三维CT重建在骨性Ⅱ类错畸形矫治预后评估中的应用

doi:10.19439/j.sjos.2025.01.007

摘要/Abstract

摘要： 目的: 探讨三维CT重建在骨性Ⅱ类错畸形患者矫治预后评估中的应用价值。方法: 选择2022年1月—2023年1月于宝鸡市人民医口腔科收治的骨性Ⅱ类错畸形患者48例。治疗前1周（T0）、治疗后1个月（T1）和治疗后6个月（T2）对患者进行CBCT扫描,使用3D Slicer建模并导入Geomagic Qualify拟合配准,测量上下颌各标志点三维移动距离。对T1、T2各标志点坐标值进行比较分析。采用Pearson相关性分析明显复发标志点间的相关性,采用SPSS 19.0软件包对数据进行统计学分析。结果: T1与T2相比,标志点Rgo水平向坐标产生变化,A、RP、B、Pog、Gn、Me、Rgo和Lgo前后向坐标点产生变化,Gn垂直向坐标点产生变化,差异有统计学意义（P<0.05）。相关性分析显示,水平向标志点Rgo移动距离|T1-T0|与复发距离呈正相关（r=0.293,P=0.043）。前后向标志点A移动距离|T1-T0|与复发距离呈正相关（r=0.418,P=0.003）,RP移动距离|T1-T0|与复发距离呈正相关（r=0.470,P=0.001）,B点移动距离|T1-T0|与复发距离呈负相关（r=-0.523,P=0.000）,Pog移动距离|T1-T0|与复发距离呈负相关（r=-0.391,P=0.006）。结论: 三维CT重建能够为骨性Ⅱ类错畸形双颌术后的预后评估提供精确的三维定量分析,有助于识别复发风险高的标志点,为临床提供更有针对性的后续治疗和监测策略。

关键词: 三维CT重建, 骨性Ⅱ类错畸形, 正畸, 预后评估, 复发风险

Abstract: PURPOSE: To explore the clinical value of 3D computed tomography (CT) reconstruction in the prognostic evaluation of orthodontic treatment for patients with skeletal Class Ⅱ malocclusion. METHODS: A total of 48 patients with skeletal Class Ⅱ malocclusion who received orthodontic treatment at the Department of Stomatology, Baoji People's Hospital from January 2022 to January 2023 were selected. All patients underwent CBCT scans 1 week before treatment (T0), 1 month after treatment(T1) and 6 months after treatment(T2). 3D Slicer software was used for modeling, and Geomagic Qualify software was utilized for fitting alignment and measuring the three-dimensional movement distances of various landmarks on the maxilla and mandible. The coordinates of the landmarks at T1 and T2 were compared and analyzed. Pearson correlation analysis was used to determine the correlation between significant relapse landmarks. SPSS 19.0 software package was used for statistical analysis of the data. RESULTS: One month and six months post-treatment, changes in the horizontal coordinate of landmark Rgo and changes in the anteroposterior coordinates of landmarks A, RP, B, Pog, Gn, Me, Rgo and Lgo, as well as changes in the vertical coordinate of Gn were statistically significant(P<0.05). Correlation analysis revealed a positive correlation between the horizontal movement distance of landmark Rgo from T1 to T0 and the relapse distance(r=0.293, P=0.043). There was a positive correlation between the anteroposterior movement distance of landmark A from T1 to T0 and the relapse distance(r=0.418, P=0.003), a positive correlation between the movement distance of RP from T1 to T0 and the relapse distance (r=0.470, P=0.001), a negative correlation between the movement distance of B from T1 to T0 and the relapse distance(r=-0.523, P=0.000), and a negative correlation between the movement distance of Pog from T1 to T0 and the relapse distance(r=-0.391, P=0.006). CONCLUSIONS: Three-dimensional CT reconstruction can provide precise three-dimensional quantitative analysis for the prognostic assessment post-orthognathic surgery in patients with skeletal Class Ⅱ malocclusion. It helps identify landmarks with a high risk of relapse, thus providing more targeted postoperative treatment and monitoring strategies for clinical practice.

Key words: Three-dimensional CT reconstruction, Skeletal Class Ⅱ malocclusion, Orthodontics, Prognostic assessment, Relapse risk

中图分类号:

R783.5

刘媛, 丁丽丽. 三维CT重建在骨性Ⅱ类错畸形矫治预后评估中的应用[J]. 上海口腔医学, 2025, 34(1): 38-42.

LIU Yuan, DING Li-li. Application of 3D CT reconstruction in the prognostic evaluation of orthodontic treatment for skeletal Class Ⅱ malocclusion[J]. Shanghai Journal of Stomatology, 2025, 34(1): 38-42.

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