下颌角肥大矫正术式的研究与分析

Research and analysis of different surgical methods of prominent mandibular angle

目的:探讨经口内入路不同术式矫正下颌角肥大的适应证及疗效分析。方法:应用下颌角全层截骨术矫正15例后下突出型下颌角肥大,下颌角外板矢状劈开截骨术矫正15例外翻型下颌角肥大,下颌角全层截骨术与下颌角外板矢状劈开截骨术联合应用矫正15例复合型下颌角肥大,通过X线头影测量评价疗效。结果:下颌角全层截骨组:术后下颌角角度为(124.87±2.54)°,下颌平面角为(31.32±2.03)°,升支平面角为(92.31±0.82)°,面下部宽度为(10.14±0.37)cm,与术前比较差异均有统计学意义(P<0.05),接近于正常人群。下颌角外板矢状劈开截骨组:术后面下部宽度为(10.01±0.40)cm,与术前比较差异有统计学意义(P<0.05);术后下颌角角度为(123.40±1.97)°,下颌平面角为(32.33±1.23)°,升支平面角为(92.33±0.77)°,与术前比较差异均无统计学意义(P>0.05)。下颌角全层截骨术与下颌角外板矢状劈开截骨术联合应用组:术后下颌角角度为(126.34±3.01)°,下颌平面角为(31.53±1.50)°,升支平面角为(92.09±0.79)°,面下部宽度为(9.97±0.40)cm,与术前比较差异均有统计学意义(P<0.05)。所有患者容貌较术前均有明显改观,无下齿槽神经损伤、下颌骨骨折等并发症发生。结论:针对不同类型的下颌角肥大,需采用其相对应的术式,方可有效矫正下颌角肥大畸形。

Objective To discuss the indication and analyze the effects of different reduction mandibuloplasty methods correcting broad mandibular by intra-oral approach. Methods 15 cases of prominent prominent mandibular angles were treated with mandibular angle full-thickness osteotomy.15 cases of ectropion prominent mandibular angles were treated with mandibular angle sagittal split osteotomy.15 cases of compound prominent mandibular angles were treated with mandibular angle full-thickness osteotomy and sagittal split osteotomy.The results were evaluated with cephalometric analysis of X-ray flims. Results The postoperative mandibular angle, mandibular plane angle, ramus planesella nasion angle, and the width of lower face of full-thickness osteotomy group were（124.87±2.54）°,（31.32±2.03）°,（92.31±0.82）°,and（10.14±0.37）cm,respectively.The difference between these preoperative and postoperative values had statistic significance（P0.05）.And those postoperative values were close to normal.Sagittal split osteotomy group,postoperative width of lower face was（10.01±0.40）cm,and statistic analysis showed significant difference from preoperation（P0.05）.While the postoperative mandibular angle,mandibular plane angle, and ramus planesella nasion angle were（123.40±1.97）°,（32.33±1.23）°,and（92.33±0.77）°respectively.Statistic analysis showed no significance（P 0.05）.Full-thickness osteotomy and sagittal split osteotomy group,the postoperative mandibular angle, mandibular plane angle, ramus planesella nasion angle, and the width of lower face were（126.34 ±3.01）°,（31.53 ±1.50）°,（92.09 ±0.79）°,and（9.97 ±0.40）cm,respectively.The difference between these preoperative and postoperative values had statistic significance（P0.05）. The cosmetic results were satisfied.No complications,such as inferior alveolar nerve injury and mandible fracture,occurred in any patient. Conclusion For different types of mandibular angle,requires the use of the corresponding different surgical,can correct effectively the malformation of prominent mandibularangle.