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전산화단층촬영법을 이용한 하악 전돌증 환자의 하악지 시상 골절단술후 하악과두 위치변화 분석
Evaluation of Condylar Position Using Computed Tomograph Following Bilateral Sagittal Split Ramus Osteotomy
이상한(Sang Han Lee),최강영(Kang Young Choi)
UCI I410-ECN-0102-2009-510-004064323

This study was intended to perform the influence of condyle positional change after surgical correction of skeletal Class 3 malocclusion after BSSRO in 20 patients(males 9, females 11) using computed tomogram that were taken in centric occlusion before, immediate, and long term after surgery and lateral cephalogram that were taken in centric occlusion before, 7 days within the period intermaxillary fixation, 24hour after removing intermaxillary fixation and long term after surgery. 1. Mean intercondylar distance was 84.45±4.01mm and horizontal long axis of condylar angle was 11.89±5.19on right, 1l.65±2.09on left side and condylar lateral poles were located about 12mm and medial poles about 7mm from reference line(AA`) on the axial tomograph. Mean intercondylar distance was 84.43±3.96mm and vertical axis angle of condylar angle was 78.72±3.43on right, 78.09±6.12on left. 2. No statistical significance was found on the condylar change(T2C - T1C) but it had definitive increasing tendency. There was significant decreasing of the distance between both condylar pole and the AA`(p<0.05) during the long term(TLC - T2C). 3. On the lateral cephalogram, no statistical significance was found between immediate after surgery and 24 hours after the removing of intermaxillary fixation but only the lower incisor tip moved forward about 0.33mm(p40.05). Considering individual relapse rate, mean relapse rate was 1.2% on L1, 5.0% on B, 2.0% on Pog, 9.1% on Gn, 10.8 on Me(p<0.05). 4. There was statistical significance on the influence of the mandibular set-back to the total mandibular relapse(p<0.05), 5. There was no statistical significance on the influence of the mandibular set-back(T2-Tl) to the condylar change ( T2C-T1C), the condylar change (T2C-T1C, TLC-T2C) to the mandibular total relapse, the pre - operative condylar position to the condylar change (T2C-T1C, TLC-T2C), the pre-operative mandibular posture to the condylar change (T2C-T2C TLC-T2C)(p>0.05). 6. The result of multiple regression analysis on the influence of the pre-operative condylar position to the total mandibular relapse revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condyalr head long axis angle, the more increasing of mandibular horizontal relapse (L1, B, Pog, Gn, Me) on the right side condyle. The same result was founded in the ease of horizontal relapse(L1,Me) on the left side condyle (p<0.05). 7. The result of multiple regression analysis on the influence of the pre-operative codylar position to the pre-operative mandibular posture revealed that the more increasing of increasing of intercondylar distance and condylar vertical axis angle and decreasing of condylar head long axis angle, the more increasing of mandibular vertical length on the right side condyle and increasing of vertical lengh & prognathism on the left side condyle (P<0.05). 8. The result of simple regression analysis on the influence of the pre-operative mandibular posture to the mandibular total relapse revealed that the more increasing of prognathism the more increasing of mandibular total relapse on B and the more increasing of over-jet the more increasing of mandibular total relapse(p<0.05). Consequently, surgical mandibular repositioning was not significantly influenced to the change of condylar position with condylar reposition method.

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