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下颌前伸术后软组织变化的研究——171 例连续患者的人体测量评估。

Soft tissue outcome after mandibular advancement--an anthropometric evaluation of 171 consecutive patients.

机构信息

Department of Cranio-Maxillofacial & Plastic Surgery, Friedrich Schiller University Jena, Erlanger Allee 101, Jena, Germany.

出版信息

Clin Oral Investig. 2013 Jun;17(5):1415-23. doi: 10.1007/s00784-012-0821-2. Epub 2012 Aug 15.

Abstract

OBJECTIVES

There is an ongoing discussion in the literature about preoperative planning and postoperative evaluation of orthognathic surgery and its impact on facial appearance and aesthetics.

MATERIALS AND METHODS

We present an anthropometric and cephalometric evaluation of orthognathic surgery results based on reference anthropometric data. In 171 Class II patients, mandibular advancement by bilateral sagittal split osteotomy was performed. Preoperative as well as 3 and 9 months postoperative standardized frontal view and profile photographs and lateral cephalograms were evaluated in a standardized manner by use of 21 anthropometric indices. In cephalograms, SNA and SNB angle as well as Wits appraisal were investigated. Results of anthropometric and cephalometric measurements were correlated.

RESULTS

Lower vermilion contour, vermilion and cutaneous total lower lip height, nose-lower face height, nose-face height, upper face-face height, upper lip- and chin-mandible height index showed significant pre- to postoperative changes as well as SNB angle and Wits appraisal. Furthermore, medial-lateral cutaneous upper lip height, vermilion and cutaneous total lower lip height and philtrum-mouth width index presented significant correlations to cephalometric measurements.

CONCLUSIONS

The investigated anthropometric indices and cephalometric measurements presented reproducible results related to surgery. The correlation of cephalometric to anthropometric measurements has been proven useful for preoperative planning and postoperative evaluation of orthognathic surgery patients.

CLINICAL RELEVANCE

The presented anthropometric measurements and their observed correlation to cephalometric measurements could lead to a better prediction and optimized planning of the soft tissue result in orthognathic surgery patients and thereby improve the aesthetic outcome.

摘要

目的

文献中正在讨论正颌手术的术前规划和术后评估及其对面部外观和美学的影响。

材料和方法

我们根据参考人体测量学数据对正颌手术结果进行了人体测量学和头影测量学评估。在 171 例 II 类错颌畸形患者中,采用双侧矢状劈开截骨术进行下颌前突。通过使用 21 个人体测量指标,对术前以及术后 3 个月和 9 个月的标准正面和侧位照片和头颅侧位片进行了标准化评估。在头颅侧位片中,研究了 SNA 和 SNB 角以及 Wits 评价。对人体测量和头影测量测量结果进行了相关性分析。

结果

下唇轮廓、唇红和皮肤总下唇高度、鼻下颜面高度、鼻面高度、上面部-面高度、上唇-下颌高度指数在术前到术后均有显著变化,SNB 角和 Wits 评价也有显著变化。此外,上唇正中-外侧皮肤高度、唇红和皮肤总下唇高度以及人中-口裂宽度指数与头影测量呈显著相关性。

结论

所研究的人体测量学指标和头影测量学测量结果与手术具有可重复性。头影测量与人体测量学测量的相关性已被证明对正颌手术患者的术前规划和术后评估有用。

临床意义

所提出的人体测量学测量及其与头影测量学测量的观察相关性可以更好地预测和优化正颌手术患者的软组织结果,从而提高美学效果。

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