这项前瞻性研究的目的是评估涉及边缘切口和LeFortI截骨术的手术方案是否会影响牙周结局。本研究选择了29名需要手术矫正上颌骨发育不良的患者。在手术前(T0)评估上颌前牙的牙周状况,一个月(T1),和手术后6个月(T2)。牙间乳头丢失,评估前区的牙周参数和美学结果.用弗里德曼检验和方差分析(p≤0.05)进行统计分析,然后进行事后检验。乳头高度从T0下降到T1(p=0.003),随后从T1增加到T2(p=0.040)。PPD(T0=1.72±0.46;T2=2.13±0.43)和CAL(T0=1.24±0.55;T2=1.99±0.70)在6个月后增加。T0、T1和T2之间的美学评分差异有统计学意义。正颌手术后的牙周变化在可接受的生物学水平内。尽管据报道手术后乳头高度发生了变化,初始值在6个月后恢复。手术切口设计可能会改善Le-FortI截骨术的结果。前美学区可能受益于边缘切口设计,因为它尊重血管化原则,可以确保伤口愈合而没有并发症。
The purpose of this prospective
study was to evaluate whether the surgical protocol involving marginal incision and Le Fort I osteotomy affects the periodontal outcome. Twenty-nine patients requiring surgical correction of maxillary dysgnathia were selected for this
study. Periodontal conditions of maxillary anterior teeth were assessed prior to the surgery (T0), one month (T1), and 6 months (T2) after the surgical procedure. Interdental papillae loss, periodontal parameters and aesthetic outcomes in the anterior zone were assessed. Statistical analysis was performed with Friedman´s test and within ANOVA (p ≤ 0.05) followed by post-hoc tests. Papilla height decreased from T0 to T1 (p = 0.003), followed by an increase from T1 to T2 (p = 0.040). PPD (T0 = 1.72 ± 0.46; T2 = 2.13 ± 0.43) and CAL (T0 = 1.24 ± 0.55; T2 = 1.99 ± 0.70) increased after 6 months. There were statistically significant differences in aesthetic score among T0, T1 and T2. Periodontal changes after orthognathic surgery were within acceptable biological levels. Although a change in papillae height was reported after the surgery, initial values were recovered after 6 months. Surgical incision design might improve the outcome of Le-Fort I osteotomy. Anterior aesthetic zone may benefit from a marginal incision design, as it respects vascularization principle and may ensure a wound healing without complications.