Evaluation in Facial Contour and Maxillofacial Function Following Orthognathic Surgery

1.对至少随访1年的Le Fort I型截骨术患者进行头影测量，评价手术前后软组织侧貌的变化。鼻角和鼻高值降低是因为SN比PRN有更大的进展量。结论：1.上颌骨前段截骨术与PRN后移几乎可以忽略的情况相比，鼻高没有降低，而SN明显前移。本文对45例下颌前突患者的性角和升支倾斜度进行了头影测量。仰卧位膝角和升支角度均有改善，平均值分别为4.3度和4.5度。结果表明，下颌升支矢状劈开截骨术对改善下颌前突患者钝性性角有较大作用。利用下颌牙弓石膏模型、咬合夹板和计算机图形系统，开发了一种新的二维和三维预测软硬组织轮廓的技术。对178例下颌骨畸形患者行下颌骨矢状劈开截骨术、前段截骨术和颧骨成形术，对患者的咀嚼功能、下唇感觉障碍和颞下颌关节功能进行问卷调查。术后1年内80.2%的患者咀嚼功能满意，50%的患者感觉障碍消失。37.9%的矢状劈开截骨术患者在术后2年内出现关节功能障碍。38.7%的患者在解除颌间固定后即行截骨术，术后3年关节活动疼痛全部消失。

1. Surgical changes in soft tissue profile after Le Fort I type osteotomy were cephalometrically evaluated in patients with minimum 1 year follow-up. Nasal angle and nasal height were reduced in their values because of larger amount of advancement of Sn than that of Prn. By maxillary anterior segmental osteotomy, nasal height was not reduced and Sn was remarkably brought anteriorly in comparison with posterior movement of Prn which could be nearly disregarded.2. Surgical changes of gonial angle and ramus inclination were cephalometrically evaluated in 45 patients with mandibular prognathism. The gonial angle and ramus in clination were improved with the mean values of 4.3 and 4.5 degree respectively. These results showed that the sagittal splitting osteotomy of the mandibular ramus plays great role in improvement of the obtuse gonial angle in the patient with mandibular prognathism. A new technique for two- and three-dimensional prediction of soft and hard tissue contour was developed using plaster cast of the mandubular dental arch, occlusal splint and computer graphic system.3. A questionnare study was made in 178 patients with mandibular deformities operated by sagittal splitting osteotomy, anterior segmental osteotomy and genioplasty for evaluation on masticatory function, sensory disturbance of the lower lip and temporomandibular joint function. 80.2% of the patients was satisfied in masticatory function and sensory disturbance was disappeared in 50% of the patients within 1 year postoperatively. 37.9% of the patients operated by sagittal splitting osteotomy complained of the disturbance in 2 years postoperatively. The joint pain at jaw movement was observed in 38.7% of the patients by the osterotomy immediately after releasing intermaxillary fixation and disappeared completely in all of the poerated cases after 3 years postoperatively.