅰ型上颌前徙术或两种手术联合治疗的患者，将术后1年及术后2年或更长时间的头颅侧位X线片进行数字化处理。通过四份自填式问卷确定患者对治疗的看法：满意度、术后对咬合和功能的感知、面部感觉问题以及术后感知。从术后1年到最长随访期，上颌前徙组的标志点位置几乎没有平均变化，下颌后退组和双颌手术组的平均变化最小。在所有三组中，超过90%的患者未出现具有临床意义的长期变化，这表明Ⅲ类错 畸形治疗后的长期变化比Ⅱ类错 畸形治疗后的可能性更小。在长期回访中，89%的患者对治疗表示满意并会向他人推荐，74%的患者报告社交互动有所改善，63%的患者表示外貌变化符合预期。报告的主要问题是67%的患者面部感觉改变，52%的患者对恢复时间之长感到意外。
