頭部Ｘ線規格写真による下顎枝矢状分割術後の顎位の安定性に関する形態学的研究

DOI 被引用文献8件 参考文献41件

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  • Cephalometric Evaluation of Stability of Mandibular Position after Treatment of Mandibular Prognathism by Sagittal Splitting Ramus Osteotomy.

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The planning of jaw defomity has been established for postoperative stability of maxilla and mandible. However, there are many types of jaw deformity, and there are many types of mandibular prognathism such as mandibular prognathism with mandibular asymmetry or open bite. The purpose of this study was to evaluate the postoperative stability of the mandibular position.<BR>The subjects were 94 patients (34 males and 60 females) who underwent treatment of mandibular prognathism by sagittal splitting ramus osteotomy (parallel method). Cases of mandibular asymmetry and open bite were excluded. In the selected subjects, bone fragments were fixed using a total of 4 A-0 bone-penetrating screws (2 on each side). Cephalometric radiographs of the patients were taken before surgery and 1 month, 3 months, 6 months, 1 year, and 2 years after surgery.<BR>Straight posterior movement parallel to the occlusal plane of the mandible were 5.7mm on average at point B and 6.2 mm on average at the Pogonion 1 month after surgery. The Lower incisors were moved posteriorly 7.4mm on average and were inclined to the lingual side 2.8°on average 1 month after surgery.<BR>The mandibular body showed anterior movement of 1.5mm on average at point B and 2.3mm on average at the Pogonion 2 years after surgery. However, almost no change was observed at the ANS-Menton. Anterior movement of the mandibular body during the first 6 months of the postoperative period correlated to the operative movement of the mandibular body. Incisor overjet was decreased 1.0mm on average in the first year after surgery. Incisor overbite tended to increase during the 2 years after surgery. The occlusal relationship in the anterior teeth was maintained for 2 years after surgery. The lower molar teeth showed anterior movement of 1.0 mm on average. Their movement correlated with the postoperative movement of the mandibular body during the 2 years after surgery. The maxillary and mandibular anterior teeth were both inclined to the labial side 2 years after surgery. Upon measurement, almost all movement tended to be observed during the first year after surgery.<BR>Mandibular bodies, corrected by sagittal splitting ramus osteotomy, acquired a new position during the first year after surgery. In our cases, mandibular replacement was allowed at clinical levels, and there were no signs or evidence that suggested relapse.

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