手术先行方案中术后牙齿加速移动的初步研究

Preliminary Study on Postoperatively Accelerated Orthodontic Tooth Movement in Surgery-first Approach

目的:手术先行方案治疗牙颌面畸形是目前的研究热点。在采用手术先行方案的治疗中,发现正颌手术后3-4个月牙齿加速移动,提出了正颌手术致颌面部损伤加快牙齿移动的观点。本文通过实验分析手术先行方案中术后牙齿快速移动的原因。材料与方法:12只成年新西兰大白兔,分为AB两组,每组6只,A组为实验组,B组为对照组,A以兔左下颌骨建立手术先行方案模型,术后以75 gf为初始力移动左下颌第一前臼齿向前。B组仅用75 gf初始力移动左下颌第一前臼齿向前。结果:A组中左下颌第一前臼齿移动距离平均为0.96 mm,B组为0.91 mm,两组间无明显差异,p=0.36。结论:实验中对下颌骨的损伤并不明显引起术后下颌牙齿快速移动,局部因素包括咬合功能减弱、牙颌面关系改善致生物力改变等的影响在采用手术先行方案时的不可忽视。

Objective：Surgery-first become prevalent for dentofacial deformity currently.Tooth movement was accelerated 3-4 months after orthognathic surgery in surgery-first approach.Orthognathic surgery accelerate tooth movement has been raised In this pa-per,experiment had executed to analyze the reason of postoperative rapid orthodontic tooth movement.Materials and Methods： 12 adult New Zealand rabbits,divided into two groups,A＆amp;B,6 in each group,group A for the experimental group,group B for the control group,left mandibular first premolar moved forward by 75gf as initial force after surgery-first model been done in mandible. Group B, left mandibular first premolar been moved forward by 75gf as initial force without surgery.Results：The distance left mandibular first premolar had moved is 0.96mm on average in group A,0.91mm in group B.There are no significant difference between the two groups, p=0.36.Conclusions：In this study,injury of orthognathic surgical on mandible do not evidently induce postoperative rapid orthodontic tooth movement in mandible.Local factors such as weakening of occlusal function and biomechanics changed caused by improvement of dentofacial relationship could not be ignored in surgery-first approach.