Soncul Murat, Bamber Mohammad Anwar
Department of Oral and Maxillofacial Surgery, Eastman Dental Institute, University College London, England.
J Oral Maxillofac Surg. 2004 Nov;62(11):1331-40. doi: 10.1016/j.joms.2004.04.019.
To evaluate the soft tissue changes after correction of Class III dentoskeletal deformity with orthognathic surgery using the optical surface scanner as a 3-dimensional imaging tool and thin-plate splines as a morphometric analysis.
Forty-six patients with Class III dentoskeletal relationship who underwent a bimaxillary orthognathic surgical procedure involving advancement of the maxilla and mandibular setback to correct the deformity and create a Class I dentoskeletal relationship were included. Optical surface scans (lasergraphs) were obtained from all patients preoperatively and 6 months postoperatively. They were evaluated for the soft tissue changes 3-dimensionally and on the profile line. The cephalographs taken pre- and postoperatively were digitized and evaluated using the CogSoft digitizing software (Consultant Orthodontists Group Software, Bristol, United Kingdom) to confirm whether the preoperative surgical plan was applied.
The soft tissue change in different areas of the face ranged from 30% on the nasal tip to 80% on subnasale and from 50% on subcomissural region corresponding to lateral parts of the mandibular body to 100% on the pogonion. The direction of soft tissue movement was not solely forwards and backwards on a horizontal plane but had upward and downward vectors.
The soft tissue changes following orthognathic surgery depend on various factors; hence it can be difficult to predict. However, there is a general trend as discussed in this study for the direction and amounts of facial soft tissue changes in the middle and lower facial thirds.
使用光学表面扫描仪作为三维成像工具，薄板样条作为形态计量分析方法，评估正颌手术矫正III类牙颌面畸形后的软组织变化。
纳入46例III类牙颌面关系患者，他们接受了双颌正颌手术，包括上颌前徙和下颌后退以矫正畸形并建立I类牙颌面关系。术前及术后6个月对所有患者进行光学表面扫描（激光扫描）。对软组织变化进行三维及轮廓线评估。术前和术后拍摄的头颅侧位片经数字化处理，并使用CogSoft数字化软件（英国布里斯托尔正畸顾问组软件）进行评估，以确认术前手术方案是否得以实施。
面部不同区域的软组织变化范围为：鼻尖处为30%，鼻下点处为80%，对应下颌体外侧部分的口周区域为50%，颏前点处为100%。软组织移动方向并非仅在水平面上前后移动，还存在上下向量。
正颌手术后的软组织变化取决于多种因素，因此难以预测。然而，本研究讨论了面中下部面部软组织变化方向和量的一般趋势。
