中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2018, Vol. 16 ›› Issue (4): 338-342.doi: 10.19438/j.cjoms.2018.04.009

• 论著 • 上一篇    下一篇

功能板影响错伴特发性髁突吸收正颌术后稳定性的初步研究

河奈玲1,2, 洪越扬1, 杨筱1, 房兵2,*, 江凌勇1,*   

  1. 1.上海交通大学医学院附属第九人民医院·口腔医学院 口腔颅颌面科,正颌-正畸中心,
    2. 口腔正畸科,国家口腔疾病临床研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011
  • 收稿日期:2018-04-23 修回日期:2018-05-10 出版日期:2018-07-20 发布日期:2018-08-09
  • 通讯作者: 江凌勇,E-mail: jiangly1996@sh9hospital.org;房兵,E-mail: fangbing@sh9hospital.org。*共同通信作者
  • 作者简介:河奈玲 (1993-),女,硕士,E-mail: csd-hnl@hotmail.com
  • 基金资助:
    国家自然科学基金(81371121, 81570950); SMC-晨星青年学者奖励计划优秀青年教师（B类计划）; 上海高校高峰高原学科建设项目; 上海市口腔医学研究所院基金（KY科2018-07）

The influence of functional splint therapy on post-surgical stability in patients with idiopathic condylar resorption: a pilot study

HA Na-young1,2, HONG Yue-yang1, Yang Xiao1, FANG Bing2, JIANG Ling-yong1   

  1. 1.Department of Oral and Craniomaxillofacial Surgery,
    2.Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology. Shanghai 200011, China;
  • Received:2018-04-23 Revised:2018-05-10 Online:2018-07-20 Published:2018-08-09

摘要： 目的:探讨特发性髁突吸收（idiopathic condylar resorption, ICR）患者在关节功能板治疗结合正颌-正畸联合治疗后下颌骨及髁突位置的改变,为后期研究提供依据。方法:回顾分析2008—2012年收治的13例特发性髁突吸收患者的临床数据,所有患者均在正颌手术前接受关节功能板治疗7.5±1.5个月。对患者正颌术前(T0)、正颌术后即刻(T1)、正颌术后至少12个月(T2)的咬合、头颅侧位片、MRI检查结果进行测量,采用SPSS 22.0软件包对数据进行统计学分析,评价正颌术后髁突和下颌骨的位置变化。结果:正颌手术(T1)纠正了所有患者的骨性Ⅱ类错畸形,建立了正常的咬合关系、前伸运动及侧方斜导运动。正颌手术平均下颌骨前移量(Y Axis-B, T1-T0)为（5.05±3.54）mm。与T1相比,T2时颞下颌关节间隙参数无显著改变。下颌骨位置参数中, 仅Y轴到B点的距离（Y轴-B）在T2与T1间存在统计学差异,其改变量平均值为（-1.64±2.48）mm,其余参数均无显著差异。13例患者中,11例患者Y轴-B 改变值<2 mm（84.6%）,仅 2例患者出现>2 mm的后退（15.4%）。结论:关节功能板治疗可增加ICR患者正颌手术的稳定性,可能是关节功能板保守治疗能够稳定ICR患者髁突在关节窝内的位置。

关键词: 关节功能板治疗, 特发性髁突吸收, 正颌-正畸联合治疗, 正颌手术, 复发率

Abstract: PURPOSE:To investigate the influence of functional splint therapy, a conservative treatment which stabilizes the relationship between the condylar head and glenoid fossa, on post-surgical relapse in patients with idiopathic condylar resorption (ICR). METHODS: Thirteen patients treated between 2008—2012, who underwent orthognathic surgery for mandibular advancement were included in this retrospective study. Patients were treated with conventional functional splint therapy for 7.5±1.5 months followed by orthognathic surgery. Cephalometric analysis and temporomandibular joint spaces on serial magnetic resonance images were measured prior to orthognathic surgery(T0), immediately post-surgery(T1), and at least 12 months follow-up(T2) for evaluation of the long-term stability. The differences of data between the two periods were compared using SPSS 22.0 software package. RESULTS: All patients obtained an aesthetic facial profile after orthognathic surgery and a normal occlusion after treatment. Normal protrusive and lateral excursion were presented. The mean advancement of the mandible immediately following surgery (Y axis-B, T1-T0) was (5.05±3.54)mm. No significant difference in temporomandibular joint space was found between T1 and T2(0.17±1.93). Y Axis - B was the only measurement changed, which showed sagittal positional change of the mandible, the mean backward movement of (T2-T1) was (-1.64±2.48)mm. Eleven out of 13 patients presented no post-surgical relapse or less than 2 mm of mandibular backward movement(84.6%), 2 out of 13 patients showed more than 2 mm of mandibular backward movement(15.4%). CONCLUSIONS: Patients who underwent functional splint therapy showed stable condylar position in condylar fossa. Functional splint therapy reduces post-surgical relapse in patients with ICR. Functional splint therapy may be of value in patients with ICR treated with orthognathic surgery combined orthodontics.

Key words: Functional splint, Idiopathic condylar resorption, Orthognathic surgery combined orthodontic treatment, Orthognathic surgery, Surgical relapse

中图分类号: