改良鼻旁植骨减少Le Fort I型截骨术后上颌骨垂直向复发的探讨

doi:10.19438/j.cjoms.2023.02.011

中国口腔颌面外科杂志 ›› 2023, Vol. 21 ›› Issue (2): 163-167.doi: 10.19438/j.cjoms.2023.02.011

改良鼻旁植骨减少Le Fort I型截骨术后上颌骨垂直向复发的探讨

葛卫文¹, 祁磊¹, 王昀², 张雷¹

1.上海交通大学医学院附属第九人民医院口腔颅颌面科,上海交通大学口腔医学院,国家口腔医学中心, 国家口腔疾病临床医学研究中心,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;
2.上海交通大学医学院附属第九人民医院整复外科,上海市组织工程研究重点实验室,上海 200011

收稿日期:2022-11-14 修回日期:2022-12-23 出版日期:2023-03-20 发布日期:2023-06-12
通讯作者: 张雷,E-mail: oral66@126.com
作者简介:葛卫文（1997-）,男,硕士,E-mail: nostalojalopy@163.com
基金资助:
上海市自然科学基金（20ZR1432200）; 上海九院偏突颌畸形生物样本库项目（YBKB202110）

Modified paranasal bone grafting reduced vertical maxillary recurrence after Le Fort Ⅰ osteotomy

GE Wei-wen¹, QI Lei¹, WANG Yun², ZHANG Lei¹

1. Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology. Shanghai 200011;
2. Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Tissue Engineering. Shanghai 200011, China

Received:2022-11-14 Revised:2022-12-23 Online:2023-03-20 Published:2023-06-12

摘要/Abstract

摘要： 目的： 探讨改良鼻旁植骨是否能减少Le Fort 1型截骨下降手术术后上颌骨垂直向的复发。方法： 选择双颌手术中上颌骨下降幅度>3 mm的患者30例,分为改良鼻旁植骨组和非改良鼻旁植骨组。利用术前(T0)、术后3天(T1)和术后6个月(T2)的颌面CT数据对上颌骨位置进行三维测量;同时利用T1与T2的CT数据计算植骨块厚度的变化。采用SPSS 22.0 软件包对数据进行统计学分析。结果： 术后6个月,在垂直方向上,改良鼻旁植骨组上切牙点复发量为（0.54±0.35）mm,非改良鼻旁植骨组上切牙点复发量为（1.18±0.76）mm（P=0.3997）。2组在前后、水平方向的复发率无显著差异。改良鼻旁植骨组的植骨块厚度降低（11.75±6.25）%,非改良鼻旁植骨组的植骨块厚度降低（33.77±11.56）%(P<0.0001)。结论： 改良鼻旁植骨可有效减少植骨块吸收,以及术后上颌骨垂直向复发。

关键词: 鼻旁植骨, 复发, 三维分析, Le Fort Ⅰ型截骨术, 正颌手术

Abstract: PURPOSE: To evaluate if the modified paranasal bone grafting can reduce the recurrence of Le Fort I osteotomy for maxillary downward. METHODS: A total of 30 patients with a large maxillary downward movement (>3 mm) during orthognathic surgery were included in the study. Patients were divided into modified paranasal bone grafting group and non-modified paranasal bone grafting group. Three-dimensional measurements of the maxillary position were taken using maxillofacial CT data at preoperative(T0), 3 days postoperatively(T1), and 6 months postoperatively (T2). Meanwhile, CT scans of T1 and T2 were used to calculate the changes in bone thickness. SPSS 22.0 software package was used for data analysis. RESULTS: At 6 months after operation, in the vertical direction, the recurrence amount of U1 in the modified paranasal bone grafting group was (0.54±0.35)mm, and the recurrence amount of U1 in the non-modified paranasal bone grafting group was (1.18±0.76)mm(P=0.3997). There was no significant difference in recurrence between the two groups in the anteroposterior and horizontal directions. In the modified group, the bone graft thickness was reduced by (11.75±6.25)%, and that of the non-modified group was (33.77±11.56)%(P<0.0001). CONCLUSIONS: Modified nasal bone graft can effectively reduce the absorption of bone graft and decrease the vertical recurrence of maxilla.

Key words: Paranasal bone grafting, Recurrence, 3D analysis, Le Fort I osteotomy, Orthognathic surgery

中图分类号:

R782.2

葛卫文, 祁磊, 王昀, 张雷. 改良鼻旁植骨减少Le Fort I型截骨术后上颌骨垂直向复发的探讨[J]. 中国口腔颌面外科杂志, 2023, 21(2): 163-167.

GE Wei-wen, QI Lei, WANG Yun, ZHANG Lei. Modified paranasal bone grafting reduced vertical maxillary recurrence after Le Fort Ⅰ osteotomy[J]. China J Oral Maxillofac Surg, 2023, 21(2): 163-167.

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改良鼻旁植骨减少Le Fort I型截骨术后上颌骨垂直向复发的探讨

Modified paranasal bone grafting reduced vertical maxillary recurrence after Le Fort Ⅰ osteotomy

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