Skeletal stability after 2-jaw surgery via surgery-first approach in facial asymmetry patients using CBCT
황대석, 서정석, 최홍석,
소속 상세정보
황대석 ( Hwang Dae-Seok ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
서정석 ( Seo Jeong-Seok ) - Bongseng Hospital Department of Dental Clinic
최홍석 ( Choi Hong-Seok ) - Bongseng Hospital Department of Dental Clinic
Abstract
Background: The purpose of this study is to compare the skeletal stability of two-jaw surgery via surgery-first approach with conventional two-jaw surgery in facial asymmetry patients by measuring the skeletal changes after surgery from a three-dimensional analysis. From January 2010 to January 2014, 40 patients with facial asymmetry who underwent two-jaw surgery in Pusan National University Hospital were included in this study. They were classified into experimental group (n = 20) who underwent two-jaw surgery via surgery-first approach and control group (n = 20) who underwent conventional two-jaw surgery. After selection of 24 landmarks and the construction of horizontal and sagittal, coronal reference planes, changes in 10 linear measurements and 2 angular measurements were compared between the surgery-first approach and conventional groups in the preoperative, immediate postoperative, and postoperative periods. The paired t test and Student t test were used for statistical analysis. The mean and standard deviation of the measurement were calculated for the experimental and control groups.
Results: The statistical analysis showed that changes in skeletal measurements were similar between the surgery-first approach and conventional groups, according to each period. However, U1-SRP measurement showed statistically significant changes in surgery-first approach groups at postsurgical change (T1 to T2). Also, the mean treatment duration in the treatment group was 15.9 ± 5.48?months whereas that in the control group was 32.9 ± 14.05?months.
Conclusion: In facial asymmetry patients, similar results were observed in the postoperative skeletal stability when 2-jaw surgery via surgery-first approach was compared with conventional 2-jaw surgery. However, significant lateral deviation of upper incisor midline was observed. In addition, a shorter average treatment duration was observed. To stabilize the unstable occlusion after surgery, increased wearing of the stent and proactive rubber guidance will be needed.
키워드
Facial asymmetry; Orthognathic surgery; Surgery-first approach; Skeletal stability; 3-Dimensional analysis
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