Osseous Healing after Sagittal Splitting Ramus Osteotomy in Mandibular Prognathism. Three-dimensional CT Measurement.:Three-dimensional CT Measurement

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概要

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• The purpose of the present study was to clarify the relationship between the cleavage and fixation of bone fragments and the osseous healing after sagittal splitting ramus osteotomy.<BR>Subjects consisted of 12 patients with mandibular prognathism, on which we performed sagittal splitting ramus osteotomy on both sides. Thus, we performed this osteotomy on 24 rami. These rami were studied immediately after, and 1 year after, surgery by Three-dimensional CT.<BR>(1) With regard to the morphology of the anterior and posterior borders of the mandibular ramus, the majority (70.8%) showed the smooth type (smooth type: proximal and distal bone fragments are not discernible, and there is a smooth transition between them) in the lower plane. In the upper plane, the smooth type was less frequent (39.6%), and the stairway type (stairway type: either the proximal bone fragment or the distal bone fragment is protruded, thus showing a stairway form) was more frequent (43.8%). The concave type (concave type: there is a gap, i.e. an opened bone fragment, between two bone fragments, thus showing a concave form) was more frequently observed at the anterior border than at the posterior border, in both planes.<BR>(2) With regard to the relationship between the morphology of the posterior border of the mandibular ramus and the cleavage of proximal and distal fragments, the stairway type was more frequent if both fragments were completely split through the posterior border, but the smooth type was more frequent if the cleavage spared the posterior border.<BR>(3) With regard to the relationship between the morphology of the anterior and posterior borders of the mandibular ramus and the distance between proximal and distal bone fragments, the distance was greatest in the concave type, followed by the stairway type and the smooth type, in this order. The concave type was observed in cases in which the mean distance was more than 6.1mm.<BR>(4) As for the relationship between the posterior protrusion of the distal bone fragment and the morphology of the posterior border of the mandibular ramus, the posterior protrusion of the distal bone was most pronounced in the stairway type, followed by the smooth type and the concave type, in this order, in the upper plane. In the lower plane, the protrusion was most pronounced in the stairway type, followed by the concave type and the smooth type, in this order. In both planes, the stairway type was observed in cases in which the posteror protrusion was more than 5.3mm.<BR>The above-mentioned results show that, in cases in which the distance between bone fragments is larger, or where the posterior protrusion is marked after the ramus had been split through the posterior border, there is no morphological shape even at one year after osteotomy.

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特定非営利活動法人 日本口腔科学会 | 論文

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