Mandibuler Setback Cerrahisi Sonrası Sagittal Split Osteotomi Hattında Meydana Gelen Değişikliklerin Üç Boyutlu Olarak İncelenmesi

Yıl 2016, Cilt: 6 Sayı: 4, 155 - 160, 15.12.2016

Kadir Beycan , Ahu Acar

Öz

Amaç: Bu çalışmadaki amacımız çift çene ortognatik cerrahi operasyonu geçiren Sınıf III hastalarda sagittal split osteotomi (SSO) hattında meydana gelen değişimlerin üç boyutlu olarak incelenmesi ve maksiller gömme olup olmamasına bağlı olarak oluşan değişikliklerin belirlenmesidir.

 

Yöntemler: Bu çalışmada ortognatik çene ameliyatı geçirmiş olan 21 Sınıf III hastadan cerrahi öncesi ve sonrası 3-6 aylık dönemde alınmış olan konik ışınlı bilgisayarlı tomografi verileri kullanılmıştır. Yirmi bir hasta iki gruba ayrılmıştır: maksiller ilerletme-gömme ve mandibuler setback uygulanan olgular (10 hasta) “Grup I”, maksiller ilerletme ve mandibuler setback uygulanan olgular (11 hasta) “Grup II” olarak tanımlanmıştır. Üç boyutlu konik ışınlı bilgisayarlı tomografi görüntüleri kafa kaidesi üzerinde çakıştırılmış, sagittal split osteotomi hattında ameliyata bağlı olarak meydana gelen değişimler üç boyutlu imaj rekonstrüksiyonları kullanılarak tespit edilmiştir.

 

Bulgular: Grup II’de SSO hattı noktalarının aksiyel düzlemde medial yönlü değişim miktarı, istatistiksel olarak anlamlıdır (p<0,05). Grup I ve Grup II arasındaki farklar karşılaştırıldığında, aksiyal düzlemde SSO hattı ölçümlerinde meydana gelen değişimin Grup II’de Grup I’den istatistiksel olarak anlamlı derecede yüksek olduğu belirlenmiştir (p<0,05).

 

Sonuç: Maksiller ilerletme ve mandibuler setback uygulanan olgularda SSO hattında x ekseninde istatistiksel olarak anlamlı medial yönlü yer değiştirme meydana geldiği, maksiller ilerletme, gömme ve mandibuler setback uygulanan olgularda ise SSO hattında anlamlı bir değişim meydana gelmediği belirlenmiştir.

Anahtar Kelimeler

Sagittal split osteotomisi, mandibuler setback, konik ışınlı bilgisayarlı tomografi

Three-Dimensional Evaluation of the Changes at the Sagittal Split Osteotomy Line after Mandibular Setback Surgery

Öz

Objective: The aim of this study was to evaluate three-dimensional positional changes at the sagittal split osteotomy (SSO) line after double jaw surgery for class III patients and determine the effect of maxillary impaction at the SSO line.

 

Methods: In this study, cone-beam computed tomography scans of 21 Class III patients taken before and 3–6 months after orthognathic surgery were used. Twenty-one patients were divided into two groups: “Group I” consisted of 10 patients who had combined maxillary advancement, maxillary impaction, and mandibular setback surgery, and “Group II” consisted of 11 patients who had combined maxillary advancement and mandibular setback surgery. Three-dimensional cone-beam computed tomography images were registered using cranial base superimposition and the changes of the SSO line were examined based on the three-dimensional reconstructed images.

 

Results: Medial displacement of the SSO line was statistically significant on the axial plane in Group II (p<0.05). Comparison of the changes between Groups I and II showed that the amount of displacement of the SSO line in the axial plane in Group II was significantly greater than that in Group I (p<0.05).

 

Conclusion: In cases that have maxillary advancement and mandibular setback surgery, significant medial displacement of the SSO line was observed. There was no significant change in patients who had combined maxillary advancement, impaction, and mandibular setback surgery.

Anahtar Kelimeler

Sagittal split osteotomy, mandibular setback, cone-beam computed tomography

Kaynakça

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