双侧下颌升支矢状劈开截骨术后近心骨段横向宽度变化的临床观察

doi:10.3969/j.issn.1005-4979.2023.01.004

摘要/Abstract

摘要： 目的: 基于锥形束CT（cone beam computed tomography，CBCT）三维测量，探究骨性Ⅲ类错颌畸形患者行双侧下颌升支矢状劈开截骨术（bilateral sagittal split ramus osteotomy，BSSRO）后近心骨段横向宽度的变化。方法: 选择26例行BSSRO的骨性Ⅲ类错颌畸形患者，于术前、术后1周及术后1年行CBCT扫描。利用Mimics 21.0软件行三维重建，测量髁状突顶点（condylion，Co）间距、喙突顶点（corsup，Cor）间距、下颌角点（gonion，Go）间距、下颌角外展度，比较治疗前后的差异。结果: 术后1周，患者Go间距、Co间距及下颌角外展度较术前分别增加了（4.37±3.32）、（1.58±1.51） mm及（5.92±2.04）°（均P<0.05）；Cor间距减小了（2.19±3.99） mm（P<0.05）。术后1年，患者Go间距及下颌角外展度较术前分别增加了（2.43±3.04） mm及（5.08±2.59）°（均P<0.05），Cor间距减小了（2.83±4.41） mm（P<0.05）；而Co间距与术前的差异无统计学意义。结论: BSSRO术后1周，髁状突及下颌角会出现一定程度的外展，喙突则会有一定程度的内收；术后1年，髁状突的位置基本恢复，下颌角的外展有一定程度的恢复，而喙突的位置并未恢复。

关键词: 骨性Ⅲ类错颌畸形, 双侧下颌升支矢状劈开截骨术, 锥形束CT, 三维

Abstract:

Objective: To explore the changes of transverse width of proximal bone segment after bilateral sagittal split ramus osteotomy(BSSRO) for skeletal class Ⅲ malocclusion based on the three-dimensional(3D) measurement of cone beam computed tomography(CBCT). Methods: A total of 26 patients with skeletal class Ⅲ malocclusion underwent BSSRO were scanned by CBCT before operation, one week, and one year after operation. Mimics 21.0 software was used for 3D reconstruction, and the distance between bilateral condylion (Co), bilateral corsup (Cor), bilateral gonion(Go) and abduction of mandibular angle were measured. The differences of preoperative and postoperative treatment effects were compared. Results: The distance between bilateral Go, the distance between bilateral Co and the abduction of mandibular angle at one week after operation increased by (4.37±3.32), (1.58±1.51) mm and (5.92±2.04)° respectively compared with those of preoperation (all P<0.05); the distance between bilateral Cor decreased by (2.19±3.99) mm (P<0.05). The distance between bilateral Go and the abduction of mandibular angle increased by (2.43±3.04) mm and (5.08±2.59)° respectively at one year after operation compared with those of preoperation (all P<0.05), the distance between bilateral Cor decreased by (2.83±4.41) mm (P<0.05); there was no significant difference in the distance between bilateral Co before operation and after operation. Conclusion: One week after BSSRO, the condyle and the angle of mandible showed a certain degree of abduction, and the coracoid showed a certain degree of adduction; one year after the operation, the position of the condyle was basically restored, the abduction of the angle of mandible was restored to a certain extent, but the position of the coracoid was not restored.

Key words: skeletal class Ⅲ malocclusion, bilateral sagittal split ramus osteotomy, cone beam computed tomography, three dimension

中图分类号:

R782

高明, 陶永炜, 毕思思, 李锦峰, 任战平. 双侧下颌升支矢状劈开截骨术后近心骨段横向宽度变化的临床观察[J]. 《口腔颌面外科杂志》, 2023, 33(1): 20-25.

GAO Ming, TAO Yongwei, BI Sisi, LI Jinfeng, REN Zhanping. Clinical observation on the changes of transverse width of proximal bone segment after BSSRO[J]. 《Journal of Oral and Maxillofacial Surgery》, 2023, 33(1): 20-25.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2023/V33/I1/20

图/表 7

参考文献 23

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测量指标	T1	T2	T1~T2	t值	P值
Go-Go/mm	95.63±5.54	100.00±5.48	-4.37±3.32^①	-6.72	0.000
Cor-Cor/mm	96.80±4.12	94.61±5.97	2.19±3.99^①	2.80	0.010
Co-Co/mm	117.40±9.94	118.98±10.12	-1.58±1.51^①	-5.33	0.000
∠Go-Me-Go/（°）	71.61±7.26	77.53±7.30	-5.92±2.04^①	-14.78	0.000

测量指标	T1	T2	T1~T2	t值	P值
Go-Go/mm	95.63±5.54	100.00±5.48	-4.37±3.32^①	-6.72	0.000
Cor-Cor/mm	96.80±4.12	94.61±5.97	2.19±3.99^①	2.80	0.010
Co-Co/mm	117.40±9.94	118.98±10.12	-1.58±1.51^①	-5.33	0.000
∠Go-Me-Go/（°）	71.61±7.26	77.53±7.30	-5.92±2.04^①	-14.78	0.000

测量指标	T1	T3	T1~T3	t值	P值
Go-Go/mm	95.63±5.54	98.06±5.54	-2.43±3.04^①	-4.07	0.000
Cor-Cor/mm	96.80±4.12	93.98±5.63	2.83±4.41^①	3.27	0.003
Co-Co/mm	117.40±9.94	117.48±9.92	-0.08±0.24	-1.69	0.104
∠Go-Me-Go/（°）	71.61±7.26	76.70±7.41	-5.08±2.59^①	-10.01	0.000

测量指标	T1	T3	T1~T3	t值	P值
Go-Go/mm	95.63±5.54	98.06±5.54	-2.43±3.04^①	-4.07	0.000
Cor-Cor/mm	96.80±4.12	93.98±5.63	2.83±4.41^①	3.27	0.003
Co-Co/mm	117.40±9.94	117.48±9.92	-0.08±0.24	-1.69	0.104
∠Go-Me-Go/（°）	71.61±7.26	76.70±7.41	-5.08±2.59^①	-10.01	0.000

测量指标	T2	T3	T2~T3	t值	P值
Go-Go/mm	100.00±5.48	98.06±5.54	1.94±1.30^①	7.64	0.000
Cor-Cor/mm	94.61±5.97	93.98±5.63	0.63±1.56^①	2.08	0.048
Co-Co/mm	118.98±10.12	117.48±9.92	1.50±1.47^①	5.21	0.000
∠Go-Me-Go/（°）	77.53±7.30	76.70±7.41	0.84±1.41^①	3.02	0.006

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