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目的:研究下颌偏突颌畸形患者手术前后力,咀嚼效能的变化,并探讨其影响因素。方法:从2008年2月~2008年10月对24例在武汉大学口腔医学院接受正颌手术的下颌偏突颌畸形患者。根据畸形的具体情况,将其分为两组,仅接受双侧下颌升支矢状劈开截骨术16例(单颌治疗组),接受LeFortⅠ型截骨术合并双侧下颌升支矢状劈开截骨术8例(双颌治疗组)。利用咬合力计和分光光度计分别对两组患者术前、术后1、3、6个月的力和咀嚼效能进行测定。结果:术后1个月时,两组患者力及咀嚼效能显著低于术前。术后3个月时,两组患者力和咀嚼效能已有明显改善。术后6个月时,单颌治疗组患者的力均值超过术前,而双颌组患者的咀嚼效能均值也高于术前。结论:正颌手术短时间内对下颌偏突颌畸形患者的力、咀嚼效能影响较大。随着手术后患者对新的关系逐渐适应,其力和咀嚼效能均有明显变化。单颌治疗组力改善较快,双颌治疗组咀嚼效能提高更明显。
Objective: To study the changes of muscle force and masticatory efficiency in patients with mandibular deviation maxillary deformity before and after operation, and to explore the influencing factors. Methods: From February 2008 to October 2008, 24 patients with mandibular deviation maxillary malformation under orthognathic surgery at School of Stomatology, Wuhan University were enrolled. According to the specific conditions of deformity, they were divided into two groups, only received bilateral sagittal ramification of mandibular ascending split osteotomy in 16 cases (single jaw treatment group), received LeFort Ⅰ osteotomy combined with bilateral mandibular ascending sagittal Cleft osteotomy in 8 cases (bimax treatment group). Bite force and spectrophotometer were used to measure the force and masticatory efficiency of the two groups before operation, 1,3,6 months after operation. Results: At 1 month after operation, the strength and chewing performance of the two groups were significantly lower than those before operation. At 3 months after operation, the strength and masticatory efficacy of both groups had been significantly improved. At 6 months after operation, the mean force of patients in the single jaw group was higher than that of the preoperative group, while the average chewing power of the patients in the bilateral jaw group was also higher than that before operation. Conclusion: Orthognathic surgery in a short period of time on the mandibular deviation of jaw deformity in patients with the force, masticatory effect greater impact. With the gradual adaptation of the patient to the new malaria after surgery, there is a significant change in maneuvering and chewing performance. Single-jaw treatment group to improve muscle force faster, double-jaw treatment group improved more obvious masticatory.