影響下顎前移正顎手術方式於成年患者治療的長期穩定性之因素探討

王 郁智, Chiung-Shing Huang, Eric Jein-Wein Liou, Ellen Wen-Ching Ko

Research output: Contribution to journalJournal Article peer-review

Abstract

造成以手術 (BSSO) 方式將下顎前移,再發生下顎後縮回復的位置主要發生在於下顎關節與截骨區域。而影響長期穩定性的因素包括下顎前移的量、手術醫師的經驗、術後固定的方式、術後下顎周圍軟組織牽扯的力量、及術後關節位置與型態的變化。下顎於術後發生後縮的情況在術後6-8周就可能產生,產生的原因主要被認為是與下顎關節在手術後產生的移動有關,此關節的移動包括了線性與角度的變化,而移動的方向包括了各個方向,尤其是往後上方與外側方向移動。在下顎關節長時間受到壓迫後,最後可能導致關節產生吸收的現象,而造成術後9個月至18個月開始產生所謂late relapse的現象,其發生率為2.3%至7.7%。而這種情況的發生與手術時下顎前移的量,與術前是否有顳顎關節症狀存在有關聯性。
Bilateral sagittal spilt osteotomy for advancing the mandible of retrognathic patients is one of the most unstable orthognathic surgical techniques. Posterior mandible relapse can happen at the osteotomy site and/or the temporomandibular joint. Osteotomy slippage, condylar sag and condylar compression are the primary sources of early and late mandibular relapse associated with mandibular advancement. Other factors, including magnitude of advancement, mandibular counterclockwise rotation, high mandibular plane, soft tissue management, surgeon skill level, fixation method, and inherent condylar conditions of the patients are all contributing to posterior mandibular relapse after mandibular advancement. Early relapse can happen in 7 weeks after surgery, and even 9 months later, late relapse can keep going on due to progressive condylar remolding.
Original languageChinese (Traditional)
Pages (from-to)22-28
Journal中華民國齒顎矯正學雜誌
Volume17
Issue number2
StatePublished - 2005

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