Evaluation in Facial Contour and Maxillofacial Function Following Orthognathic Surgery

1. Le Fort I型截骨术后软组织形态的改变在随访至少1年的患者中进行头位测量。鼻角和鼻高均因Sn超前量大于Prn而减小。上颌前节段截骨术后鼻高未降低，鼻Sn明显前移，而鼻Sn后移几乎可以忽略。本文对45例下颌骨前突患者进行了手术后角和支倾角的改变。斜向角和分支均得到改善，平均值分别为4.3度和4.5度。结果表明，矢状面劈开截骨对改善下颌前突患者的钝角有重要作用。本文提出了一种利用上下颌牙弓石膏模型、咬合夹板和计算机图形系统进行软硬组织轮廓二维和三维预测的新技术。对178例经矢状劈裂截骨、前节段截骨及颏成形术治疗的下颌畸形患者进行问卷调查，评价其咀嚼功能、下唇感觉障碍及颞下颌关节功能。80.2%的患者咀嚼功能满意，50%的患者术后1年内感觉障碍消失。37.9%行矢状劈裂截骨术的患者在术后2年内有不适症状。38.7%的患者在解除上颌间固定后立即开骨，术后3年疼痛完全消失。

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.