Postoperative changes in mandibular prognathism surgically treated by intraoral vertical ramus osteotomy
Postoperative changes in mandibular prognathism surgically treated by intraoral vertical ramus osteotomy
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DOI：
10.1016/j.ijom.2012.06.024
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发表时间：
2013-01-01
影响因子：
2.4
通讯作者：
Saito, I.
中科院分区：
文献类型：
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作者：
Nihara, J.;Takeyama, M.;Saito, I.
本研究调查了通过侧位头颅造影确定的下颌前突口内垂直支截骨术（IVRO）术后短期和长期的骨骼变化。研究对象为20例已行外科正畸联合IVRO治疗的下颌前突患者。分别于术前1个月、术后1天、3个月、6个月、1年、约2年摄侧位脑电图。所有患者均维持4枚单皮质螺钉上颌间固定（IMF） 1周。手术时，颏部平均后侧移位5.9 mm。术后3个月，FMA角和FH-CorMe角分别增加6.3度和6.2度，表明下颌骨远段顺时针旋转。所有20例患者均观察到这种旋转，提示术后短期内下颌骨的旋转可能发生在IVRO术后，可以认为是手术新建立的咀嚼系统的适应。在IVRO后的长期内，Me仅向前移动了0.9 mm，复发率为15.3%。这些结果表明外科正畸治疗联合IVRO治疗下颌前突患者具有良好的长期稳定性。
This study investigated short- and long-term postoperative skeletal changes following intraoral vertical ramus osteotomy (IVRO) for mandibular prognathism, as determined from lateral cephalograms. The subjects were 20 patients with mandibular prognathism who had undergone surgical orthodontic treatment combined with IVRO. Lateral cephalograms were taken at six time points: 1 month before surgery, and 1 day, 3 months, 6 months, 1 year, and approximately 2 years after surgery. Intermaxillary fixation (IMF) with four monocortical screws was maintained for 1 week in all patients. Mean posterior movement of the menton (Me) was 5.9 mm at surgery. 3 months after surgery, the FMA and FH-CorMe angles had increased 6.3 and 6.2 degrees, respectively, indicating clockwise rotation of the distal segment of the mandible. This rotation was observed in all 20 patients, suggesting that postoperative rotation of the mandible in the postoperative short term is likely to occur after IVRO and could be considered an adaptation of the mastication system newly established by surgery. In the long term after IVRO, Me had moved anteriorly by only 0.9 mm. and the relapse ratio was 15.3%. These findings suggest the excellent long-term stability of surgical orthodontic treatment combined with IVRO in patients with mandibular prognathism.