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Abstract：
OBJECTIVE: The present study aims to assess the impact of bilateral and high oblique sagittal split osteotomy (BSSO/HSSO), as well as displacement distances and directions on the expected and achievable bone contact area (BCA) and changes in the intercondylar distance (ICD). The primary question addressed is whether mandibular splitting through BSSO results in a greater BCA and/or ICD when compared to splitting through HSSO.
METHODS: Totally 80 mandibular displacements were performed on 20 fresh cadavers, for each subject, four splints were produces to facilitate mandibular advancement as well as setbacks of 4 and 8 mm. Pre- and postoperative CBCT scans were performed to plan the surgical procedures and to analyze the expected and achieved BCA and ICD.
RESULTS: Regarding the maximum mandibular displacement, the expected BCA for HSSO/BSSO were 352.58 ± 96.55mm2 and 1164.00 ± 295.50mm2, respectively, after advancement and 349.11 ± 98.42mm2 and 1344.70 ± 287.23mm2, respectively, after setback. The achieved BCA for HSSO/BSSO were 229.37 ± 75.90mm2 and 391.38 ± 189.01mm2, respectively, after advancement and 278.03 ± 97.65mm2 and 413.52 ± 169.52 mm2, respectively after setback. The expected ICD for HSSO/BSSO were 4.51 ± 0.73 mm and 3.25 ± 1.17 mm after advancement and - 5.76 ± 1.07 mm and - 4.28 ± 1.58 mm after setback. The achieved ICD for HSSO/BSSO were 2.07 ± 2.9 mm and 1.7 ± 0.60 mm after advancement and - 2.57 ± 2.78 mm and - 1.28 ± 0.84 mm after setback. Significant differences between the BCA after HSSO and BSSO were at each displacement (p < 0.001), except for the achieved BCA after 8-mm setback and advancement (p ≥ 0.266). No significant differences were observed regarding ICD, except for the expected ICD after 8-mm setback and advancement (p ≤ 0.037).
CONCLUSIONS: Compared to the virtual planning, the predictability regarding BCA and ICD was limited. ICD showed smaller clinical changes, BCA decreased significantly in the BSSO group.
CONCLUSIONS: BCA and ICD might have been less important in choosing the suitable split technique. in orthognathic surgery.
METHODS: Totally 80 mandibular displacements were performed on 20 fresh cadavers, for each subject, four splints were produces to facilitate mandibular advancement as well as setbacks of 4 and 8 mm. Pre- and postoperative CBCT scans were performed to plan the surgical procedures and to analyze the expected and achieved BCA and ICD.
RESULTS: Regarding the maximum mandibular displacement, the expected BCA for HSSO/BSSO were 352.58 ± 96.55mm2 and 1164.00 ± 295.50mm2, respectively, after advancement and 349.11 ± 98.42mm2 and 1344.70 ± 287.23mm2, respectively, after setback. The achieved BCA for HSSO/BSSO were 229.37 ± 75.90mm2 and 391.38 ± 189.01mm2, respectively, after advancement and 278.03 ± 97.65mm2 and 413.52 ± 169.52 mm2, respectively after setback. The expected ICD for HSSO/BSSO were 4.51 ± 0.73 mm and 3.25 ± 1.17 mm after advancement and - 5.76 ± 1.07 mm and - 4.28 ± 1.58 mm after setback. The achieved ICD for HSSO/BSSO were 2.07 ± 2.9 mm and 1.7 ± 0.60 mm after advancement and - 2.57 ± 2.78 mm and - 1.28 ± 0.84 mm after setback. Significant differences between the BCA after HSSO and BSSO were at each displacement (p < 0.001), except for the achieved BCA after 8-mm setback and advancement (p ≥ 0.266). No significant differences were observed regarding ICD, except for the expected ICD after 8-mm setback and advancement (p ≤ 0.037).
CONCLUSIONS: Compared to the virtual planning, the predictability regarding BCA and ICD was limited. ICD showed smaller clinical changes, BCA decreased significantly in the BSSO group.
CONCLUSIONS: BCA and ICD might have been less important in choosing the suitable split technique. in orthognathic surgery.
摘要：
目的：本研究旨在评估双侧和高斜位矢状位劈开截骨术（BSSO/HSSO）的影响，以及预期和可实现的骨接触面积（BCA）的位移距离和方向以及髁间距离（ICD）的变化。解决的主要问题是，与通过HSSO分裂相比，通过BSSO分裂的下颌是否会导致更大的BCA和/或ICD。
方法：对20具新鲜尸体进行80次下颌移位，对于每个主题，生产四个夹板以促进下颌前移以及4和8毫米的挫折。术前和术后进行CBCT扫描以计划手术程序并分析预期和实现的BCA和ICD。
结果：关于下颌最大位移，HSSO/BSSO的预期BCA分别为352.58±96.55mm2和1164.00±295.50mm2，推进后，分别为349.11±98.42mm2和1344.70±287.23mm2，挫折后。HSSO/BSSO的BCA分别为229.37±75.90mm2和391.38±189.01mm2，推进后和挫折后分别为278.03±97.65mm2和413.52±169.52mm2。HSSO/BSSO的预期ICD在前进后为4.51±0.73mm和3.25±1.17mm，在后退后为-5.76±1.07mm和-4.28±1.58mm。HSSO/BSSO的ICD在前进后达到2.07±2.9mm和1.7±0.60mm，在后退后达到-2.57±2.78mm和-1.28±0.84mm。HSSO和BSSO后的BCA之间的显着差异在每个位移（p<0.001），除了在8毫米后退和前进后达到的BCA(p≥0.266)。关于ICD没有观察到显著差异，除了8-mm挫折和推进后的预期ICD（p≤0.037）。
结论：与虚拟规划相比，BCA和ICD的可预测性有限.ICD显示较小的临床变化，BSSO组BCA显著下降。
结论：BCA和ICD在选择合适的拆分技术方面可能不太重要。在正颌手术中。
方法：对20具新鲜尸体进行80次下颌移位，对于每个主题，生产四个夹板以促进下颌前移以及4和8毫米的挫折。术前和术后进行CBCT扫描以计划手术程序并分析预期和实现的BCA和ICD。
结果：关于下颌最大位移，HSSO/BSSO的预期BCA分别为352.58±96.55mm2和1164.00±295.50mm2，推进后，分别为349.11±98.42mm2和1344.70±287.23mm2，挫折后。HSSO/BSSO的BCA分别为229.37±75.90mm2和391.38±189.01mm2，推进后和挫折后分别为278.03±97.65mm2和413.52±169.52mm2。HSSO/BSSO的预期ICD在前进后为4.51±0.73mm和3.25±1.17mm，在后退后为-5.76±1.07mm和-4.28±1.58mm。HSSO/BSSO的ICD在前进后达到2.07±2.9mm和1.7±0.60mm，在后退后达到-2.57±2.78mm和-1.28±0.84mm。HSSO和BSSO后的BCA之间的显着差异在每个位移（p<0.001），除了在8毫米后退和前进后达到的BCA(p≥0.266)。关于ICD没有观察到显著差异，除了8-mm挫折和推进后的预期ICD（p≤0.037）。
结论：与虚拟规划相比，BCA和ICD的可预测性有限.ICD显示较小的临床变化，BSSO组BCA显著下降。
结论：BCA和ICD在选择合适的拆分技术方面可能不太重要。在正颌手术中。
