Case School of Dental Medicine, Cleveland, Ohio, USA.
Angle Orthod. 2011 Nov;81(6):988-93. doi: 10.2319/112210-681.1. Epub 2011 Jun 7.
To examine and compare the maxillofacial characteristics affecting chin deviation three-dimensionally in facial asymmetry patients with mandibular retrusion and mandibular prognathism.
Maxillofacial computed tomography (CT) scan data were obtained from 48 orthognathic surgery patients (24 cases of mandibular retrusion and 24 cases of mandibular prognathism) with facial asymmetry. Although chin deviation was assessed on the basis of the ANS-to-menton line on frontal cephalograms, its contributing factors were evaluated on three-dimensional CT images. Maxillary height, ramus length, frontal ramal inclination, lateral ramal inclination, mandibular body length, and body height were defined on each side, and right-left differences were calculated and analyzed.
In an assessment of chin deviation, subjects in this study showed predominantly left side deviation regardless of the group, and the degree of menton deviation did not reveal significant differences between groups. In a comparison of right-left differences in contributing factors, all values were noted to be greater in the retrusion group, except for body height, which showed no difference between chin-deviated and contralateral sides. In particular, ramus length presented a statistically significant difference between the two groups.
Based on the same degree of chin deviation in mandibular prognathism and retrusion in this study, results of right-left differences in contributing factors indicate that chin deviations are expressed easily in mandibular prognathism, whereas they occur only with significant right-left differences in relevant maxillofacial structures in individuals with mandibular retrusion.
研究并比较下颌后缩和下颌前突的面部不对称患者中影响颏部偏斜的三维颌面特征。
从 48 例接受正颌手术的面部不对称患者(24 例下颌后缩,24 例下颌前突)中获取颌面计算机断层扫描(CT)数据。尽管颏部偏斜是基于侧位头颅定位片的 ANS 至颏下连线来评估的,但在三维 CT 图像上评估了其影响因素。在每一侧定义了上颌高度、下颌升支长度、前升支倾斜度、侧升支倾斜度、下颌体长度和体高度,并计算和分析了左右差异。
在评估颏部偏斜时,无论组别如何,本研究的受试者均表现为明显的左侧偏斜,且颏部偏斜程度在组间无显著差异。在比较影响因素的左右差异时,除了下颌体高度,所有值在后退组中均较大,而在颏部偏斜侧和对侧之间无差异。特别是下颌升支长度在两组之间存在统计学差异。
在本研究中,下颌前突和后退的颏部偏斜程度相同的情况下,影响因素的左右差异结果表明,下颌前突容易表现出颏部偏斜,而下颌后缩的患者只有在相关颌面结构存在明显的左右差异时才会出现。