下颌升支矢状劈开截骨术后下颌骨短期稳定性的三维分析

doi:10.13701/j.cnki.kqyxyj.2021.10.015

口腔医学研究 ›› 2021, Vol. 37 ›› Issue (10): 931-935.DOI: 10.13701/j.cnki.kqyxyj.2021.10.015

下颌升支矢状劈开截骨术后下颌骨短期稳定性的三维分析

焦星琦, 李阳, 伊彪^*

北京大学口腔医学院·口腔医院口腔颌面外科国家口腔疾病临床研究中心口腔数字化医疗技术和材料国家工程试验室口腔数字医学北京市重点实验室北京 100081

收稿日期:2021-04-15 出版日期:2021-10-28 发布日期:2021-10-18
通讯作者: *伊彪,E-mail:yibiao@sina.com
作者简介:焦星琦(1994~ )，女，河北人，硕士在读，研究方向：口腔颌面外科学，正颌外科。

Three-dimensional Evaluation of Mandibular Stability during Intermaxillary Fixation after Bilateral Sagittal Split Ramus Osteotomy Surgery

JIAO Xingqi, LI Yang, YI Biao^*

Department of Oral and Maxillofacial Surgery,Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081,China

Received:2021-04-15 Online:2021-10-28 Published:2021-10-18

摘要/Abstract

摘要： 目的:本研究利用三维测量方法分析下颌骨在下颌升支矢状劈开截骨术后短期内的复发趋势。方法:收集在北京大学口腔医院接受正颌-正畸联合治疗并行下颌升支矢状截骨手术的患者共49例,分为下颌前徙患者22例,下颌后退患者27例,收集术前4 d(T0)、术后4 d(T1)、术后4~6周(T2)、3 个月(T3)的CBCT数据,利用计算机辅助设计软件Pro Plan进行三维头颅重建,建立坐标系并测量下颌骨相关指标。利用SPSS 20.0软件对T1、T2 时的测量结果进行配对t检验。结果:在接受下颌升支矢状劈开截骨术的患者中,下颌前徙患者的下颌骨在B点、Pg点存在水平向的复发趋势,下颌平面存在顺时针旋转的倾向。下颌后退患者的下颌骨在B点存在水平向的复发趋势,Pg点存在水平向和垂直向的复发趋势。结论:下颌升支矢状劈开截骨术后术后下颌骨在短期内存在复发倾向,但在临床可接受范围内。

关键词: 下颌升支矢状劈开截骨术, 下颌骨, 三维分析稳定性

Abstract: Objective: To analyze the short-term relapse tendency of mandible after bilateral sagittal split ramus osteotomy (BSSRO) surgery with three-dimension measurement. Methods: CBCT images of forty-nine patients seeking for orthognathic surgery were collected in the study. The collection time was four days preoperatively (T0), four days postoperatively (T1), four to six weeks postoperatively (T2), and three months postoperatively (T3). A three-dimensional analytic method to measure mandible was set up with Pro Plan software. The study measured and analyzed the indicators and angles to describe the mandibular position and orientation. Results: For mandibular advancement patients, the measurements showed a significant difference in B and Pg in horizontal axis during short term (T1-T2). The mandibular plane tended to have a clockwise rotation. For mandibular setback patients, the measurements showed a significant difference in B in horizontal axis and Pg in horizontal and vertical axis. Conclusion: There was a three-dimensional relapse tendency of mandible in short-term after BSSRO,however, in the acceptable region.

Key words: bilateral sagittal split ramus osteotomy surgery, mandible, three-dimensional stability analysis

焦星琦, 李阳, 伊彪. 下颌升支矢状劈开截骨术后下颌骨短期稳定性的三维分析[J]. 口腔医学研究, 2021, 37(10): 931-935.

JIAO Xingqi, LI Yang, YI Biao. Three-dimensional Evaluation of Mandibular Stability during Intermaxillary Fixation after Bilateral Sagittal Split Ramus Osteotomy Surgery[J]. Journal of Oral Science Research, 2021, 37(10): 931-935.

