Department of Orthodontics, School of Dental Medicine, University of Geneva, Geneva, Switzerland.
Eur J Orthod. 2010 Aug;32(4):395-402. doi: 10.1093/ejo/cjp104. Epub 2009 Nov 9.
The objectives of this study were to evaluate the assessments of maxillofacial surgeons, orthodontists, and laypersons on the predicted aesthetic outcome of various surgical options in Class III correction and the associations between certain initial cephalometric values and the judges' preferred option. Pre-surgical lateral headfilms and coloured profile photographs of 18 skeletal Class III Caucasian adult patients (10 males and 8 females) with a mean age of 24.5 years were used. The headfilms were hand traced and digitized. Conventional cephalometric analysis was performed. Computerized predictions of three surgical options, mandibular setback, Le Fort I advancement, and bimaxillary surgery, were made. For each case, the pre-surgical profile photograph with the three predictions was presented on a printed page. The questionnaire was sent to 51 maxillofacial surgeons (response rate 45.1 per cent), 78 orthodontists (response rate 71.8 per cent), and 61 laypersons (response rate 100 per cent) to aesthetically evaluate the pre-surgical photographs and the surgical predictions by placing a mark along a 10-graded visual analogue scale (VAS) using a standard profile for calibration. Confidence interval was calculated for each patient. An independent samples t-test was used to detect initial cephalometric values associated with the judges' preferred option and analysis of variance/Tukey's honestly significant differences to evaluate differences between judges. Intra-observer reliability was assessed with a paired t-test. All treatment predictions led to improved scoring of facial aesthetics with the exception of the setback option for three patients. For 14 patients, general agreement for the preferred option existed between the three groups of judges. Laypersons tended to give lower improvement scores than professionals. Overjet, nasofacial, and nasomental angles were important in decision making between the mandibular setback and Le Fort I options (the more negative the overjet, the larger the nasofacial angle, the smaller the nasomental angle, the greater the preference for the Le Fort I option). Wits appraisal seemed to be important in decision making between the mandibular setback and bimaxillary options (the more negative the Wits appraisal, the greater the preference for the latter option).
本研究的目的是评估颌面外科医生、正畸医生和非专业人士对三类矫正中各种手术选择的预测美学效果的评估，以及某些初始头影测量值与评判者首选方案之间的关系。使用了 18 名高加索成年人骨骼 III 类患者（10 名男性和 8 名女性）的术前侧头影和彩色侧面照片，平均年龄为 24.5 岁。对头影进行了手工追踪和数字化。进行了常规头影测量分析。对三种手术选择（下颌后退、Le Fort I 前徙和双颌手术）进行了计算机预测。对于每个病例，术前侧位片和三种预测结果的术前侧位片都打印在一页纸上。问卷寄给了 51 名颌面外科医生（回复率为 45.1%）、78 名正畸医生（回复率为 71.8%）和 61 名非专业人士（回复率为 100%），让他们通过在标准侧面图上使用 10 级视觉模拟量表（VAS）对术前照片和手术预测进行美学评估，并用一个标记进行标记。为每个患者计算置信区间。使用独立样本 t 检验检测与评判者首选方案相关的初始头影测量值，并使用方差分析/Tukey 的诚实显著差异检验评估评判者之间的差异。采用配对 t 检验评估观察者内可靠性。所有治疗预测都导致面部美学评分的改善，除了三名患者的后退选择。对于 14 名患者，三组评判者对首选方案存在普遍共识。非专业人士的改善评分低于专业人士。上前牙突距、面鼻角和鼻颏角对面部后退和 Le Fort I 选择之间的决策很重要（上前牙突距越负，面鼻角越大，鼻颏角越小，对 Le Fort I 选择的偏好越大）。Wits 评价似乎在下颌后退和双颌手术选择之间的决策中很重要（Wits 评价越负，对后者的偏好越大）。
