正颌外科患者的术后正畸

目的 :探讨术后正畸的必要性及矫治的目的。方法 :对 10例正颌外科患者术后正畸的分析讨论。结果 :术后矫正可进一步改善正颌外科患者的关系。结论 :正颌外科术后要取得良好的关系 ,建立平衡 ,必需进行术后矫正     

正颌外科术后患者的满意度调查

本文通过问卷回顾性地调查了126位正颌外科术后1年以上患者的满意度。93．6%的患者对手术后容貌的改变满意;849%的患者愿意向有类似畸形的亲朋好友推荐正颌外科手术;74.8％的患者愿意再选择手术;64.3％以上的患者术后感觉自信心提高,与他人交往更自如,幸福感增强。     

正颌外科术后的功能评价

经长期观察研究表明,正颌外科手术后颜面及下颌功能并非都获得全面改善。本文就正颌外科手术后颞颌关节运动范围、咀嚼肌功能改变、(牙合)力改善、以及颞下颌关节的解剖位置变化等作了客观的评价。     

正颌外科手术的术前及术后矫治：附24例病例报告

正颌外科手术患者常表现为较严重的面颌部畸形,严重影响患者美观与咬合功能,给患者带来很大的生理与心理负担。由于存在明显的颌骨畸形,只有经过正颌外科手术,畸形才能得以矫正。但要达到美观与功能的和谐,就要求正畸医生与正颌外科医生密切合作。笔者1985～1989年先后进行正颌外科手术患者的术     

双板在双颌正颌外科中的应用

目的　总结双牙合板在双颌正颌外科中的作用。方法　在对６８ 例上颌前突、双颌前突、骨性开牙合及双颌后缩等颌面部畸形患者施行双颌正颌手术中,利用双牙合板的引导作用,使上下颌骨骨段准确移动达到术前设计的位置,同时辅以微型钛夹板坚固内固定。结果　术后随访６ 个月～７ 年,效果良好,面部外形及咬合关系明显改善且稳定。结论　双牙合板的应用可实现颌骨在三维空间的定量化移动并保持上下牙弓的咬合关系,提高了手术的精确度。     

正颌术后硬组织位置变化预测的准确性评价

目的　探讨牙颌面畸形患者行正颌外科手术术后硬组织位置变化与术前预测误差的影响因素。方法　对 15例牙颌面畸形患者正颌外科手术后 1个星期拍头颅定位侧位片进行头影测量 ,并和术前正畸后头颅定位侧位片模拟手术后所得预测值进行 15项硬组织测量指标统计分析。结果　术后测量值和术前预测值在水平向量变化上存在着绝对值差异 ,但无显著性差异 ,而在一些垂直向量变化中存在着显著性差异 ,分析差异引起的原因 :术前头影测量和模型外科的差异 ,牙合板制作不准确的影响 ,颞颌关节的影响及术中因素的影响。结论　术前精确的头影测量和模型外科 ,牙合板的精确制作 ,术中选用合适的口外标记点并仔细行手术操作是取得完善疗效的关键     

正颌外科在治疗OSAS中的应用

睡眠呼吸暂停综合征可分为三型：1、阻塞性睡眠呼吸暂停综合征（obstructivesleepapneasyndrom，OSAS）：是上呼吸道各段在睡眠时发生阻塞所致。2、中枢性睡眠呼吸暂停综合征：是呼吸中枢对血液中二氧化碳分压的反射性呼吸功能发生障碍，致各呼吸肌停止运动所致的呼吸暂停。3、混合型呼吸暂停：是指呼吸暂停既有阻塞性原因又有中枢性原因。对于OSAS的治疗可采用保守疗法及手术疗法二类。而三型之中对手术疗法最有效的是阻塞性睡眠呼吸暂停综合征（OSAS）。近年来，国内外一些学者对一部分OSAS患者行正颌手术，并在手术前后对患者进行…     

正颌外科在颌骨骨折治疗中的应用

颌骨骨折的治疗方法很多 ,但对复杂的骨折病例 ,往往感到束手无策。我科自 1 995年至今 ,对所遇到的 8例上、下颌骨复杂骨折病人 ,应用正颌外科手段 ,取得了良好的治疗效果 ,报道如下。1　临床资料1 .1　一般资料本组患者男 7例 ,女 1例 ,年龄 2 8～ 3 9岁 ,平均年龄 3 2岁。致伤原因为交通事故伤和建筑工地伤。1 .2　治疗方法病人急诊来我院后均行预防性气管切开 ,其中4例行急诊手术 ,术中取模 ,制做定位板。另 4例病人因疑有脑外伤 ,请脑外科会诊排除 ,分别于伤后5～ 8天手术。1 .3　手术过程8例病人均采用全麻。 6例病人术中取上、下颌…     

正颌外科患者的术前矫治

为使正颌外科术中、术后建牙合顺利、稳定、排除牙合干扰,必需进行术前正畸．本文通过对１０例正颌外科患者术前正畸的分析讨论,提出术前正畸的必要性、矫治目的及注意事项,可进一步指导临床     

Changes in quality of life after orthognathic surgery in Saudi patients

Aim

This study was conducted to measure the impact of orthognathic surgery on quality of life in Saudi patients.

