日本における下顎に対する顎変形症手術の実態調査 ２． 術前・術後矯正治療，外側骨片の復位について

Abstract

Questionnaires were sent to oral and maxillofacial surgery, orthodontics, anesthesiology departments where board members of the Japanese Association of Oral and Maxillofacial Surgeons, Japan Orthodontic Society, or Japanese Dental Society of Anesthesiology are working. Questionnaires included questions on surgical procedures applied to mandibular deformities, fixation methods between segments, the duration of postoperative intermaxillary fixation, complications of perioperative phase and preoperative and postoperative orthodontic treatments.This paper, as part 2 of this study, presents the results of the survey on positioning procedures of the proximal segment of the mandible after osteotomy and preoperative and postoperative orthodontic treatment based on the replies from 22 orthodontic departments and 99 oral and maxillofacial surgery departments.Results1. Two thirds of oral and maxillofacial surgery departments position the proximal segment before bone fixation, if sagittal splitting ramus osteotomy was applied in the treatment of mandibular deformity.2. Many kinds of procedures for positioning the proximal segment of the mandible, i. e., from manual positioning to positioning with special devices, are applied.3. Rigid fixation (screws, and miniplate and screws) group uses some positioning procedures of the proximal segment more frequently than the nonrigid fixation (wire and circumferential wiring) group (p<0.01).When compared between oral and maxillofacial departments that uses screws, and miniplate and screws, departments using screws tend to position the proximal segment more frequently than those using miniplate and screws (p<0.01).4. Most oral and maxillofacial surgery departments (94/97) answered that orthodontic treatment is applied preoperatively and/or postoperatively in the treatment of mandibular deformity. Comparison whether all orthognathic patients receive orthodontic treatment preoperatively or not, between hospital with and without orthodontic department, revealed that patients treated at hospitals having orthodontic department have a greater chance to receive preoperative orthodontic treatment than patients treated at hospital without it (p<0.01).5. One third of the orthodontic departments have cases who were referred for postoperative orthodontic treatment without any preoperative consultations