Abstract:
Although surgical accuracy has been evaluated in bi-maxillary procedures, few studies have investigated the relationship between maxillary and mandibular accuracy. The present study evaluated the effect of maxillary impaction accuracy on mandibular surgical outcome. This cohort study analyzed skeletal class III patients who underwent planned maxillary impaction in bi-maxillary surgery. The primary predictor was the difference between the virtual plan and surgical outcome in the maxilla, as determined by three-dimensional (3D) and vertical differences. The secondary predictors were the planned 3D distances in the maxilla and mandible. The primary outcome was mandibular surgical accuracy, defined as the difference between the planned and actual outcomes, calculated as 3D Euclidean distance. The study included 73 patients. Increased differences between the planned and actual outcomes in the maxilla were associated with increased differences in the mandible. The post-operative position of the mandible was closer to the planned position when the position of the impacted maxilla was superior than when it was inferior to the planned position. Moving the maxilla closer to the planned position resulted in a more accurate mandibular position. These findings suggest that careful surgical procedures are needed to avoid inferior positioning of the maxilla during maxillary impaction surgery.
摘要:
虽然手术的准确性已经在双颌手术中进行了评估,很少有研究调查上颌和下颌精度之间的关系。本研究评估了上颌嵌塞准确性对下颌手术结果的影响。这项队列研究分析了在双颌手术中接受计划上颌嵌塞的骨骼III类患者。主要预测因素是上颌骨虚拟计划和手术结果之间的差异,由三维(3D)和垂直差异确定。次要预测因素是上颌骨和下颌骨的计划3D距离。主要结果是下颌手术准确性,定义为计划结果和实际结果之间的差异,计算为3D欧几里得距离。该研究包括73名患者。上颌骨计划和实际结果之间的差异增加与下颌骨差异增加有关。当上颌骨的位置高于计划位置时,下颌骨的术后位置更接近计划位置。将上颌骨移动到更靠近计划位置导致更准确的下颌位置。这些发现表明,在上颌骨嵌塞手术期间,需要进行仔细的外科手术,以避免上颌骨的下位。