参考文献

[1] Van Sickel JE, Richardson DA. Stability of orthognathic surgery: a review of rigid fixation [J]. Br J Oral Maxillofac Surg, 1996, 34(4):279-285.
[2] 王友山.东耀峻,杨学文.正颌外科术后畸形复发的生物学因素及其防治[J].中华口腔医学杂志, 1996,31(3):188-190.
[3] Perrott DH, Lu YF, Pogrel MA, et al. Stability of sagittal split osteotomies: A comparison of three stabilization techniques [J]. Oral Surg Oral Med OralPathol, 1994, 78(6):696-704.
[4] Joss CU, Vassalli IM. Stability after bilateral sagittal split osteotomy setback surgery with rigid internal fixation: a systematic review [J]. J Oral Maxillofac Surg, 2008, 66(8):1634-1643.
[5] Proffit WR, Phillips C, Dann C 4th, et al. Stability after surgical- orthodontic correction of skeletal Class Ⅲ malocclusion. Ⅰ. Mandibular setback [J]. Int J Adult Orthod Orthognath Surg, 1991,6(1):7-18.
[6] McNeill RW, Hooley JR, Sundberg RJ. Skeletal relapse during intermaxillary fixation [J]. J Oral Surg, 1973, 31(3):212-227.
[7] Lee JH, Kim SO, Jeon JH. The assessment of the stability in mandibular setback surgery related to spatial factors under rotational control of the proximal segment [J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2014, 117(5):560-566.
[8] Park SH, Yu HS, Kim KD, et al. A proposal for a new analysis of craniofacial morphology by 3-dimensional computed tomography [J]. Am J Orthod Dentofacial Orthop, 2006, 129(5):600.e23-34.
[9] Gateno J, Xia JJ, Teichgraeber JF. New 3-dimensional cephalometric analysis for orthognathic surgery [J]. J Oral Maxillofac Surg, 2011, 69(3): 606-622.
[10] 盛潇,聂萍,朱敏,等.多平面辅助定位法提高颅颌面三维CT测量准确性的研究[J].口腔颌面外科杂志,2013,23(6):443-448.
[11] 金珉廷,刘怡.三维颅面水平参考平面的确定方法[J].北京大学学报(医学版),2019,51(5):937-943.
[12] Matteson SR, Bechtold W, Phillips C, et al. A method for three-dimensional image reformation for quantitative cephalometric analysis [J]. J Oral Maxillofac Surg, 1989, 47(10):1053-1061.
[13] 何颖,王晓霞,刘筱菁.常用正颌外科三维头影测量标志点的可重复性研究[J].中华口腔正畸学杂志,2013,20(2):95-99.
[14] 应王君子,沈舜尧,李彪,等.唇腭裂患者正颌术后上颌骨短期稳定性的三维分析[J].上海口腔医学,2016,25(3):345-351.
[15] 程家龙,林阳阳,宋大立,等.颌骨偏斜的三维分析及分类研究[J].口腔医学研究,2017,33(12): 1314-1318.
[16] Proffit WR, Turvey TA, Phillips C. The hierarchy of stability and predictability in orthognathic surgery with rigid fixation: an update and extension [J]. Head Face Med, 2007, 3:21.
[17] Mobarak KA, Espeland L, Krogstad O, et al. Mandibular advancement surgery in high-angle and low-angle class Ⅱ patients: different long-term skeletal responses [J]. Am J Orthod Dentofacial Orthop, 2001, 119(4): 368-381.
[18] Joss CU, Vassalli IM. Stability after bilateral sagittal split osteotomy advancement surgery with rigid internal fixation: a systematic review [J]. J Oral Maxillofac Surg, 2009, 67(2): 301-313.
[19] Mobarak KA, Krogstad O, Espeland L, et al. Long-term stability of mandibular setback surgery: A follow-up of 80 bilateral sagittal split osteotomy patients [J]. Int J Adult Orthod Orthognath Surg, 2000, 15(2):83-95.
[20] Ayoub AF, Millett DT, Hasan S. Evaluation of skeletal stability following surgical correction of mandibular prognathism [J]. Br J Oral Maxillofac Surg, 2000, 38(4):305-311.
[21] Wiechmann D, Meyer U, Büchter A. Success rate of mini- and micro-implants used for orthodontic anchorage: a prospective clinical study[J]. Clin Oral Implants Res, 2007, 18(2):263-267.
[22] Ueki K, Marukawa K, Shimada M, et al. The use of an intermaxillary fixation screw for mandibular setback surgery[J]. J Oral Maxillofac Surg, 2007, 65(8):1562-1568.
[23] Choi BH, Min YS, Yi CK, et al. A comparison of the stability of miniplate with bicortical screw fixation after sagittal split setback [J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2000, 90(4):416-419.

