Risk factors related to aggressive condylar resorption after orthognathic surgery for females: retrospective study
Risk factors related to aggressive condylar resorption after orthognathic surgery for females: retrospective study
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DOI：
10.1080/08869634.2016.1201886
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发表时间：
2017-01-01
影响因子：
1.6
通讯作者：
Takahashi, Tetsu
中科院分区：
文献类型：
--
作者：
Nogami, Shinnosuke;Yamauchi, Kensuke;Takahashi, Tetsu
目的：探讨正颌外科手术后侵袭性髁状突吸收(ACR)的危险因素。方法：将25例女性骨性关节炎(OA)患者随机分为两组：ACR阳性组(n=8)和ACR阴性组(n=17)。临床指标用于确定下颌前移的程度、是否存在颞下颌关节紊乱病(TMD)以及相关的医疗历史(包括口服避孕药的使用)。TMJ功能障碍的临床评估包括疼痛、声音(滴答声或爆裂音)、关节盘移位、关节积液(JE)和滑膜增生(SH)；这些都通过磁共振成像(MRI)进行了进一步研究。结果：ACR(+)组和ACR(-)组下颌前移平均(SD)分别为11.4 mm(2.4)和4.1 mm(1.8)。ACR(+)患者的TMD病史比ACR(-)患者的TMD病史要广泛得多，ACR(+)患者均有OC使用史。在MRI上，ACR(+)的患者比ACR(-)的患者有更多的TMJ功能障碍和关节盘移位、JE和SH。术前X线片显示ACR(+)患者表现为下颌骨逆时针旋转和下颌后突，这是由于鞍底B角(SNB)较小、下颌平面角较大和下颌骨呈负倾斜所致。结论：本研究结果提示正颌外科手术治疗下颌后缩术后ACR的发生可能与TMJ并存的病理异常有关。
Objective: The aim of the present study was to identify the risk factors for aggressive condylar resorption (ACR) after orthognathic surgery.Methods: A total of 25 female patients with osteoarthritis (OA) scheduled for orthognathic surgery were divided into two groups: those who exhibited ACR (ACR (+), n=8) and those who did not exhibit ACR (ACR (-), n=17) after surgery. Clinical indices were used to determine the extent of mandibular advancement, the presence of temporomandibular disorder (TMD), and relevant medical treatment histories (including the use of oral contraceptive (OC) medication. TMJ dysfunction was clinically evaluated in terms of pain, the presence of sounds (clicks or crepitus), and disc displacement, joint effusion (JE), and synovial hyperplasia (SH); these were further investigated with the aid of magnetic resonance imaging (MRI). The cephalographic findings were compared with the normal profiles of Japanese subjects.Results: The mean (with SD) extent of mandibular advancement was 11.4mm (2.4) in ACR (+) and 4.1mm (1.8) in ACR (-). The TMD medical history of ACR (+) was much more extensive than that of ACR (-); all patients in ACR (+) had a history of OC use. More patients in ACR (+) than in ACR (-) had TMJ dysfunction and disc displacement, JE, and SH on MRI. Preoperative cephalograms showed that ACR (+) patients exhibited counterclockwise rotation of the mandible and retrognathism that was attributable to a small sella-nasion-B (SNB) angle, a wide mandibular plane angle, and a negative inclination of the ramus.Conclusions: The present findings suggest that the development of ACR after orthognathic surgery to treat mandibular retrognathism may be associated with coexisting TMJ pathologic abnormality.