骨性Ⅲ类错正颌手术前、后面部软、硬组织变化比率的三维研究

doi:10.19439/j.sjos.2019.02.010

上海口腔医学 ›› 2019, Vol. 28 ›› Issue (2): 158-164.doi: 10.19439/j.sjos.2019.02.010

骨性Ⅲ类错正颌手术前、后面部软、硬组织变化比率的三维研究

吴雨桐^1,2, 孙健^1,2,3,4, 李亚莉¹, 陈立强^1,2, 陈晨^1,2, 邓楠^1,2, 李莉^1,2, 王志浩^1,2

1.青岛大学附属医院口腔颌面外科,山东青岛 266000;
2.青岛大学口腔医学院,山东青岛 266000;
3.青岛市口腔数字医学与3D打印工程实验室,山东青岛 266000;
4.山东省数字医学与计算机辅助手术重点实验室, 山东青岛 266000

收稿日期:2018-08-02 修回日期:2018-11-10 出版日期:2019-04-25 发布日期:2019-06-20
通讯作者: 孙健,E-mail：sunjianqy@126.com
作者简介:吴雨桐（1991-）,女,硕士,住院医师,E-mail: 379849501@qq.com
基金资助:
山东省科技发展计划项目（2014GSF118108）

Three dimensional study on change ratios of hard and soft tissue after orthognathic surgery

WU Yu-tong^1,2, SUN Jian^1,2,3,4, LI Ya-li¹, CHEN Li-qiang^1,2, CHEN Chen^1,2, DENG Nan^1,2, LI Li^1,2, WANG Zhi-hao^1,2

1. Department of Oral and Maxillofacial Surgery, Qingdao University Affiliated Hospital. Qingdao 266000;
2. School of Stomatology of Qingdao University. Qingdao 266000;
3. Oral Digital Medicine and 3-Dimensional Printing Engineering Laboratory. Qingdao 266000;
4. Shandong Provincial Key Laboratory of Digital Medicine and Computer-Assisted Surgery. Qingdao 266000, Shandong Province,China

Received:2018-08-02 Revised:2018-11-10 Online:2019-04-25 Published:2019-06-20

摘要/Abstract

摘要： 目的研究骨性Ⅲ类错畸形患者面部软、硬组织三维方向上变化的相关性,以及手术前、后软、硬组织的变化比率,以期更好地对术后软组织外貌进行预测。方法对20例骨性Ⅲ类错畸形成人患者分别于术前2周及术后3个月进行颅面CT扫描和三维重建及面部软组织3D摄影成像,将采集的数据导入Dolphin软件,转换为三维面像数字化模型,建立三维测量坐标系(轴面、矢状面及冠状面),筛选19个软、硬组织标记点并进行测量、对比和配对,共12对。读取标记点的三维坐标（X、Y、Z）,进行手术前、后的定点对比测量,采用 SPSS 22.0 软件包对测量数据进行统计学分析。结果 12对软、硬组织标志点在X轴即左右方向仅Pn/A、Gn'/Gn及Me'/Me存在相关性,在Y轴即上下方向仅Gn'/Gn存在相关性,在Z轴上所有软、硬组织配对点均存在相关性。除UL'/UI及UL/SPr外,均为高度相关。手术前、后,下颌的软、硬组织测量标志点的变化比率大于上颌。结论骨性Ⅲ类错畸形患者双颌手术前、后软、硬组织的变化主要集中于Z轴即前后向的变化,各软、硬组织配对标志点间呈线性相关关系,且下颌软、硬组织位移比率大于上颌。

关键词: 三维重建测量, 软、硬组织相关性, 软、硬组织变化比率, 3D摄影

Abstract: PURPOSE: To investigate the change ratios of soft and hard tissue after orthognathic surgery three-dimensionally in osseous Class Ⅲ patients, in order to predict postoperative soft tissue three-dimensionally. METHODS: Twenty adult patients were selected as the experimental group, craniofacial spiral CT and three-dimensional (3D) stereophotogrammetry were conducted 2 weeks before surgery and 3 months after surgery. Dolphin imaging software was used to establish 3D image digitizing model and 3D measurement coordinate system. Nineteen soft and hard tissue land marks were selected and matched into 12 pairs. 3D coordinate value of these landmarks were read both before and after surgery and were used for statistical analysis with SPSS 22.0 software package. RESULTS: There was a linear relationship only in Pn/A, Gn'/Gn and Me'/Me in X axis, in Gn'/Gn in Y axis and all pairs of landmarks had a close correlation except UL'/UI and UL/SPr in Z axis. Additionally, the change ratio between soft and hard tissue landmarks of mandible was greater than maxilla. CONCLUSIONS: The changes of soft and hard tissue after orthognathic surgery only lie in Z axis(forward and backward), each pair of matched landmarks exhibits a linear relationship, and the change ratio of mandible is greater than the maxilla.

