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骨性安氏Ⅲ类错牙合双颌手术后软组织的三维头影测量分析(1)
http://www.100md.com 2012年2月1日 尹晓娟,张苗苗
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     [摘要]目的:评价伴有左右面部不对称骨性安氏Ⅲ类错牙合的成年患者接受正畸-正颌联合治疗后软组织的三维头影测量变化。

    方法:选择10例接受正畸-正颌联合治疗(正颌外科手术术式均为上颌Lefort Ⅰ型截骨术+双侧下颌升支矢状劈开切骨术+颏部成型术)的伴有下颌左右不对称的成人骨性Ⅲ类错牙合患者,分别在术前1个月(T0)和术后6个月(T1)进行三维CT(3DCT)扫描。在CT后处理工作站中进行三维模型重建,确定软组织标记点和变量并测量计算,从而进行三维头影测量分析。结果:所有患者的凹面型及面部偏斜畸形均得到明显矫正,口内牙牙合关系理想、稳定。术后软组织变量的测量结果:鼻基底宽度、鼻翼宽度和上唇峰宽度明显增大;口角宽度、下颌宽度、颏唇角和下颌宽度角明显减小;上唇及颏部的不对称率明显改变。结论:①伴有下颌骨不对称的骨性安氏Ⅲ类错牙合患者双颌手术后,其软组织在三维方向上各项测量指标均有明显改变,患者的软组织外貌得到明显改善;②三维CT可以更精确的反映出颌面部软组织的特征,在临床上具有较高的使用价值。

    [关键词]骨性Ⅲ类错牙合;软组织;双颌手术;三维重建头影测量

    [中图分类号]R783.5 [文献标识码]A [文章编号]1008-6455(2012)02-0277-04

    3-Dimensinal evaluation of soft tissue cephalometric analysis after bimaxillary surgery in skeletal Angle Ⅲ

    YIN Xiao-juan,ZHANG Miao-miao

    (Department of Orthodontics,School of Stomatology,Haerbin Medical University,Haerbin 150001,Heilongjiang, China)

    Abstract: Objective To evaluate the 3-dimensional cephalometric changes in the soft tissue of the skeletal classⅢ malocclusion adult patients with facial asymmetry by orthodontic-surgical treatment. Methods The samples consisted of 10 audlt Skeletal classⅢ patients treated with orthodontic-surgical treatment using Bilateral Sagittal Split Ramus Osteotomy+Maxillary Osteotomy Lefort Ⅰ+Genioplasty.3D computerized tomography images were taken 1 month before (T0) and 6 months after (T1) bimaxillary surgery.Reconstruct three-dimensional mode is in CT post-processing workstation. The landmarks and variables of soft tissue were determined and measured to 3D cephalometric analysis. Results Concavity and facial asymmetry of all the patients were significantly corrected.The relationship of dental articulation were stable and perfect.The measurements of soft tissue variables after surgery: The width of nasal base, alae nasi and upper cupid bow point were significant increase.The width of cheilion and mandible were obviously decreased.The angle of LL-B'-Pog' and Go'-N'-Go' were evidently diminished.The rate of upper lip and chin dissymmetry were strikingly changed. Conclusion ①Satisfactory physiognomy of soft tissue can be obtained with bimaxillary surgery in severe skeletal class Ⅲ malocc lusions with facial asymmethy;②The 3-dimensional CT can precisely reflect characteristic of soft tissue in Maxillofacial region ......

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