下颌升支矢状劈开截骨术后下颌骨短期稳定性的三维分析

Three-dimensional Evaluation of Mandibular Stability during Intermaxillary Fixation after Bilateral Sagittal Split Ramus Osteotomy Surgery

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

[1]	张立刚, 易杰, 张霓霓, 姚礼, 黄桂林, 胡小华, 代敏, 任小清. 儿童下颌第二磨牙冠周炎致下颌骨骨髓炎的临床诊治[J]. 口腔医学研究, 2021, 37(3): 246-249.
[2]	庞亚倩, 刘亮, 冯大军, 李婕, 王栋, 张凯. 下颌骨正中联合部囊性病变有限元建模及生物力学研究[J]. 口腔医学研究, 2021, 37(3): 250-254.
[3]	王冬香, 王光素, 唐正龙, 陈友利, 高琼, 安宁. 下颌骨髁突高位骨折游离复位愈合过程中DKK-1/BMP-2的表达研究[J]. 口腔医学研究, 2020, 36(8): 748-752.
[4]	叶斯哈提·木合塔尔, 克热木·阿巴司, 胡露露, 龚忠诚. 6例下颌骨Garrè's骨髓炎临床分析[J]. 口腔医学研究, 2020, 36(7): 678-682.
[5]	王兴涛, 刘才华, 吕玉祥, 靳乐, 刘筱菁. 机器人系统在腓骨修复下颌骨重建中的动物试验研究[J]. 口腔医学研究, 2020, 36(11): 1040-1044.
[6]	刘刚, 张良, 李长顺. 双侧下颌骨矢状劈开截骨后退术对骨性Ⅲ类错牙合畸形患者上气道的影响[J]. 口腔医学研究, 2020, 36(10): 938-941.
[7]	鲁婷玮, 刘朝明, 吴添福, 邵喆, 孙艳芳, 孙志军, 刘冰. 个性化原位塑形导板在血管化髂骨肌瓣修复下颌骨缺损中的应用[J]. 口腔医学研究, 2019, 35(8): 766-771.
[8]	程慧敏, 庄芳璐, 阿地力·莫明. 3种创伤严重度评分法对下颌骨骨折评估的对比分析[J]. 口腔医学研究, 2019, 35(7): 701-703.
[9]	梁燕, 马文, 聂焱, 付帅, 张长彬, 崔庆赢, 王立冬, 黎明. 3D打印塞治器在下颌骨囊性病变中的应用[J]. 口腔医学研究, 2019, 35(12): 1153-1156.
[10]	刘之奥, 徐卫华, 郑之峻. 基于CBCT的后段牙合平面和下颌骨形态间相关性研究[J]. 口腔医学研究, 2019, 35(11): 1078-1083.
[11]	雷欣, 邓书海, 关崧华, 黄辉, 陈玉婷, 刘虹. 螺旋CT三维重建和MRI在下颌骨髁突骨折中的临床应用比较[J]. 口腔医学研究, 2018, 34(7): 746-750.
[12]	任留阳, 王喜迎, 苏家筠, 胡瓦特·赛热克, 熊晖. 上颌快速扩弓对安氏Ⅱ类1分类患者颌面三维组织结构的影响[J]. 口腔医学研究, 2018, 34(5): 539-543.
[13]	郑赵杨, 张苗苗, 刘志杰. 骨性Ⅲ类错牙合畸形上气道与下颌骨形态结构研究[J]. 口腔医学研究, 2018, 34(4): 405-410.
[14]	李鹏, 邵小云, 李燕玲, 黄达鸿, 曾华江, 汤炜. 下颌骨重建个性化修复体暴露原因的有限元分析[J]. 口腔医学研究, 2018, 34(4): 424-427.
[15]	卢斌华, 习伟宏, 李建福, 周五超, 甘烟紫. 辅助髁突定位改良型咬合导板的设计与制作[J]. 口腔医学研究, 2018, 34(3): 236-240.