Key words: 3D reconstruction measurement, Hard and soft tissue correlation, Hard and soft tissue change ratio, 3D stereophotogrammetry

中图分类号:

R783.5

吴雨桐, 孙健, 李亚莉, 陈立强, 陈晨, 邓楠, 李莉, 王志浩. 骨性Ⅲ类错正颌手术前、后面部软、硬组织变化比率的三维研究[J]. 上海口腔医学, 2019, 28(2): 158-164.

WU Yu-tong, SUN Jian, LI Ya-li, CHEN Li-qiang, CHEN Chen, DENG Nan, LI Li, WANG Zhi-hao. Three dimensional study on change ratios of hard and soft tissue after orthognathic surgery[J]. Shanghai Journal of Stomatology, 2019, 28(2): 158-164.

参考文献

[1] Sarver DM, Johnston MW, Matukas VJ.Video imaging for planning and counseling in orthognathic surgery[J]. J Oral Maxillofac Surg, 1988, 46(11): 939-945.
[2] San Miguel Moragas J, Van Cauteren W, Mommaerts MY. A systematic review on soft-to-hard tissue ratios in orthognathic surgery part I: maxillary repositioning osteotomy[J]. J Craniomaxillofac Surg, 2014, 42(7): 1341-1351.
[3] San Miguel Moragas J, Oth O, Büttner M, et al. A systematic review on soft-to-hard tissue ratios in orthognathic surgery part Ⅱ: Chin procedures[J]. J Craniomaxillofac Surg, 2015, 43(8): 1530-1540.
[4] Olate S, Zaror C, Blythe JN, et al.A systematic review of soft-to-hard tissue ratios in orthognathic surgery. Part Ⅲ: Double jaw surgery procedures[J]. J Craniomaxillofac Surg, 2016, 44(10): 1599-1606.
[5] Swennen GR, Schutyser F, Barth EL, et al.A new method of 3-D cephalometry Part I: the anatomic Cartesian 3-D reference system[J]. J Craniofac Surg, 2006, 17(2): 314-325.
[6] Shafi MI, Ayoub A, Ju X, et al.The accuracy of three-dimensional prediction planning for the surgical correction of facial deformities using Maxilim[J]. Int J Oral Maxillofac Surg, 2013, 42(7): 801-806.
[7] 史雨林, 商洪涛, 田磊, 等. 骨性Ⅲ类错畸形患者双颌手术前后面部软组织变化的三维研究[J]. 中国修复重建外科杂志, 2018, 32(5): 612-616.
[8] Olate S, Zaror C, Mommaerts MY.A systematic review of soft-to-hard tissue ratios in orthognathic surgery. Part IV: 3D analysis - Is there evidence?[J]. J Craniomaxillofac Surg, 2017, 45(8): 1278-1286.
[9] Schendel SA, Jacobson R, Khalessi S.3-Dimensional facial simulation in orthognathic surgery: is it accurate?[J]. J Oral Maxillofac Surg, 2013, 71(8): 1406-1414.
[10] Aboul-Hosn Centenero S, Hernández-Alfaro F. 3D planning in orthognathic surgery: CAD/CAM surgical splints and prediction of the soft and hard tissues results - our experience in 16 cases[J]. J Craniomaxillofac Surg, 2012, 40(2): 162-168.
[11] Van Hemelen G, Van Genechten M, Renier L, et al.Three-dimensional virtual planning in orthognathic surgery enhances the accuracy of soft tissue prediction[J]. J Craniomaxillofac Surg, 2015, 43(6): 918-925.
[12] Liebregts J, Xi T, Timmermans M, et al.Accuracy of three-dimensional soft tissue simulation in bimaxillary osteotomies[J]. J Craniomaxillofac Surg, 2015, 43(3): 329-335.
[13] Bazina M, Cevidanes L, Ruellas A, et al.Precision and reliability of Dolphin 3-dimensional voxel-based superimposition[J]. Am J Orthod Dentofacial Orthop, 2018, 153(4): 599-606.
[14] Schendel SA, Jacobson R, Khalessi S.3-dimensional facial simulation in orthognathic surgery: is it accurate ?[J]. J Oral Maxillofac Surg, 2013, 71(8): 1406-1414.
[15] Mommaerts MY, Lippens F, Abeloos JV, et al.Nasal profile changes after maxillary impaction and advancement surgery[J]. J Oral Maxillofac Surg, 2000, 58(5): 470-475.
[16] Freihofer HP Jr.Changes in nasal profile after maxillary advancement in cleft and non-cleft patients[J]. J Maxillofac Surg, 1977, 5(1): 20-27.
[17] Engel GA, Quan RE, Chaconas SJ.Soft-tissue change as a result of maxillary surgery. A preliminary study[J]. Am J Orthod, 1979, 75(3): 291-300.
[18] Mansour S, Burstone C, Legan H, An evaluation of soft-tissue changes resulting from Le FortⅠmaxillary surgery[J]. Am J Orthod, 1983, 84(1): 37-47.
[19] Rosen HM.Lip-nasal aesthetics following Le FortⅠosteotomy[J]. Plast Reconstr Surg, 1988, 81(2): 171-182.
