Therapeutic effect of anterior subapical osteotomy combined with postoperative orthodontic treatment for bimaxillary protrusion based on surgery-first approach
10.3760/cma.j.issn.1009-4598.2017.06.002
- VernacularTitle: 手术优先模式根尖下截骨术联合正畸治疗双颌前突的效果评价
- Author:
Bin YANG
1
;
Huailiang WANG
;
Binghang LI
;
Jian NI
;
Yude DING
;
Xiaomei SUN
;
Li TENG
Author Information
1. Maxillofacial and Digital Plastic Surgery Centre Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100144, China
- Publication Type:Clinical Trail
- Keywords:
Subapical osteotomy;
Surgical orthodontics;
Bimaxillary protrusion;
Cephalometric analysis
- From:
Chinese Journal of Plastic Surgery
2017;33(6):406-412
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To invesigate the therapeutic effect of anterior subapical osteotomy combined with postoperative orthodontic treatment for bimaxillary protrusion based on surgery-first approach(SFA).
Methods:From April 2015 to April 2016, 22 adult patients with bimaxillary protrusion were treated with bimaxillary anterior subapical osteotomy without peroperative orthodontic treatment. Digital computer-aided technology was used for preoperative design and dental model simulation surgery. Then the occlusal guide plate was made for intraoperative built-up of temporary occlusion. Two weeks after orthognathic surgery, a short-term orthodontic treatment was carried out to improve the occlusion. Cephalometric analysis was done to evaluate the treatment effects. 19 cephalometric parameters about hard and soft tissues were measured and compared in all cases before and after SFA combined treatments. All data were statistically analyzed by SPSS software package.
Results:Primary healing was achieved in all the 22 cases without any infection or necrosis of bone and dental pulp. During the follow-up period of 6-12 months, all the patients were satisfied with the profile contour. The cephalometric parameters of hard and soft tissues changed remarkably. U1E-McN and L1E-McN set back (-10.5±4.9) mm and (-8.0± 6.9) mm respectively. Upper and lower lip set back obviously. SNA decreased from (82.5±2.8) to (77.9±2.3) degrees on average. SNB decreased from (79.1±5.4) to (74.6±3.8) degrees on average. Upper and lower lip protrusion decreased obviously. TUL-E line decreased from the mean value of (2.7±2.7) mm to (0.5±3.2) mm and TLL-E line from (5.2±4.0) mm to (1.4±2.7) mm. The aesthetic contours were remarkably improved.
Conclusions:Anterior subapical osteotomy combined with postoperative orthodontic treatment based on SFA could correct adult bimaxillary protrusion effectively with normal occlusion, satisfactory soft tissue aesthetic profile.
