摘要
目的分析骨性Ⅲ类牙颌面畸形患者双侧下颌升支矢状劈开术(BSSRO)后近心骨段三维方向位移情况,评估远心骨段后退距离与近心骨段横向间距变化量的关联。方法横断面研究。纳入2019年6月—2021年6月于南京大学附属口腔医院就诊的30例骨性Ⅲ类牙颌面畸形患者,其中男16例、女14例,年龄18~27岁(平均21.3岁),均接受BSSRO手术治疗。收集患者手术前1周(T0)、术后1周(T1)、术后6个月(T2)的多层螺旋CT数据进行三维重建和分析。观察项目:(1)测量手术前后不同时间近心骨段髁突顶点(Co)、髁突外极点(Cdlat)、髁突内极点(Cd_(med))、下颌角点(Go)、喙突点(Cor)、乙状切迹点(SN)在三维方向上的移动距离及横向间距变化;(2)评估远心骨段的后退距离与近心骨段术后横向间距变化量间的相关性。结果(1)与T0时比较,T1时双侧Co点向外、下方移位,双侧Cdmed点向外、后、下方移位,双侧Cdlat点向外、前方移位,髁突间距均增加;与T1时比较,T2时双侧Co点向内、上方移位,双侧Cdmed点向内、前、上方移位,双侧Cdlat点向内侧移位,髁突间距均减小;与T0时比较,T2时双侧Cdmed点向后方移位,双侧Cdlat点向前方移位:差异均有统计学意义(P值均<0.05)。髁突间距与术前差异无统计学意义(P>0.05)。(2)与T0时比较,T1时双侧Go点向外、后、下方移位,双侧Cor点和SN点向内、后、下移位,Go-Go间距增加,Cor-Cor、SN-SN间距均减小;与T1时比较,T2时左侧Go点向内、前方移位,右侧Go点向前、下方移位,左侧Cor点向上移位,右侧Cor点向前、上方移位,左侧SN点向前、上移位,右侧SN点向上移位,Go-Go间距减小;与T0时比较,T2时双侧Go点向外、下方移位,双侧Cor点向内、后方移位,双侧SN点向内侧移位,Go-Go间距增加,Cor-Cor、SN-SN间距均减小:差异均有统计学意义(P值均<0.05)。(3)远心骨段的后退距离与T0-T1期间两侧Co-Co间距增宽量呈正相关(r=0.410,P=0.025),
Objective This study aims to analyze three-dimensional displacement of the proximal segments after bilateral sagittal split ramus osteotomy(BSSRO)in patients with skeletal classⅢdentofacial deformity and evaluate the correlation between back distance and transversal width of the proximal segments.Methods This retrospective cross-sectional study reviewed 30 patients with skeletal classⅢmalocclusion who underwent bimaxillary surgery in Department of Oral and Maxillofacial Surgery,Nanjing Stomatological Hospital,from June 2019 to June 2021.The patients included 16 males and 14 females,aged 18-27 years,with an average age of 21.3 years.CT data at 1 week preoperative(T0),1 week postoperative(T1),and 6 months postoperative(T2)were collected for 3D reconstruction and assessment.(1)The displacements and transverse widths of the condylar apex(Co),condylar medial(Cd_(med))and lateral poles(Cdlat),mandibular corner(Go),coracoid point(Cor),and sigmoid notch(SN)after bimaxillary surgery were measured in three-dimensional direction.(2)The correlation between the back distance and postoperative transverse spacing of the proximal segment was evaluated.Results(1)The comparison of T1 with T0 showed that bilateral Co points moved outward and downward,bilateral Cdmed points shifted outward,backward and downward,bilateral Cdlat points were displaced outward and forward,and the transverse spacing of condyle increased.During the postoperative recovery period(T1-T2),bilateral Co points returned to inward and upward,bilateral Cdmed points returned to inward,forward and upward,bilateral Cdlat points returned to inward,and condyle spacing decreased.Compared with T0,bilateral Cdmed points at T2 were displaced to backward and bilateral Cdlat points were displaced to forward.The differences were statistically significant(all P values<0.05).However,no significant difference was found in the condylar distance before and after the operation(P>0.05).(2)The comparison of T1 with T0 showed that bilateral Go points moved outward,backward,and dow
作者
孔庆梅
蒲玉梅
王育新
邹维娜
张昆
胡小蓓
孔德彬
杨旭东
Kong Qingmei;Pu Yumei;Wang Yuxin;Zou Weind;Zhang Kun;Hu Xiaobei;Kong Debin;Yang Xudong(Department of Oral and Maxillofacial Surgery,Nanjing Stomatological Hospital,Medical School,Nanjing University,Nanjing 210008,China;Department of Orthodontics,Nanjing Stomatological Hospital,Medical School,Nanjing University,Nanjing 210008,China)
出处
《中华解剖与临床杂志》
2023年第4期238-244,共7页
Chinese Journal of Anatomy and Clinics
基金
江苏省重点研发计划(BE2021609)。
关键词
口颌系统畸形
骨性Ⅲ类牙颌面畸形
双侧升支矢状劈开术
近心骨段
后退距离
Stomatognathic system abnormalities
Skeletal classⅢdentofacial deformity
Bilateral sagittal split ramus osteotomy
Proximal segment
Back distance