[20] Hack GA, de Mol van Otterloo JJ, et al. Long-term stability and prediction of soft tissue changes after Le Fort Ⅰsurgery[J]. Am J Orthod Dentofacial Orthop, 1993,104(6): 544-555.
[21] Hui E, Hagg EU, Tideman H.Soft tissue changes following maxillary osteotomies in cleft lip and palate and non-cleft patients[J]. J Craniomaxillofac Surg, 1994, 22(3): 182-186.
[22] 梁立卿, 孙健, 李亚莉, 等. 正颌外科二维头影测量与三维面颅重建测量的比较[J]. 现代口腔医学杂志, 2016, 30(6): 342-345.
[23] Rossini G, Cavallini C, Cassetta M, et al.3D cephalometric analysis obtained from computed tomography[J]. Ann Stomatol (Roma), 2011, 2(3-4): 31-39.
[24] Jung PK, Lee GC, Moon CH.Comparison of cone-beam computed tomography cephalometric measurements using a midsagittal projection and conventional two-dimensional cephalometric measurements[J]. Korean J Orthod, 2015, 45(6): 282-288.
[25] 王瑞晨, 李桂珍, 柳春明, 等. 三维头影测量分析法在正颌外科术前测量中的应用[J]. 中国修复重建外科杂志, 2014, 28(7): 873-878.
[26] Enacar A, Taner T, Toroglu S.Analysis of soft tissue profile changes associated with mandibular setback and double-jaw surgeries[J]. Int J Adult Orthodon Orthognath Surg, 1999, 14(1): 27-35.
[27] Coleta KE, Wolford LM, Gonçalves JR, et al.Maxillo-mandibular counter-clockwise rotation and mandibular advancement with TMJ Concepts total joint prostheses: part IV-soft tissue response[J]. Int J Oral Maxillofac Surg, 2009, 38(6): 637-646.
[28] Lu CH, Ko EW, Huang CS.The accuracy of video imaging prediction in soft tissue outcome after bimaxillary orthognathic surgery[J]. J Oral Maxillofac Surg, 2003, 61(3): 333-342.
[29] Lee DY, Bailey LJ, Proffit WR.Soft tissue changes after superior repositioning of the maxilla with Le Fort I osteotomy: 5-year follow-up[J]. Int J Adult Orthodon Orthognath Surg, 1996, 11(4): 301-311.
[30] Jensen AC, Sinclair PM, Wolford LM.Soft tissue changes associated with double jaw surgery[J]. Am J Orthod Dentofacial Orthop, 1992, 101(3): 266-275.
[31] Aydemir H, Efendiyeva R, Karasu H, et al.Evaluation of long-term soft tissue changes after bimaxillary orthognathic surgery in Class Ⅲ patients[J]. Angle Orthod, 2015, 85(4): 631-637.
[32] Conley RS, Boyd SB.Facial soft tissue changes following maxillomandibular advancement for treatment of obstructive sleep apnea[J]. J Oral Maxillofac Surg, 2007, 65(7): 1332-1340.
[33] Lin SS, Kerr WJ.Soft and hard tissue changes in Class Ⅲ patients treated by bimaxillary surgery[J]. Eur J Orthod, 1998, 20(1): 25-33.
[34] Chew MT.Soft and hard tissue changes after bimaxillary surgery in Chinese Class Ⅲ patients[J]. Angle Orthod, 2005, 75(6): 959-963.
[35] Chew MT, Sandham A, Wong HB.Evaluation of the linearity of soft- to hard-tissue movement after orthognathic surgery[J]. Am J Orthod Dentofacial Orthop, 2008, 134(5): 665-670.
[36] Altug-Atac AT, Bolatoglu H, Memikoglu UT.Facial soft tissue profile following bimaxillary orthognathic surgery[J]. Angle Orthod, 2008, 78(1): 50-57.
[37] Aydil B, Özer N, Marsan G.Bimaxillary surgery in Class Ⅲ malocclusion: soft and hard tissue changes[J]. J Craniomaxillofac Surg, 2013, 41(3): 254-257.
[38] Kuvat SV, Güven E, Hocaoglu E, et al.Body fat composition and weight changes after double-jaw osteotomy[J]. J Craniofac Surg, 2010, 21(5): 1516-1518.
[39] Worrall SF.Changes in weight and body composition after orthognathic surgery and jaw fractures: a comparison of miniplates and intermaxillary fixation[J]. Br J Oral Maxillofac Surg, 1994, 32(5): 289-292.
[40] Kau CH, Cronin AJ, Richmond S.A three-dimensional evaluation of postoperative swelling following orthognathic surgery at 6 months[J]. Plast Reconstr Surg, 2007,119(7): 2192-2199.
[41] Joss CU, Joss-Vassalli IM, Kiliaridis S, et al.Soft tissue profile changes after bilateral sagittal split osteotomy for mandibular advancement: a systematic review[J]. J Oral Maxillofac Surg, 2010, 68(6): 1260-1269.

