改良鼻旁植骨减少Le FortⅠ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

作　　者：葛卫文 祁磊 王昀 张雷[1] GE Weiwen;QI Lei;WANG Yun;ZHANG Lei(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 20001l;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 20001l,China)

机构地区：[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

出　　处：《中国口腔颌面外科杂志》2023年第2期163-167,共5页China Journal of Oral and Maxillofacial Surgery

基　　金：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)。

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)。结果: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。PURPOSE:To evaluate if the modified paranasal bone grafting can reduce the recurrence of Le Fort I osteoto-my for maxilary 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 grafing group and non-modified paranasal bone grafting group.Three-dimensional measurements of the maxillary position were taken using maxillofacial CT data at preoperative(TO),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=0.0061).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.

关 键 词：鼻旁植骨 复发 三维分析 Le FortⅠ型截骨术 正颌手术 

分 类 号：R782.2[医药卫生—口腔医学]