骨性Ⅲ类错牙合的三维CT头影测量分析(1)
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[摘要]目的：观察骨性安氏Ⅲ类偏牙合的成人女性患者接受正颌手术后硬组织的三维改变。方法：5例接受外科手术(上颌Lefort1型截骨术+双侧下颌升支矢状劈开切骨术+颏部成形术)的成人女性骨性安氏Ⅲ类患者，分别在术前1个月(T0)和术后6个月(T1)接受3DCT扫描。在CT后处理工作站中实现三维模型重建，并进行标记点的确定和变量的测量以完成三维头影测量分析。结果：所有患者的下颌前突均得到显著纠正。不仅偏颌得到改善(Pg-dev)，而且牙合平面的偏斜也得到矫正(Ore/OP)。硬组织的改变在前后向(SNA,ANB)、垂直向(Ans-Me，MP/SN)和水平向(Gc-Gc',Go-Na-Go')方面均有显著改变。结论：①骨性Ⅲ类偏牙合患者手术前后，硬组织在三维分析中的各个方面均有明显改变；②与传统的二维头影测量分析相比，三维头影测量分析可以更加全面的反映出颅颌面部的特征，具有较大的临床意义。
[关键词]骨性Ⅲ类；偏牙合；三维重建；头影测量分析
[中图分类号]R783.5 [文献标识码]A [文章编号]1008-6455(2011)07-1146-04
3-Dimensional cephalomentry analysis of skeletal Class III malocclusion
WU Fei,ZHANG Miao-miao
(Department of Orthododontics,School of Stomatology,Harbin Medcal University,Harbin 150001,Heilongjiang,China)
Abstract:ObjectiveTo investigate the 3-dimensional (3D) changes in the hard tissues of skeletal class III malocclusion(CIII) patients with facial asymmetry by orthognathic surgery. Methods Five female adult CIII patients treated with orthognathic surgery (Bilateral Sagittal Split Ramus Osteotomy+Maxillary Osteotomy Lefort1+Genioplasty) who had 3D computerized tomography taken 1 month before (T0) and 6 months after (T1) MSS.Reconstruct three-dimensional models in CT post-processing workstation.The landmarks and variables were measured to complete 3-dimensional cephalomentry analysis. Results Mandibular prognathism of all the patients was significantly corrected.Facial asymmetry and lean of the occlusion plane was significantly corrected too(Pg-dev, Gc-Gc',Go-Na-Go').There were significant changes in hard tissue related in the,anteroposterior(SNA,ANB),vertical(Ans-Me，MP/SN) and horizontal(Gc-Gc',Go-Na-Go') direction. Conclusion ①There were significant changes in the hard tissues of skeletal class III malocclusion(CIII) patients with facial asymmetry by orthognathic surgery.②The three-dimensional cephalomentry analysis indicated a more comprehensive characteristic of Craniofacial,compared with traditional cephalomentry analysis.
Key words:skeletal class III malocclusion;facial asymmetry;3-dimensional reconstruction;cephalomentry analysis
骨性安氏Ⅲ类错牙合畸形是口腔正畸临床上较为常见的复杂畸形，大多数病例被列为正颌外科的手术适应证，常规手术治疗的步骤为术前正畸-手术治疗-术后正畸 ......
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