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Title: 下顎枝矢状分割法術後の安定性および安定性に影響する因子に関する研究
Other Titles: Study on the postoperative stability and its contributing factors in Sagittal Split Ramus Osteotomy
Authors: 原田, 沙織1 Browse this author
松下, 和裕2 Browse this author →KAKEN DB
山口, 博雄3 Browse this author
三古谷, 忠4 Browse this author →KAKEN DB
鄭, 漢忠5 Browse this author →KAKEN DB
Authors(alt): Harata, Saori1
Matsushita, Kazuhiro2
Yamaguchi, Hiro-o3
Mikoya, Tadashi4
Tei, Kanchu5
Keywords: 下顎枝矢状分割法
Postoperative stability
Issue Date: Mar-2019
Publisher: 北海道歯学会
Journal Title: 北海道歯学雑誌
Volume: 39
Issue: 2
Start Page: 111
End Page: 121
Abstract: われわれは理想的かつ機能的アプローチを行うため,外科的矯正治療において1972年以降,補綴科も加えた治療体制を築いてきた.われわれは外科的矯正治療の評価において長期安定性は重要な評価項目の一つであると考えている.これまでの経験から当施設での術後安定性は臨床的には良好である.しかし,統計学的評価は十分には行われていない.そこで本研究は下顎枝矢状分割法(Sagittal split ramus osteotomy : SSRO)による下顎後方移動を行った症例を対象に術後安定性を評価し,術後安定性に影響する因子を明らかにする目的で行った.153名中,選択基準に合致した症例は31名であった.手術直前,直後,術後6ヶ月,1-3年の各時点で撮影した側面頭部エックス線規格写真を用い,13項目(角度計測:7項目,距離計測:6項目)を計測した.  半年時点でANBとB(X)は有意な変化を認めたがその後は安定していた.それ以外の項目は観察期間中,安定していた.多変量解析の結果,術後安定性に関わる因子としてSNB手術変化量が有意であった.回帰方程式としてβ=-1.31-0.54α(α=SNB手術変化量,β=術後3年後のpoint Bの水平変化量)が得られた.  これらより,術後安定性に影響する因子として過去に報告されているB点の水平変化とともに,垂直方向の変化にも影響されることが示唆された.
We have created our own team, recruiting prosthodontists, to achieve a desirable and functional occlusion since 1972. We believe that long-term stability is one of the most important evaluation items which appraise successful orthognathic treatment. From the standpoint of our previous experiences, postoperative stability was clinically fine. However, statistical evaluations have not sufficiently been performed yet. This study is performed to evaluate the dentofacial changes in the case requiring setback movement by sagittal split ramus osteotomy (SSRO) and clarify the contributing factors for postoperative stability. Out of 306 patients, 31 patients met the inclusion criteria. Measurements were performed on the lateral cephalogram taken at just before and after surgery, and sequentially at the period of 6 month, 1-year and 3- year postoperatively. Thirteen cephalometric parameters (7 angular and 6 linear) were selected. At 6-month postoperatively, ANB and point B were significantly changed, and they were stable after then. Other measurements than ANB and point B were stable completely throughout the follow-up period. In the multivariate analysis, SNB change produced by surgery was significantly related to the postoperative stability. SNB will change back to original value. Regression formula was obtained as β= -1.31-0.54α (α : Angular change of SNB in surgery(°), β= Liner horizontal change of point B at 3 years after surgery (mm)). It suggests that vertical change is also a contributing factor which predicts postoperative stability in addition to the amount of direct horizontal liner movement by surgery.
Type: article
Appears in Collections:北海道歯学雑誌 = Hokkaido Journal of Dental Science > 第39巻 第2号

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