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양악 악교정 수술에서 르포트 I형과 U-자형 복합 골절단술 후 상악골의 안정성에 관한 임상적 연구
POST-OPERATIVE SKELETAL STABILITY OF THE MAXILLA TREATED WITH LE FORT I AND U-SHAPED OSTEOTOMIES IN SIMULTANEOUS MAXILLOMANDIBULAR ORTHOGNATHIC SURGERY

김민근    (국군 강릉병원 치과   ); 박영욱    (강릉원주대학교 치과대학 구강악안면외과학교실  );
  • 초록

    Postoperative skeletal stability was evaluated in combination of Le Fort I and U-shaped osteotomies for superior repositioning of maxilla in bi-maxillary surgeries in 30 consecutive patients. The fifteen patients underwent Le Fort I osteotomy alone and the other fifteen patients underwent Le Fort I and U-shaped osteotomies. In all patients, the maxilla was first osteomized and fixed with absorbable plates system. A bilateral sagittal split ramus osteotomy (BSSRO) of the mandible was then carried out and fixation was performed using absorbable plates. Maxillo-mandibular fixation with rubber ring was used for two weeks post-operatively in all patients. Lateral cephalograms were obtained pre-operatively, 1 day post-operatively, 6 months after surgery. The changes in anterior nasal spine (ANS), point A, upper incisior (U1), and point of maxillary tuberosity (PMT) were examined. The maxillas in the fifteen patients of both examination group were repositioned nearly in their planned positions during surgery and no significant post-operative changes in the examined points of the maxilla were found. These results suggest that a combination of a Le Fort I and U-shaped osteotomy is a useful technique for reliable superior repositioning of the maxilla. The post-operative change in the maxilla using this combination osteotomy was comparatively stable.


  • 주제어

    U-shaped osteotomy .   Superior repositioning of the maxilla .   Combination osteotomy.  

  • 참고문헌 (20)

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    11. Lanigan DT, Hey JH, West RA : Aseptic Necrosis Following Maxillary Osteotomies: Report of 36 Cases. J Oral Maxillofac Surg 48 : 142, 1990 
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    17. Yoshioka I, Khanal A, Kodama M et al : Postoperative skeletal stability and accuracy of a new combined Le Fort I and horseshoe osteotomy for superior repositioning of the maxilla. Int J Oral Maxillofac Surg 5 : 2009 [Epub ahead of print] 
    18. Hoppenreijs TJM, Freihofer HPM, Stoelinga PJW et al : Skeletal and dento-alveolar stability of Le Fort I intrusion osteotomies and bimaxillary osteotomies in anterior open bite deformities. Int J Oral Maxillofac Surg 26 : 161, 1997 
    19. Proffit WR, Phillips C, Turvey TA : Stability following superior repositioning of the maxilla by Le Fort I intrusion osteotomy. Am J Orthod Orthog Surg 11 : 151, 1987 
    20. Van Sickels JE, Larsen AJ, Triplett RG : Predictability of maxillary surgery: A comparison of internal and external reference marks. Oral Surg 61 : 542, 1986 

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