Liebregts Jeroen, Xi Tong, Timmermans Maarten, de Koning Martien, Bergé Stefaan, Hoppenreijs Theo, Maal Thomas
Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands.
Department of Oral and Maxillofacial Surgery, Rijnstate Hospital, Wagenerlaan 55, 6815 AD, Arnhem, The Netherlands.
J Craniomaxillofac Surg. 2015 Apr;43(3):329-35. doi: 10.1016/j.jcms.2014.12.012. Epub 2014 Dec 30.
The purpose of this study was to evaluate the accuracy of an algorithm based on the mass tensor model (MTM) for computerized 3D simulation of soft-tissue changes following bimaxillary osteotomy, and to identify patient and surgery-related factors that may affect the accuracy of the simulation. Sixty patients (mean age 26.0 years) who had undergone bimaxillary osteotomy, participated in this study. Cone beam CT scans were acquired pre- and one year postoperatively. The 3D rendered pre- and postoperative scans were matched. The maxilla and mandible were segmented and aligned to the postoperative position. 3D distance maps and cephalometric analyses were used to quantify the simulation error. The mean absolute error between the 3D simulation and the actual postoperative facial profile was 0.81 ± 0.22 mm for the face as a whole. The accuracy of the simulation (average absolute error ≤2 mm) for the whole face and for the upper lip, lower lip and chin subregions were 100%, 93%, 90% and 95%, respectively. The predictability was correlated with the magnitude of the maxillary and mandibular advancement, age and V-Y closure. It was concluded that the MTM-based soft tissue simulation for bimaxillary surgery was accurate for clinical use, though patients should be informed of possible variation in the predicted lip position.
本研究的目的是评估基于质量张量模型（MTM）的算法在双颌截骨术后软组织变化的计算机三维模拟中的准确性，并确定可能影响模拟准确性的患者和手术相关因素。60例接受双颌截骨术的患者（平均年龄26.0岁）参与了本研究。在术前和术后一年获取锥形束CT扫描图像。将术前和术后的三维重建扫描图像进行匹配。对上颌骨和下颌骨进行分割并与术后位置对齐。使用三维距离图和头影测量分析来量化模拟误差。整个面部的三维模拟与实际术后面部轮廓之间的平均绝对误差为0.81±0.22毫米。整个面部以及上唇、下唇和下巴子区域的模拟准确性（平均绝对误差≤2毫米）分别为100%、93%、90%和95%。预测性与上颌和下颌前徙的幅度、年龄以及V-Y闭合有关。研究得出结论，基于MTM的双颌手术软组织模拟在临床应用中是准确的，不过应告知患者预测的唇部位置可能存在变化。
