Kang Sang-Hoon, Kim Moon-Key, Park Sun-Yeon, Lee Ji-Yeon, Park Wonse, Lee Sang-Hwy
Department of Oral and Maxillofacial Surgery, National Health Insurance Corporation Ilsan Hospital, Goyang-si, Gyeonggi-do, Korea.
J Craniofac Surg. 2011 Mar;22(2):473-81. doi: 10.1097/SCS.0b013e318207b95c.
To correct dentofacial deformities, three-dimensional skeletal analysis and computerized orthognathic surgery simulation are used to facilitate accurate diagnoses and surgical plans. Computed tomography imaging of dental occlusion can inform three-dimensional facial analyses and orthognathic surgical simulations. Furthermore, three-dimensional laser scans of a cast model of the predetermined postoperative dental occlusion can be used to increase the accuracy of the preoperative surgical simulation. In this study, we prepared cast models of planned postoperative dental occlusions from 12 patients diagnosed with skeletal class III malocclusions with mandibular prognathism and facial asymmetry that had planned to undergo bimaxillary orthognathic surgery during preoperative orthodontic treatment. The data from three-dimensional laser scans of the cast models were used in three-dimensional surgical simulations. Early orthognathic surgeries were performed based on three-dimensional image simulations using the cast images in several presurgical orthodontic states in which teeth alignment, leveling, and space closure were incomplete. After postoperative orthodontic treatments, intraoral examinations revealed that no patient had a posterior open bite or space. The two-dimensional and three-dimensional skeletal analyses showed that no mandibular deviations occurred between the immediate and final postoperative states of orthodontic treatment. These results showed that early orthognathic surgery with three-dimensional computerized simulations based on cast models of predetermined postoperative dental occlusions could provide early correction of facial deformities and improved efficacy of preoperative orthodontic treatment. This approach can reduce the decompensation treatment period of the presurgical orthodontics and contribute to efficient postoperative orthodontic treatments.
为了矫正牙颌面畸形，采用三维骨骼分析和计算机化正颌外科手术模拟来促进准确的诊断和手术方案制定。牙合的计算机断层扫描成像可为三维面部分析和正颌外科手术模拟提供信息。此外，对预定术后牙合的石膏模型进行三维激光扫描可用于提高术前手术模拟的准确性。在本研究中，我们为12例被诊断为伴有下颌前突和面部不对称的骨性III类错牙合畸形患者制备了计划术后牙合的石膏模型，这些患者计划在术前正畸治疗期间接受双颌正颌手术。石膏模型的三维激光扫描数据用于三维手术模拟。在牙齿排齐、整平及间隙关闭不完全的几种术前正畸状态下，基于石膏图像的三维图像模拟进行早期正颌手术。术后正畸治疗后，口腔检查显示没有患者出现后牙开合或间隙。二维和三维骨骼分析表明，正畸治疗的术后即刻与最终状态之间未出现下颌偏斜。这些结果表明，基于预定术后牙合石膏模型的三维计算机模拟早期正颌手术可早期矫正面部畸形并提高术前正畸治疗的效果。这种方法可以缩短术前正畸的去代偿治疗期，并有助于高效的术后正畸治疗。