Materials and methods

Patients with a discrepancy of 5 mm or more who underwent orthognathic surgery either single jaw or bimaxillary at the Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, between September 2007 and June 2013 were included in the study. They were asked to complete the Arabic version of the 22-item Orthognathic Quality of Life Questionnaire (OQLQ) preoperatively and postoperatively. Responses at these two timepoints were compared using paired t-tests, with the significance level set to P < 0.05.

Results

Seventeen patients participated in the study. Total OQLQ scores and those in the instrument’s four domains (oral function, facial aesthetics, awareness of dentofacial aesthetics, and social aspects) indicated that quality of life was significantly improved by orthognathic surgery (all P < 0.001).The social aspect domain was shown to be more important for patients than were facial aesthetics and oral function.

Conclusion

The present study revealed highly significant improvement in Saudi patients’ quality of life following orthognathic surgery. This improvement was evident in all four OQLQ domains.     

正颌外科治疗对颞下颌关节功能影响的研究

目的　观察正颌手术后颞下颌关节病各种症状及体征的变化 ,比较不同固定方式及手术方式对于颞下颌关节的影响。方法　正颌手术矫治的连贯患者 46例 ,术前 1周内及术后 1年记录患者的颞下颌关节情况。结果　全组Helkimo主诉症状指数 (Ai) ,临床指数 (Di)的差异无显著性 ,术后最大开口度与下颌前伸度皆减小 ,但只有 1%差别 ,无明显临床意义。单双颌手术及升支的 3种术式之间比较 ,各项症状与体征的变化差异无显著性。结论　正颌外科治疗对颞下颌关节的影响不大 ,不同的术式间对颞下颌关节的影响无明显不同     

数字化技术用于25例患者正颌手术效果评价

目的:应用数字化技术辅助正颌外科三维重建测量、术前诊断、手术设计与模拟、导板制作、导航验证和效果评估,探索制订更加科学、合理的数字化诊治方法和流程.方法:选取25例先天性牙颌面畸形患者,术前行颅颌面CT扫描,将CT数据导入Mimics 20.0软件,建立数字化原始模型.确定三维重建测量硬组织标志点并进行测量、分析、诊断...     

成人错畸形患者正颌手术治疗决策的质性研究

目的 深入了解和探讨国内成人错畸形患者正颌手术的决策体验。方法 采用定性描述性研究方法,以目的抽样选取2018年1月—3月就诊的10例患者为研究对象,以面对面、半结构式深入访谈的形式收集资料,并运用Colaizzi内容分析法对资料进行整理与分析。结果 通过资料的归纳分析,总结出2个主题,即治疗动机、治疗决策干扰因素。结论 错畸形患者正颌手术治疗决策的信息服务具有局限性,需要进一步研究以完善支持错畸形患者治疗决策的信息服务,帮助患者做出最佳的选择。     

正颌外科手术前、后患者人格特征的变化

目的:测量和评估正颌外科术前和术后患者的人格特征及其变化。方法:选取中山大学附属口腔医院正颌外科中心2008年6月—2009年3月实施正颌手术的患者36例,以2006年华东师范大学选取325名受试者(大学生161名,外企员工164名)所制定的常量表为对照组,采用美国卡特尔教授编制的卡特尔16种个性因素问卷(16PF),测量患者手术前、后的人格特征并分析其变化,应用SPSS10.0软件包对数据进行t检验。结果:正颌外科手术前,患者组的16PF-A因素(乐群性)、16PF-F因素(活跃性)和16PF-L因素(警惕性)与对照组相比具有显著性(P<0.05);术后3个月复诊患者31例,患者16PF-A因素(乐群性)和16PF-L因素(警惕性)在术前、术后存在显著差异(P<0.05)。结论:正颌外科手术患者有缄默、孤独、冷漠,喜欢待在自己的小圈子,不爱与人交流的倾向;同时有轻松、兴奋、随遇而安,对事件抱有无所谓的态度;存在敏感多疑,不信任别人,与人相处常常斤斤计较,不顾及别人利益的人格特征倾向;术后3个月,患者开始变得外向、热情、乐群,信赖随和,容易与人相处,但患者轻松、兴奋、随遇而安,对事件抱有无所谓的态度并无明显改变。     

Jaw-stretch reflex is weaker in patients after orthognathic surgery

ObjectivesThe jaw-stretch reflex (JSR) was studied in both patients and healthy participants in order to investigate the possible long-term impact of orthognathic surgery on the motor function of the masticatory system.DesignJSR was measured in patients before surgery (PC), 1 year after surgery (PS) and in healthy controls (HC) (N = 31 in each group). JSR was evoked by a standardized stretch device and recorded bilaterally from masseter and anterior temporalis muscles using surface electromyography (EMG).ResultsThe peak-to-peak amplitude (which was normalized to pre-stimulus EMG activity) of JSRs in PC and PS were significantly smaller than in HC (P < 0.001; P < 0.001). The onset latency in PS was significantly longer compared with HC (P < 0.05). The duration of JSR in PS was significantly longer than in HC and PC (P < 0.001; P < 0.05).ConclusionPatients with dentofacial deformities are characterized by reduced JSR amplitude. The delayed onset and elongated duration of JSR might be potential indicators of a long-term surgical impact on the motor function of the masticatory system.     

