颧骨颧弓联合下颌角整形术对颞颌关节髁突及Spee曲线影响.docVIP

颧骨颧弓联合下颌角整形术对颞颌关节髁突及Spee曲线影响 　　[摘要]目的：探讨颧骨颧弓联合下颌角整形术后颞颌关节髁状突及Spee曲线的变化。方法：随机选取颧骨颧弓肥大合并下颌角肥大者59例，于术前、术后10d、术后6个月分别做三维CT检查，并对颜面部进行三维测量，采用q检验（Newman-Keuls法）进行方差分析。结果：术前、术后10d及术后6个月，两侧髁状突内外侧间距均未发生改变。术前与术后10d Spee曲率半经之间比较，差异无统计学意义；术后6个月与术前、术后10d Spee曲率半经之间比较，差异有统计学意义（P0.05），术后6个月Spee曲率半径较前降低。结论：颧骨颧弓联合下颌角整形术前后髁状突内外侧间距未发生改变，据此推测髁状突未发生内收、外展。由于术后咬合肌群形态和下颌骨边缘都发生了改变，Spee曲线也随之发生了适应性变化。Spee曲线的变化提示咬合关系发生了一些改变，但有无临床意义需要进一步研究。 　　[关键词]截骨术；口颌肌群；成像；三维 　　[中图分类号]R782 [文献标志码]A [文章编号]1008-6455（2015）11-0034-04 　　Abstract： Objective To observe the TMJ condyle and Spee curve changes after zygoma combined with mandibular angel osteotomy plastic surgery. Methods We randomly selected 59 cases who owned prominent zygoma and mandibular angle，screening periodontal disease，temporomandibular joint pain and partial jaw.All of them did three-dimensional CT scan before the surgery and at 10 days，6 months after the surgery，then measured the distance between both sides of the condyle and the spee curve radius.The q test（Newman-Keuls method） were used to analysis of variance. Results Pre-operation，10 days and 6 months after surgery，there was none of the both sides of the condyle exterior and interior distance changes （P0.05）.Spee curve was no significant difference between preoperative and 10 days after surgery（P0.05），while its radius reduced at 6 months after surgery and curvature increased （P0.05）. Conclusion The condyle exterior and interior distance are not changes，so we may indicate that the condylars are neither adduction nor abduction，postoperatively.For muscles occlusal morphology and the edge of the mandible were both changed after surgery，so spee curve happened adaptive changes as well.Spee curve changes suggestive of occlusal relationship has some changed，but whether with clinical significance needs further study. 　　Key words：zygomatic；mandibular angle；3-dimensional CT；temporomandibular joint；Spee curve 　　近年来，随着审美意识的逐渐提高和整形美容技术的不断进步，人们要求通过颧骨颧弓联合下颌角整形术[1-2]改变面中下部轮廓的整形美容者日渐增多。但目前对截骨整形术后颞颌关