Schwestka-Polly R, Kubein-Meesenburg D, Luhr H G
Department of Orthodontics, Georg-August-University, Göttingen, Germany.
Int J Adult Orthodon Orthognath Surg. 1998;13(3):248-58.
Three-dimensional repositioning of the maxilla is possible after Le Fort I osteotomy. However, the preoperatively planned and desired position of the maxillary dental arch often cannot be sufficiently achieved during actual surgery, and deviations in the sagittal and vertical dimensions are common. To reduce these errors, the model-repositioning instrument was developed for model surgery in conjunction with the Göttingen concept for orthodontic-surgical treatment with condylar position control. This instrument allows a controlled three-dimensional positioning of jaw segments with three reference points directly on the teeth. The three-dimensional double-splint method combined with a surgical facebow was developed for a controlled three-dimensional positioning of the maxilla during surgery. This instrument and method were applied during treatment of 20 adult patients, and the position of the maxilla before and after surgery was analyzed. It was found that the planned position of the maxillary dental arch could be transferred from model surgery to actual surgery with an accuracy of +/- 1 mm sagittally and vertically. Thus, the application of the Göttingen concept for three-dimensional positioning of the maxilla results in an improvement of accuracy compared with other methods. Furthermore, use of these procedures is easier and less time-consuming during model and actual surgery than are other procedures.
在Le Fort I型截骨术后，上颌骨的三维重新定位是可行的。然而，在实际手术中，上颌牙弓术前计划的理想位置往往无法充分实现，矢状和垂直维度的偏差很常见。为了减少这些误差，结合哥廷根髁突位置控制的正畸-外科治疗概念，开发了用于模型手术的模型重新定位器械。该器械可通过直接在牙齿上的三个参考点对上颌骨节段进行可控的三维定位。在手术过程中，采用三维双夹板法结合手术面弓对上颌骨进行可控的三维定位。将该器械和方法应用于20例成年患者的治疗，并分析手术前后上颌骨的位置。结果发现，上颌牙弓的计划位置可以从模型手术精确地转移到实际手术中，矢状和垂直方向的精度为±1mm。因此，与其他方法相比，应用哥廷根概念对上颌骨进行三维定位可提高精度。此外，在模型手术和实际手术过程中，使用这些方法比其他方法更容易且耗时更少。