Evaluating societal outcomes of orthognathic surgery: an innovative application of the Social Return on Investment methodology to patients after orthognathic treatment

Outcomes after orthognathic treatment are complex, and include improvements to mental and physical health, and psychosocial adjustments. The Social Return on Investment (SROI), a framework that is recognised by the government, explores the wider social value of interventions, but has not yet, to our knowledge, been used to measure the value of surgical procedures. To test its feasibility in a surgical setting and to begin to understand the wider nature of the changes experienced by patients after orthognathic surgery, we designed a pilot study that focused on the first two stages of the six-stage model. We collected data from 16 participants about their perceptions and experiences of the short, medium, and longer term outcomes of their treatment during two qualitative storyboard workshops. A grounded theory-SROI method was used to explore their experiences through a process of constant comparison by which data were analysed for concepts and organised into distinct themes. This produced a theory of change that clearly expressed the short to medium-term and longer term outcomes of orthognathic treatment, and provided an initial framework for the approach. The theory captured several outcomes and showed that the framework can be used effectively to investigate the wider psychosocial changes after orthognathic treatment. It therefore provides a basis on which to develop potential indicators for the assessment and valuation of these outcomes over time. The application of these findings to the selection of patients, engagement, and postoperative care, is briefly discussed.     

The effect of orthognathic surgery on temporomandibular disorder

This study aimed to evaluate the difference in prevalence of temporomandibular disorder (TMD) before and after orthognathic surgery (OGS), particularly in patients with mandibular asymmetry.A prospective cohort study of patients undergoing corrective orthognathic surgery was conducted. Pre-operative and post-operative (3 months, 6 months and 1 year) TMD assessment were performed according to the Diagnostic Criteria for TMD (DC/TMD) protocol.64 patients were included in the study. Overall, there was a significant reduction of 26.5% in TMD prevalence from 60.9% pre-operatively to 34.4% 1-year post-operatively (p = 0.003). In all, 37.5% of patients had their TMD condition treated, 50% had no change in their symptoms while 12.5% experienced a worsening of their symptoms. No significant difference in terms of change in TMJ status was observed among the different ramus procedures, the type and magnitude of mandibular movement, skeletal class, and presence of mandibular asymmetry.In conclusion, it appears that corrective orthognathic surgery for dentofacial deformities might provide a secondary benefit of treating TMD. However, surgeons have to be aware that a small percentage of patients might experience a deterioration of their TMD condition, and that those who were previously asymptomatic may develop TMD symptoms after surgery.     

右美托咪定与艾司洛尔用于正颌手术术中控制性降压效果比较

目的: 比较右美托咪定与艾司洛尔用于正颌手术中控制性降压的效果。方法: 回顾2017年1月—2019年12月择期行正颌手术（上颌骨Le Fort I型截骨和下颌支矢状劈开术）术中用右美托咪定（D组）和艾司洛尔（E组）行控制性降压病例共109例,比较2组患者控制性降压期间心率（HR）和平均动脉压（MAP）波动情况（最高与最低值的差值和基础值的百分比）,术中失血量、异体血输注情况、手术时间及瑞芬太尼、异丙酚使用量。采用SPSS 22.0软件包对数据进行统计学分析。结果: 与E组相比,D组控制性降压期间HR和MAP的波动显著降低（P<0.05）,异丙酚和瑞芬太尼使用量显著减少（P<0.05）,其他指标无显著差异。结论: 右美托咪定用于正颌手术术中控制性降压可使降压过程更为平稳,同时减少异丙酚和瑞芬太尼的用量。     

正颌外科治疗后颞下颌关节改变的X线研究

目的 了解正颌外科手术后颞下颌关节（ｔｅｍｐｏｒｏｍａｎｄｉｂｕｌａｒ ｊｏｉｎｔ,ＴＭＪ）形态的改变,探讨手术方式不同对ＴＭＪ的影响。方法 正颌手术患者５７例,术前、术后１周、１年分别拍摄定位许勒位片用于观察髁突位置及关节形态的变化。结果 ①正颌手术可导致髁突移位,但大多数关节适应后并不发生病变,术后１年髁突位置已调整到术前相似的位置。②手术方式不同髁突位置的变化也不尽相同。③８６．４％的患者关节无明显变化或发生了适应性改建;１３．６％患者关节发生了退行性改变。结论 正颌手术可对ＴＭＪ产生影响,但大部分处于关节的正常适应范围内。