Does mandible ramus height asymmetry affect postoperative skeletal stability in orthognathic surgery patients?

IF 2 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Maxillofacial Plastic and Reconstructive Surgery Pub Date : 2024-09-02 DOI:10.1186/s40902-024-00442-9

Jihun Cha, Kyuwon Park, Jaeyoung Ryu, Seunggon Jung, Hong-Ju Park, Hee-Kyun Oh, Min-Suk Kook

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引用次数: 0

Abstract

Background: Relapses following orthognathic surgery have been reported to exceed 2% to 50%, depending on multiple factors. This study aimed to analyze the stability after orthognathic surgery in patients with mandibular ramus height asymmetry through 3D reconstruction using Cone-beam CT.

Methods: This retrospective cohort study investigated patients who underwent mandibular setback surgery using bilateral sagittal split ramus osteotomy. Three-dimensional CT scans were taken at three different time points. Evaluation of the postoperative stability involved measuring changes in the x, y, and z axes as well as roll and yaw rotations of the mandible at specific landmarks (B point, mental foramen) on 3D CT scans obtained immediately after surgery and 6-12 months postoperatively. They were categorized into four groups based on bilateral mandibular height asymmetry through Asymmetry index (AI). The one-way ANOVA was implemented to compare the intergroup differences and Tukey's post hoc test was employed. Additionally, the Pearson correlation coefficient was also calculated.

Results: A total of 24 patients were included in this study. The corresponding AI, representing the degree of asymmetry in both mandibles, were calculated as Group 1 was 1.25 ± 0.64%, Group 2 was 2.89 ± 0.47%, Group 3 was 5.03 ± 0.51%, and Group 4 was 9.40 ± 1.99%. The x-axis change in Group 4 was significantly larger at 1.71 mm compared to Group 1 at 0.64 mm. The mandibular roll, Group 4 showed a statistically significant increase at 1.33° compared to Group 1 at 0.35°. And there was a significant positive correlation observed between x-axis change and AI (p = 0.019), as well as between mandibular roll and AI (p = 0.025).

Conclusion: After orthognathic surgery, stability was influenced by numerous factors, with the findings of this study suggesting that the degree of ramus height asymmetry in the mandible can be considered one contributing factor.

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下颌骨横梁高度不对称会影响正颌手术患者术后骨骼的稳定性吗？

背景：据报道，正颌手术后的复发率超过 2%至 50%，这取决于多种因素。本研究旨在通过锥束 CT 进行三维重建，分析下颌横梁高度不对称患者正颌手术后的稳定性：这项回顾性队列研究调查了使用双侧矢状劈裂臼齿截骨术接受下颌骨后移手术的患者。在三个不同的时间点进行了三维 CT 扫描。对术后稳定性的评估包括在术后即刻和术后 6-12 个月的三维 CT 扫描中测量下颌骨在特定地标（B 点、精神孔）处的 x、y 和 z 轴以及滚动和偏航旋转的变化。根据双侧下颌骨高度不对称程度，通过不对称指数（AI）将他们分为四组。采用单因素方差分析比较组间差异，并进行 Tukey 后检验。此外，还计算了皮尔逊相关系数：本研究共纳入 24 名患者。相应的 AI（代表两个下颌骨的不对称程度）计算结果为：第 1 组为 1.25 ± 0.64%，第 2 组为 2.89 ± 0.47%，第 3 组为 5.03 ± 0.51%，第 4 组为 9.40 ± 1.99%。第 4 组的 X 轴变化为 1.71 毫米，明显大于第 1 组的 0.64 毫米。下颌滚动方面，第 4 组为 1.33°，与第 1 组的 0.35°相比，有统计学意义的明显增加。X轴变化与AI（P = 0.019）以及下颌滚动与AI（P = 0.025）之间存在明显的正相关：结论：正颌手术后，稳定性受到多种因素的影响，本研究的结果表明，下颌骨横梁高度不对称的程度可被视为一个诱因。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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