Yuan Lingjun, Shen Guofang, Wu Yong, Jiang Lingyong, Yang Zhi, Liu Jiaqiang, Mao Lixia, Fang Bing
Center of Craniofacial Orthodontics, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, PR China.
J Craniofac Surg. 2013 May;24(3):725-30. doi: 10.1097/SCS.0b013e31828010a9.
The objective of this study was to evaluate changes in soft tissue in full-face view because of surgical correction of skeletal Class III malocclusion, using 3-dimensional (3D) laser scanning.
Twenty-seven subjects with skeletal Class III malocclusion [11 males; mean age (SD), 24.0 (5.7) years] underwent bilateral sagittal split ramus osteotomy for mandibular setback combined with Lefort I osteotomy with/without maxillary advancement. Twelve patients (group 1) had mandibular setback surgery, and the other 15 (group 2) had combination surgery. Lateral cephalograms and 3D facial scan images were assessed preoperatively and postoperatively. The facial widths upon superimposition of 3D facial images were measured in the same coordinates using a Rapidform 2006 system. Paired and independent t tests were done for statistical analysis.
The midface soft tissue broadened significantly above the cheilion plane postoperatively (P < 0.05). A larger change was observed nearer to subnasale plane, and a similar trend was seen among the horizontal planes in 1- or 2-jaw surgery groups. The widths from the exocanthion plane to the subnasale plane increased more in group 2 [mean (SD), 4.45 (2.45) mm, 8.71 (2.92) mm, and 7.62 (3.13) mm] than those in group 1 [mean (SD), 1.26 (0.97) mm, 1.84 (1.06) mm, and 1.35 (0.65) mm], and this difference was significant (P < 0.05). There was a decrease below the cheilion plane with mandibular setback between groups, but this difference was not significant.
The measurement method used here for the shape outline of the lateral parts of the face could provide quantitative data for the clinical evaluation and objective analysis of the human face in full-face view. The midface soft tissue in subjects with skeletal Class III malocclusion exhibited a greater increase in width after bimaxillary surgery procedures than mandibular setback-only surgery.
本研究的目的是使用三维（3D）激光扫描评估骨骼Ⅲ类错牙合畸形手术矫正后全脸软组织的变化。
27例骨骼Ⅲ类错牙合畸形患者[11例男性；平均年龄（标准差），24.0（5.7）岁]接受双侧矢状劈开下颌升支截骨术以后退下颌，联合LeFort I截骨术，上颌或有或无前移。12例患者（1组）接受下颌后退手术，另外15例（2组）接受联合手术。术前和术后评估头颅侧位片和3D面部扫描图像。使用Rapidform 2006系统在相同坐标下测量3D面部图像叠加后的面部宽度。进行配对和独立t检验以进行统计分析。
术后人中平面上方的中面部软组织明显变宽（P < 0.05）。在鼻下平面附近观察到更大的变化，单颌或双颌手术组的水平面中也观察到类似趋势。2组从外眦平面到鼻下平面的宽度增加量[平均（标准差），4.45（2.45）mm、8.71（2.92）mm和7.62（3.13）mm]大于1组[平均（标准差），1.26（0.97）mm、1.84（1.06）mm和1.35（0.65）mm]，且差异有统计学意义（P < 0.05）。两组之间下颌后退时人中平面下方有减小，但差异无统计学意义。
这里使用的面部侧面形状轮廓测量方法可为全脸人面部的临床评估和客观分析提供定量数据。骨骼Ⅲ类错牙合畸形患者的中面部软组织在双颌手术比仅下颌后退手术后宽度增加更大。
