与骨锚式上颌前牵引方案相关的软组织变化的三维评估
Three-dimensional assessment of soft tissue changes associated with bone-anchored maxillary protraction protocols.
作者信息
Elnagar Mohammed H, Elshourbagy Eman, Ghobashy Safaa, Khedr Mohamed, Kusnoto Budi, Evans Carla A
机构信息
Department of Orthodontics, Faculty of Dentistry, Tanta University, Tanta, Egypt; Department of Orthodontics, College of Dentistry, University of Illinois at Chicago, Chicago, Ill.
Department of Orthodontics, Faculty of Dentistry, Tanta University, Tanta, Egypt.
出版信息
Am J Orthod Dentofacial Orthop. 2017 Sep;152(3):336-347. doi: 10.1016/j.ajodo.2017.01.022.
INTRODUCTION
The aim of this study was to assess the 3-dimensional soft tissue changes in growing Class III patients with maxillary deficiency associated with 2 bone-anchored maxillary protraction protocols in relation to an untreated control group of Class III patients.
METHODS
Growing skeletal Class III patients between the ages of 10 and 14 years participated in this study. In group 1 (n = 10), skeletally anchored facemasks were used with miniplates placed at the zygomatic buttress. In group 2 (n = 10), the patients were treated with Class III elastics extending from infrazygomatic miniplates in the maxilla to symphyseal miniplates in the mandible. Group 3 (n = 10) was an untreated control group. Three-dimensional stereophotogrammetry images were acquired before and after treatment, and then superimposed and analyzed. In addition, lateral cephalometric radiographs were analyzed.
RESULTS
The maxilla moved forward significantly in groups 1 and 2 compared with the untreated control group (group 1, 4.87 mm; group 2, 5.81 mm). The 3-dimensional soft tissue analysis showed significant treatment effects; the major changes were observed in the upper lips, cheeks, and middle of the face, which had a significant positive sagittal displacement in both treatment groups. The lower lip and chin area showed significant negative sagittal changes that indicated that the soft tissue growth in this area was restrained with backward displacement especially in group 1 more than in group 2.
CONCLUSIONS
The 2 bone-anchored maxillary protraction protocols effectively improved the Class III concave soft tissue profile.
引言
本研究的目的是评估生长发育期的III类错颌畸形且上颌骨发育不足的患者,采用两种骨锚式上颌前牵引方案后的三维软组织变化,并与未经治疗的III类错颌畸形对照组进行比较。
方法
年龄在10至14岁之间的生长发育期骨骼III类错颌畸形患者参与了本研究。第1组(n = 10)使用骨骼锚定式面罩,微型钛板放置在颧突。第2组(n = 10)患者使用III类弹性牵引,从位于上颌的颧下微型钛板延伸至下颌的颏部微型钛板。第3组(n = 10)为未经治疗的对照组。在治疗前后采集三维立体摄影测量图像,然后进行叠加和分析。此外,还对头颅侧位X线片进行了分析。
结果
与未经治疗的对照组相比,第1组和第2组的上颌骨明显向前移动(第1组,4.87毫米;第2组,5.81毫米)。三维软组织分析显示出显著的治疗效果;主要变化出现在上唇、脸颊和面部中部,两个治疗组均出现显著的矢状位正向位移。下唇和下巴区域出现显著的矢状位负向变化,表明该区域的软组织生长受到抑制,向后移位,尤其是第1组比第2组更明显。
结论
两种骨锚式上颌前牵引方案有效地改善了III类错颌畸形的凹面软组织轮廓。