Ohba Seigo, Kohara Haruka, Koga Takamitsu, Kawasaki Takako, Miura Kei-Ichirou, Yoshida Noriaki, Asahina Izumi
Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan.
Department of Orthodontics and Dentofacial Orthopedics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan.
Odontology. 2017 Jul;105(3):375-381. doi: 10.1007/s10266-016-0280-3. Epub 2016 Oct 31.
The soft tissue profile is crucial to esthetics after orthognathic surgery. The aim of this study was to assess the soft tissue changes of the subnasal and submental regions more than 1 year after a sagittal split ramus osteotomy (SSRO) in patients with skeletal class III malocclusion. A total of 22 patients with mandibular prognathism were included in this study. Patients had lateral cephalograms before and more than 1 year after they underwent an isolated SSRO. Soft and hard tissue changes were assessed using the lateral cephalograms. The lower lip, labiomenton, and soft tissue menton moved posteriorly by 85, 89, and 88% compared with the corresponding hard tissue, and the movement of the soft tissue B point and the top of the chin nearly reflected the displacement of the hard tissues, at 96 and 99%, respectively. The labiomenton, stomions, and naso-labial angles were changed after the mandibular set-back and the changes in these angles correlated with either the width of the soft tissue or skeletal displacement. The naso-labial angle could be altered even if an isolated mandibular osteotomy is performed. Changes to the stomions and naso-labial angles were affected by hard tissue movement, while changes to the labiomental angle were affected by the width of the soft tissue after the mandibular osteotomy. It is important to create an accurate preoperative prediction of the esthetic outcomes after a mandibular osteotomy by considering the interrelations between the hard and soft tissues.
正颌外科手术后，软组织侧貌对美观至关重要。本研究的目的是评估III类骨性错牙合患者在矢状劈开下颌升支截骨术（SSRO）后1年以上鼻下和颏下区域的软组织变化。本研究共纳入22例下颌前突患者。患者在接受单纯SSRO术前和术后1年以上拍摄了头颅侧位片。利用头颅侧位片评估软硬组织变化。下唇、唇颏沟和软组织颏点相对于相应硬组织分别向后移动了85%、89%和88%，软组织B点和下巴顶部的移动分别以96%和99%的比例几乎反映了硬组织的移位。下颌后缩后唇颏沟、口角和鼻唇角发生了变化，这些角度的变化与软组织宽度或骨骼移位相关。即使进行单纯下颌截骨术，鼻唇角也可能改变。下颌截骨术后，口角和鼻唇角的变化受硬组织移动的影响，而唇颏角的变化受软组织宽度的影响。通过考虑软硬组织之间的相互关系，对下颌截骨术后的美学效果进行准确的术前预测很重要。
