Conley R Scott, Boyd Scott B
Division of Orthodontics, Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI 48109-1078, USA.
J Oral Maxillofac Surg. 2007 Jul;65(7):1332-40. doi: 10.1016/j.joms.2006.09.026.
The goal of this retrospective study was to evaluate the horizontal and vertical facial soft tissue changes occurring after maxillomandibular advancement (MMA) surgery to treat obstructive sleep apnea (OSA).
The study group comprised 31 consecutive adult patients with OSA who underwent MMA through Le Fort I osteotomy and bilateral sagittal split ramus osteotomies. Adjunctive maxillary procedures, consisting of piriformplasty, anterior nasal spine recontouring, alar base cinch, and V-Y closure of the upper lip, were used for all patients. A "best-fit" templating cephalometric technique was used to assess dentoskeletal movements and corresponding soft tissue changes.
Maxillary movements (measured at point A) averaged 8.77 +/- 2.34 mm horizontally and 2.20 +/- 2.42 mm vertically. Mandibular movements (measured at point B) averaged 11.16 +/- 2.56 mm horizontally and 2.25 +/- 3.02 mm vertically. The horizontal upper lip soft tissue-to-hard tissue ratios averaged >0.90:1 (SLS/A, 0.97:1; Ls/U1fac, 0.96:1; Stm(s)/ls, 0.86:1). Upper lip length (Sn-Ls) increased by a clinically insignificant amount (0.37 mm). The nasolabial complex rotated in a counterclockwise rotation, with the nasolabial angle decreasing (3.87 degrees) due primarily to forward movement of the upper lip. Horizontal lower lip and chin soft tissue-to-hard tissue ratios averaged >0.90:1 (Stm(i)/li, 0.90:1; Li/Ii, 0.89:1; Pg'/Pg, 0.92:1; Me'/Me, 0.91:1).
This study demonstrated that MMA in this selected group of OSA patients results in soft tissue movements producing a soft tissue-to-hard tissue ratio of about 0.90:1 for most anatomic sites of the upper lip, lower lip, and chin.
本回顾性研究的目的是评估上颌下颌前移（MMA）手术治疗阻塞性睡眠呼吸暂停（OSA）后发生的面部软组织水平和垂直变化。
研究组包括31例连续的成年OSA患者，他们通过Le Fort I截骨术和双侧矢状劈开下颌支截骨术接受了MMA手术。所有患者均采用辅助上颌手术，包括梨状孔成形术、前鼻棘重塑、鼻翼基底收紧和上唇V-Y闭合。采用“最佳拟合”模板头影测量技术评估牙颌面运动及相应的软组织变化。
上颌运动（在A点测量）水平平均为8.77±2.34mm，垂直平均为2.20±2.42mm。下颌运动（在B点测量）水平平均为11.16±2.56mm，垂直平均为2.25±3.02mm。上唇软组织与硬组织的水平比值平均>0.90:1（SLS/A，0.97:1；Ls/U1fac，0.96:1；Stm(s)/ls，0.86:1）。上唇长度（Sn-Ls）增加量在临床上无显著意义（0.37mm）。鼻唇复合体逆时针旋转，鼻唇角减小（3.87度），主要是由于上唇向前移动。下唇和颏部软组织与硬组织的水平比值平均>0.90:1（Stm(i)/li，0.90:1；Li/Ii，0.89:1；Pg'/Pg，0.92:1；Me'/Me，0.91:1）。
本研究表明，在这组选定的OSA患者中，MMA导致软组织运动，在上唇、下唇和颏部的大多数解剖部位产生的软组织与硬组织比值约为0.90:1。
