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影响骨性II类患者下颌不对称的颅面特征。

Craniofacial features affecting mandibular asymmetries in skeletal Class II patients.

作者信息

Thiesen Guilherme, Gribel B F, Freitas M P M, Oliver D R, Kim K B

机构信息

Department of Orthodontics, University of Southern Santa Catarina, Av. Madre Benvenuta, 1285 Santa Monica, 88035-001, Florianopolis, SC, Brazil.

Department of Orthodontics, Saint Louis University, St. Louis, MO, USA.

出版信息

J Orofac Orthop. 2017 Sep;78(5):437-445. doi: 10.1007/s00056-017-0100-6. Epub 2017 Jun 30.

Abstract

OBJECTIVES

The aim of this study was to evaluate the characteristics affecting different intensities of mandibular asymmetry in skeletal Class II adults using three-dimensional images. This study is clinically relevant since it allows professionals to evaluate the morphological components related to these deformities and more carefully obtain correct diagnosis and treatment plan for such patients.

METHODS

Cone-beam computed tomography data of 120 Class II patients (40 with relative symmetry, 40 with moderate asymmetry, and 40 with severe asymmetry) were imported to SimPlant Ortho Pro 2.0 software (Dental Materialise, Leuven, Belgium). Three reference planes were established and linear measurements were performed from specific landmarks to these planes, comparing the deviated side and the contralateral side in each group, as well as the differences between groups. The correlation between midline mandibular asymmetry and other variables was also evaluated. Statistical analyses considered a significance level of 5%.

RESULTS

Comparing the values obtained on the deviated side and on the contralateral side, there were significant differences for patients with moderate asymmetry and severe asymmetry. However, differences were seen more often in severe mandibular asymmetries. In those patients, there was a significant correlation of the gnathion deviation with lower dental midline deviation, difference in the lateral gonion positions, difference in the mandibular rami heights, and difference in the jugale vertical displacements.

CONCLUSIONS

For skeletal Class II patients with mandibular asymmetry, some craniofacial features are related to chin deviation and require proper evaluation, including the bilateral differences in the ramus height, mandibular body length, transverse and vertical positioning of the gonion and jugale points.

摘要

目的

本研究旨在利用三维图像评估影响骨骼Ⅱ类成年患者下颌不对称不同程度的特征。这项研究具有临床相关性,因为它能让专业人员评估与这些畸形相关的形态学组成部分,并更仔细地为这类患者获得正确的诊断和治疗方案。

方法

将120例Ⅱ类患者(40例相对对称、40例中度不对称、40例重度不对称)的锥形束计算机断层扫描数据导入SimPlant Ortho Pro 2.0软件(比利时鲁汶Materialise牙科公司)。建立三个参考平面,并从特定标志点向这些平面进行线性测量,比较每组中患侧和对侧,以及组间差异。还评估了下颌中线不对称与其他变量之间的相关性。统计分析的显著性水平为5%。

结果

比较患侧和对侧获得的值,中度不对称和重度不对称患者存在显著差异。然而,差异在严重下颌不对称中更常见。在这些患者中,颏点偏移与下牙中线偏移、外侧角点位置差异、下颌升支高度差异和颧突垂直位移差异之间存在显著相关性。

结论

对于下颌不对称的骨骼Ⅱ类患者,一些颅面特征与颏部偏移有关,需要进行适当评估,包括升支高度、下颌体长、角点和颧突点的横向和垂直定位的双侧差异。

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