下顎枝矢状分割法を施行した下顎前突症患者の術後評価 : 顎運動機能について

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In order to investigate the mandibular movements and function after sagittal split ramus osteotomy for prognathism, occlusal contact area and points, distance of mandibular border movements, myographic activity of masseter and temporalis, biting force and masticatory efficiency were measured before and 3, 6, 12 months after surgery. Postoperative evaluation under the consideration of fixation method of bone segments and with or without orthodontic therapy was carried out. The results were as follows : 1. Occlusal contact area and points tended to increase from 3 months after surgery compared with preoperative level and they indicated a significant increase 12 months after surgery. 2. Maximal distance of opening mouth indicated a significant decrease 3 and 6 months after surgery compared with preoperative level. Significant difference however was not recognized 12 months after surgery. Distance of anterior and lateral border movements showed an increasing trend from 6 months after surgery and the distance of left border movements indicated a significant increase 12 months after surgery. 3. Myographic activity of bilateral masseter decreased 3 months after surgery compared with preoperative level. A significant increase was recognized 12 months after surgery. Myographic activity of bilateral temporalis showed an increasing trend from 3 months after surgery compared with preoperative level. Twelve months after surgery a significant increase was recognized. 4. Biting force on both sides decreased 3 months after surgery compared with preoperative level, but 12 months after surgery it indicated a significant increase. 5. Masticatory efficiency tended to increase from 3 months after surgery compared with preoperative level. Six months after surgery significant increase was recognized. 6. Significant correlation of masticatory efficiency was recognized with occlusal contact area, points and myographic activity of temporalis preoperatively and with all examined items except distance of anterior and lateral border movements postoperatively. Correlations between left and right in myographic activity and biting force, as well as between masseter and temporalis in myographic activity strengthened with the passage of time after surgery. 7. Screw fixation was superior to wire fixation in occlusal contact area, distance of anterior border movements, and myographic activity of masseter. On the contrary wire fixation was superior to screw fixation in myographic activity of temporalis and left biting force. Occlusal contact points and masticatory efficiency showed equal improvement of function. 8. The group combined with the orthodontic therapy was superior to the group without it in occlusal contact area and points, myographic activity of right masseter and temporalis, right biting force and masticatory efficiency. On the contrary in the group without the orthodontic therapy, nothing was superior to group with it. From the above results, it was suggested that application of sagittal split ramus osteotomy for prognathism is very meaningful for not only esthetic and morphological improvements but also improvement of mandibular movements and function.
九州歯科学会の論文
1990-12-25

下顎枝矢状分割法を施行した下顎前突症患者の術後評価 : 顎運動機能について

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