骨性Ⅲ类错正颌手术前、后面部软、硬组织变化比率的三维研究

Three dimensional study on change ratios of hard and soft tissue after orthognathic surgery

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	陈精诚, 赵梦丽, 程志恒, 刘昕. 隐形矫治器上前牙内收过程中侧切牙不同附件设计的三维有限元分析[J]. 上海口腔医学, 2024, 33(4): 360-366.
[2]	霍美玲, 雷颖, 辛欣, 张颖, 王瑞梅. 2种矫治器对轻中度Ⅰ类错𬌗患者前牙牙根及牙槽骨的影响[J]. 上海口腔医学, 2024, 33(4): 407-410.
[3]	丁敏林, 张海亮, 张吉敏. Frankel Ⅲ型矫治器联合口唇肌训练治疗替牙期错𬌗畸形的疗效评价[J]. 上海口腔医学, 2024, 33(4): 432-437.
[4]	欧晓丽, 方志欣, 龙智灵, 罗海欧, 唐倩. 无托槽隐形矫治器内收前牙时后牙移动趋势及牙周膜应力分布[J]. 上海口腔医学, 2024, 33(3): 239-244.
[5]	王静, 孙一凡, 路茜, 庞淑婷. 微种植钉支抗与平面导板在下前牙过长型深覆矫治中的效果评价[J]. 上海口腔医学, 2024, 33(3): 301-305.
[6]	于子航, 段亦格, 崔宇彤, 田玉楼. 不同矢状骨面型均角患者宽度特征分析[J]. 上海口腔医学, 2024, 33(3): 312-317.
[7]	李爽, 肖容容, 王明锋. 偏颌患者平面横向倾斜度与颞下颌关节间隙的相关性分析[J]. 上海口腔医学, 2024, 33(3): 318-323.
[8]	刘晔, 葛晓磊, 张士珑, 覃缘, 侯彦, 卢海燕, 马文盛. 改良前方牵引矫治器治疗骨性Ⅲ类错𬌗伴拥挤的疗效评价[J]. 上海口腔医学, 2024, 33(2): 180-185.
[9]	路茜, 王静, 庞淑婷, 周建营, 冯艳芬, 卢文娟, 张倩. 正畸修复联合疗法对改善深覆伴下前牙严重磨耗患者咀嚼功能的效果评价[J]. 上海口腔医学, 2024, 33(2): 190-194.
[10]	彭源浩, 庄昕仪, 喻婷, 吕冬梅, 温秀杰, 程钎. 青少年颧牙槽嵴区皮质骨厚度的锥形束CT测量及其与颈椎骨龄的相关性研究[J]. 上海口腔医学, 2023, 32(6): 623-629.
[11]	王萌, 陶李明, 胡亚男. Twin-block联合上颌扩弓器矫治下颌后缩儿童前后舌位的改变及上气道的三维变化[J]. 上海口腔医学, 2023, 32(6): 635-639.
[12]	王静, 路茜, 周建营, 庞淑婷, 冯艳芬, 卢文娟, 张倩. 正畸修复联合治疗内倾型深覆伴重度磨耗患者的效果分析[J]. 上海口腔医学, 2023, 32(6): 656-660.
[13]	李振霞, 袁玲君, 郑小雯, 刘璐, 刘超, 房兵. 无托槽隐形和个性化舌侧矫治技术对双牙弓前突治疗效果的比较[J]. 上海口腔医学, 2023, 32(5): 480-484.
[14]	黄仲敏, 张赟, 李小兵. 替牙列早期上颌慢速扩弓对上颌中段牙及牙槽嵴的影响[J]. 上海口腔医学, 2023, 32(5): 501-507.
[15]	陈双喜, 高美琴. 隐形矫治与SGTB治疗下颌骨后退的效果比较[J]. 上海口腔医学, 2023, 32(5): 513-518.