Gurstein K W, Sather A H, An K N, Larson B E
Section of Orthodontics, Mayo Clinic, Rochester, Minnesota 55905, USA.
Int J Adult Orthodon Orthognath Surg. 1998;13(2):131-43.
A biplanar cephalometric stereoradiographic system was used to measure maxillary positional changes during and after Le Fort I procedures for inferior or anterior repositioning of the maxilla. Of the 29 patients studied, 25 had undergone surgical maxillary advancement, and 15 had undergone inferior repositioning. These cases were divided into subgroups based on fixation technique, presence or absence of bone grafts, age, and surgeon. The postsurgical follow-up period was at least 11 months for each patient. The landmarks used to measure maxillary positional changes consisted of skeletal features and points on wire or rigid fixation devices. Mean magnitudes of postsurgical maxillary landmark displacement were insignificant for all subgroups examined except the advancement group with wire fixation. Individual patients exhibiting the greatest postsurgical displacements tended to have had large surgical advancements and received wire fixation. Magnitudes of surgical and postsurgical change did not seem correlated on the whole, except in the maxillary advancement cases in which bone grafts had not been used. Error analysis results suggest that digitizing consistency was acceptable for maxillary landmarks; however, methodologic improvements with regard to provision of cranial reference landmarks may further minimize errors in future studies.
采用双平面头颅测量立体放射摄影系统，测量上颌骨Le Fort I手术中及术后上颌骨向下或向前复位时的位置变化。在研究的29例患者中，25例行上颌骨手术前移，15例行上颌骨向下复位。这些病例根据固定技术、是否植骨、年龄和手术医生分为亚组。每位患者的术后随访期至少为11个月。用于测量上颌骨位置变化的标志点包括骨骼特征以及钢丝或坚固固定装置上的点。除钢丝固定的前移组外，所有检查的亚组术后上颌标志点位移的平均幅度均无显著意义。术后位移最大的个体患者往往手术前移幅度大且采用钢丝固定。手术和术后变化的幅度总体上似乎没有相关性，除了未使用植骨的上颌前移病例。误差分析结果表明，上颌标志点的数字化一致性是可接受的；然而，在提供颅骨参考标志点方面的方法改进可能会在未来的研究中进一步减少误差。
