顎変形症患者における顔面形態別の術後評価 質問紙法による自己評価

Abstract

Data from questionnaires consisting of 36 items which were sent to patients with prognathism were analysed, for self-evaluation on the postoperative release from various troubles that were suffered before surgery.The subjects were 77 patients (14 males and 63 females) out of 147 patients who had undergone sagittal splitting ramus osteotomy in our clinic from 1989 to 1994. The patients were divided into three groups with different facial profile, skeleton, and occlusion: prognathism group (28 patients with mandibular prognathism only), asymmetry group (27 patients with mandibular prognathism with asymmetry), and open bite group (22 patients with mandibular prognathism and open bite).The results were as follows:1) As for the preoperative particular troubles, those concerning occlusion and facial profile were noted in the prognathism group and those concerning mastication in the open bite group. The patients in the asymmetry group had the same troubles as noted in the above two groups, but suffered from multiple troubles, including temporomandibular joint disorder and others. Moreover, they were comparatively younger.2) In the open bite group, only a few patients evaluated the postoperative change in the facial profile, but much more patients evaluated the change in speech after surgery.3) Over 90 per cent of the evaluated patients from the three groups the improvement of occlusion after the operation, but it took more time for patients to eat an ordinary meal satisfacorily in the asymmetry group.4) Preoperative discomforts due to the temporomandibular joint syndrome were most remarkable in the asymmetry group, but less reduced in the prognathism group after surgery.5) As for the change in tongue and the numbness of lip or chin after surgery, there were no significant differences among the three groups.6) The difference between before and after surgery in the open bite group was move noticeable than the others.7) As for the motive of undergoing surgery, although many patients were recommended to undergo surgery by dentists among the three groups, more patients from the prognathism group decided to undergo it by themselves.8) As for the overall evaluation for the result of surgery, most patients in the three groups showed positive response to surgery. As the main reason, aesthetic improvement was evaluated in the prognathism group, that of occlusion and mastication in the open bite group, and that of the psychological aspect in the asymmetory group.