上海口腔医学

上海口腔医学 ›› 2023, Vol. 32 ›› Issue (4): 380-384.doi: 10.19439/j.sjos.2023.04.008

• 论著 • 上一篇    下一篇

双颌同期颏成形与单纯颏成形术后稳定性的三维测量分析

张晨1,2,*, 王宏伟2,*, 李彪2, 曹健2, 王兴1#, 王旭东2#   

  1. 1.山西医科大学口腔医学院·口腔医院,山西 太原 030001;
    2.上海交通大学医学院附属第九人民医院 口腔颅颌面科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011
  • 收稿日期:2022-04-10 修回日期:2022-05-15 发布日期:2023-09-07
  • 通讯作者: 王旭东,E-mail：xudongwang70@hotmail.com;王兴,E-mail：kqwx100@163.com。#共同通信作者
  • 作者简介:张晨（1994-）,男,硕士,住院医师,E-mail：zhangchen_1994@163.com;王宏伟（1988-）,女,硕士,住院医师,E-mail：118019@sh9hospital.org.cn。*并列第一作者
  • 基金资助:
    国家自然科学基金（82071096）; 上海“科技创新行动”项目（20XD1433100）; 上海交通大学“交大之星”计划医工交叉研究基金（YG2022ZD014）

Three-dimensional comparative study on the stability of bimaxillary simultaneous genioplasty and simple genioplasty

ZHANG Chen1,2, WANG Hong-wei2, LI Biao2, CAO Jian2, WANG Xing1, WANG Xu-dong2   

  1. 1. Shanxi Medical University, School and Hospital of Stomatology. Taiyuan 030001, Shanxi Province;
    2. Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology. Shanghai 200011, China
  • Received:2022-04-10 Revised:2022-05-15 Published:2023-09-07

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摘要： 目的 通过建立三维测量分析方法,探讨双颌同期颏成形与单纯颏成形术后稳定性是否存在差异。方法 选择接受水平截骨颏成形前移治疗的患者60例,其中单纯颏成形术30例,双颌同期颏成形术30例。收集患者术前2个月（T0）、术后7天（T1）及术后12个月（T2）的全头颅螺旋CT数据,并重建及分离,得到上、下颌骨三维模型。使用3D模型体配准法建立颏部稳定性三维分析方法,分析2组患者颏部骨块术后12个月在三维空间内的复发情况。采用SPSS 26.0软件包对数据进行统计学分析。结果 单纯颏成形组颏部骨块最大平移复发量为矢状向向后复发（0.54±0.38） mm,矢状向复发率为12.27%;双颌同期颏成形组为（0.60±0.31） mm,矢状向复发率为12.96%。术后12个月,2组患者均出现以左右向为轴的旋转,单纯颏成形组为 1.98°±2.70°,双颌同期颏成形组为 1.01°±1.61°（P<0.05）。2组颏部矢状向移动量无统计学差异,矢状向复发量亦无统计学差异（P>0.05）。结论 本研究建立的评价方法能在三维空间对颏部骨块的复发情况进行直观、全面的测量分析。颏成形术后复发主要出现在矢状向,双颌同期接受颏成形术不会增加颏部复发风险。

关键词: 颏成形术, 颏部畸形, 稳定性, 正颌手术

Abstract: PURPOSE: To establish a three-dimensional method to evaluate whether there is a difference in stability between bimaxillary simultaneous genioplasty and simple genioplasty. METHODS: This study was a retrospective study. Sixty patients who underwent genioplasty were selected. They were divided into bimaxillary simultaneous genioplasty group (n=30) and simple genioplasty group (n=30). The spiral CT data of patients at 2 months before operation (T0), 7 days after operation (T1) and 12 months after operation (T2) were collected, reconstructed and separated, and the three-dimensional model of maxilla and mandible was obtained. A three-dimensional analysis method of stability was established by 3D-matching. Recurrences in three-dimensional space 12 months after surgery were analyzed in two groups of patients. Statistical analysis of the data was performed with SPSS 26.0 software package. RESULTS: In simple genioplasty, the maximum amount of the chin recurrence was sagittal backward recurrence (0.54±0.38) mm, and the sagittal recurrence rate was 12.27%. In bimaxillary simultaneous genioplasty, the maximum amount of the chin recurrence was sagittal backward recurrence (0.60±0.31) mm, and the sagittal recurrence rate was 12.96%. Rotation occurred in both groups 12 months after operation, which was 1.98±2.70° in the simple genioplasty group and 1.01±1.61° in the bimaxillary simultaneous genioplasty group(P<0.05). There was no significant difference in the sagittal movement of the chin between the two groups, and in the sagittal recurrence(P>0.05). CONCLUSIONS: The three-dimensional method established in this study can be used to evaluate the stability after genioplasty. The recurrence after genioplasty mainly occurred in the sagittal direction. The rotation trend of chin after genioplasty is worthy of attention. There was no increased risk for bimaxillary simultaneous genioplasty.

Key words: Genioplasty, Chin deformity, Stability, Orthognathic surgery

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