A retrospective clinical study of the long-term stability of mandibular distractions in 1 ~ 3 years

doi:10.3877/cma.j.issn.1674-1366.2019.02.005

Abstract

Abstract:

Objective

The aim of this study was to evaluate the long-term stability of mandibular distractions by cephalometric analysis before and after the distractions and discuss the factors that influence the recurrence.

Methods

Five patients with mandibular deformities who underwent distraction osteogenesis from 2009 to 2018 were selected. The cephalometric data of T0 (before distraction osteogenesis) , T1 (distraction osteogenesis was completed/distraction distractor was removed) , and T2 (the longest follow-up after distraction osteogenesis) were compared. The length of mandible (Ar-Gn, Go-Gn, Co-Go) were measured and recorded. The numerical changes of data were compared to evaluate the stability of distraction therapy. SPSS 20.0 was used for statistical analysis, and paired t-test was used to obtain statistical analysis results.

Results

Panoramic films showed that the mandibular length increased by 6.09 mm (t = 2.97, P = 0.025) and the mandibular ramus increased by 5.72 mm (t = 3.21, P = 0.018) at the follow-up after distraction osteogenesis. The cephalometric images showed that mandibular length increased by 8.17 mm (t = 5.21, P = 0.006) , total mandibular length increased by 12.58 mm (t = 4.34, P = 0.01) , ramus height increased by 6.36 mm (t = 4.26, P = 0.01) , and SNB increased by 6.28° (t = 5.28, P = 0.006) . However, the results of panoramic tomography showed that the height of ramus decreased on average at the time of follow-up compared with that at the time of completion of surgery by 2.25 mm (t = -3.42, P = 0.014) .

Conclusions

Mandibular distraction osteogenesis has obvious effect on improving mandibular malformation and good long-term stability. However, slight recurrence of ramus height can be detected on panoramic films 1-3 years postoperatively.

Key words: Mandible, Osteogenesis, distraction, Cephalometric analysis

Xingna Yu, Shida Hou, Yihuan Huang, Rongsheng Zeng. A retrospective clinical study of the long-term stability of mandibular distractions in 1 ~ 3 years[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2019, 13(02): 90-96.

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Figures/Tables 5

References 22

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序号	性别	手术时年龄（岁）	随访时间（年）	手术部位	病因	牵张长度（mm）
1	男	5	2.75	双侧	后天	15.6
2	女	13	1.17	右侧	先天	23.1
3	女	14	3.17	左侧	先天	25.2
4	女	22	2.25	双侧	后天	11.2
5	男	16	1.75	左侧	后天	19.6
平均	-	14	2.22	-	-	18.9

序号	性别	手术时年龄（岁）	随访时间（年）	手术部位	病因	牵张长度（mm）
1	男	5	2.75	双侧	后天	15.6
2	女	13	1.17	右侧	先天	23.1
3	女	14	3.17	左侧	先天	25.2
4	女	22	2.25	双侧	后天	11.2
5	男	16	1.75	左侧	后天	19.6
平均	-	14	2.22	-	-	18.9

测量项目	例数	T0	T1	T2	T1-T0	T2-T0	T2-T1
Go-Gn	5	85.68 ± 10.09	93.76 ± 8.87	91.77 ± 10.48	8.08 ± 4.10	6.09 ± 5.42	-1.99 ± 2.43
t值	-	-	-	-	5.22	2.97	-2.17
P值	-	-	-	-	0.002	0.025	0.073
Cr-Go	5	53.44 ± 11.68	61.41 ± 10.72	59.16 ± 11.32	7.97 ± 5.96	5.72 ± 4.72	-2.25 ± 1.74
t值	-	-	-	-	3.54	3.21	-3.42
P值	-	-	-	-	0.012	0.018	0.014

测量项目	例数	T0	T1	T2	T1-T0	T2-T0	T2-T1
Go-Gn	5	85.68 ± 10.09	93.76 ± 8.87	91.77 ± 10.48	8.08 ± 4.10	6.09 ± 5.42	-1.99 ± 2.43
t值	-	-	-	-	5.22	2.97	-2.17
P值	-	-	-	-	0.002	0.025	0.073
Cr-Go	5	53.44 ± 11.68	61.41 ± 10.72	59.16 ± 11.32	7.97 ± 5.96	5.72 ± 4.72	-2.25 ± 1.74
t值	-	-	-	-	3.54	3.21	-3.42
P值	-	-	-	-	0.012	0.018	0.014

测量项目	例数	T0	T1	T2	T1-T0	T2-T0	T2-T1
Go-Gn（mm）	5	53.55 ± 11.88	60.56 ± 11.20	61.71 ± 10.07	7.02 ± 2.47	8.17 ± 3.50	1.15 ± 2.84
t值	-	-	-	-	6.34	5.21	0.91
P值	-	-	-	-	0.003	0.006	0.42
Ar-Gn（mm）	5	91.61 ± 9.01	102.98 ± 9.44	104.20 ± 8.49	11.37 ± 2.29	12.58 ± 6.49	1.21 ± 5.71
t值	-	-	-	-	11.09	4.34	0.48
P值	-	-	-	-	<0.001	0.01	0.66
Cr-Go（mm）	5	44.53 ± 9.39	53.05 ± 8.42	50.89 ± 8.67	8.52 ± 4.77	6.36 ± 3.34	-2.16 ± 2.17
t值	-	-	-	-	4.00	4.26	-2.22
P值	-	-	-	-	0.02	0.01	0.09
SNB（°）	5	64.98 ± 3.94	71.09 ± 2.44	71.06 ± 1.70	6.11 ± 1.67	6.08 ± 2.58	-0.03 ± 1.42
t值	-	-	-	-	8.17	5.28	0.05
P值	-	-	-	-	0.001	0.006	0.96

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