PDF(Pubmed)
Abstract：
This study aimed to compare the pre- and post-operative temporomandibular joint (TMJ) condylar position in dentofacial deformity (DFD) patients who had orthognathic surgeries using cone beam computed tomography (CBCT). A retrospective study evaluating the pre- and post-operative CBCT for 79 DFD patients (equivalent to 158 TMJs) (mean age = 26.62 ± 9.5 years) with a bilateral sagittal split osteotomy with or without Le Fort I surgeries (n = 29 Class II DFD, n = 50 Class III DFD) was performed. This included the compartmental measurement of TMJ spaces, in addition to the measurement of intercondylar distances and angles. Condylar position centricity was assessed using the Pullinger and Hollender formula. Clinical data were analysed for DFD class, the type of surgery and post-operative CBCT timing. Pre- and post-operative measurements were compared statistically using a paired t-test, Wilcoxon signed-rank test, and Stuart-Maxwell test. TMJ condyles tended to relocate post-operatively in a posterosuperior position with internal rotation in Class II DFD and a superior position with internal rotation in Class III DFD. However, the overall changes were within <0.5 mm translation and <4° rotation and the number of concentrically positioned condyles (according to the Pullinger and Hollender formula) did not change significantly. Orthognathic surgery is associated with minor post-operative translational and rotational condylar positional changes in Class II and III DFDs.
摘要：
这项研究旨在比较使用锥形束计算机断层扫描（CBCT）进行正颌手术的颌面畸形（DFD）患者的颞下颌关节（TMJ）髁突位置。一项回顾性研究评估了79例DFD患者（相当于158例TMJs）（平均年龄=26.62±9.5岁）的术前和术后CBCT，这些患者进行了双侧矢状劈开截骨术，有无LeFortI手术（n=29II类DFD，进行n=50III类DFD)。这包括TMJ空间的隔室测量，除了测量髁间距离和角度。使用Pullinger和Hollender公式评估髁突位置中心度。对DFD类别的临床数据进行分析，手术类型和术后CBCT时机。术前和术后测量值使用配对t检验进行统计学比较，Wilcoxon符号秩检验,还有Stuart-Maxwell测试.TMJ髁在术后倾向于在II类DFD中内旋转的后上位置和在III类DFD中内旋转的上位置。然而,总体变化在<0.5mm平移和<4°旋转范围内,同心定位髁的数量(根据Pullinger和Hollender公式)没有显著变化.正颌手术与II类和III类DFD的术后平移和旋转髁突位置变化有关。
