3D simulation of interosseous interference in sagittal split ramus osteotomy for mandibular asymmetry.

IF 2 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Maxillofacial Plastic and Reconstructive Surgery Pub Date : 2023-09-18 DOI:10.1186/s40902-023-00400-x
Santhiya Iswarya Vinothini Udayakumar, Dohyoung Kim, So-Young Choi, Tae-Geon Kwon
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Abstract

Background: The purpose of this study was to evaluate the pattern of predicted interosseous interference and to determine the influencing factor to volume of bony interference using a computer-assisted simulation system. This retrospective study recruited 116 patients with mandibular prognathism who had undergone sagittal split ramus osteotomy (SSRO) with or without maxillary osteotomy. The patients were divided into 3 groups according to the amount of menton (Me) deviation: less than 2 mm (Group 1), 2-4 mm (Group 2), and more than 4 mm (Group 3). Changes in the distal segments following BSSRO and the volume of the interosseous interference between the proximal and distal segments were simulated after matching preoperative occlusion and postoperative expected occlusion with the cone-beam computed tomography data. Ramal inclinations and other skeletal measurements were analyzed before surgery, immediately after surgery, and at least 6 months after surgery.

Results: The anticipated interosseous interference was more frequently noted on the contralateral side of chin deviation (long side) than the deviated site (short side) in Groups 2 and 3. More interference volume was predicted at the long side (186 ± 343.9 mm3) rather than the short side (54.4 ± 124.4 mm3) in Group 3 (p = 0.033). The bilateral difference in the volume of the interosseous interference of the osteotomized mandible was significantly correlated with the Me deviation (r =  - 0.257, p = 0.009) and bilateral ramal inclination (r = 0.361, p < 0.001). The predictor variable that affected the volume of the osseous interference at each side was the amount of Me deviation (p = 0.010).

Conclusion: By using the 3D simulation system, the potential site of bony collision could be visualized and successfully reduced intraoperatively. Since the osseous interference can be existed on any side, unilaterally or bilaterally, 3D surgical simulation is necessary before surgery to predict the osseous interference and improve the ramal inclination.

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下颌不对称矢状支劈开截骨中骨间干扰的三维模拟。
背景:本研究的目的是使用计算机辅助模拟系统评估预测的骨间干扰模式,并确定影响骨干扰量的因素。这项回顾性研究招募了116名下颌前突患者,他们接受了矢状支劈开截骨(SSRO),无论是否进行了上颌截骨。根据menton(Me)偏离量将患者分为3组:小于2 mm(第1组)、2-4 mm(第2组)和大于4 mm(第3组)。在将术前闭塞和术后预期闭塞与锥束计算机断层扫描数据相匹配后,模拟BSSRO后远端节段的变化以及近端和远端节段之间的骨间干扰量。在手术前、手术后立即和手术后至少6个月分析Ramal倾斜度和其他骨骼测量值。结果:在第2组和第3组中,预期的骨间干扰在下巴偏斜的对侧(长侧)比偏斜部位(短侧)更常见。预测长边的干扰量更大(186 ± 343.9 mm3)而不是短边(54.4 ± 124.4 mm3)(p = 0.033)。截骨下颌骨骨间干扰体积的双侧差异与Me偏差显著相关(r =  - 0.257,p = 0.009)和双侧斜视(r = 0.361,p 结论:利用三维仿真系统,可实现骨碰撞潜在部位的可视化,并可在手术中成功缩小。由于骨干扰可以存在于任何一侧、单侧或双侧,因此在手术前需要进行3D手术模拟,以预测骨干扰并改善下颌倾斜度。
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来源期刊
Maxillofacial Plastic and Reconstructive Surgery
Maxillofacial Plastic and Reconstructive Surgery DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
4.30
自引率
13.00%
发文量
37
审稿时长
13 weeks
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