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

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.