Udomlarptham N, Lin C-H, Wang Y-C, Ko E W-C
Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan.
Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan; Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Craniofacial Research Centre, Chang Gung Memorial Hospital, Linkou, Taiwan.
Int J Oral Maxillofac Surg. 2018 Aug;47(8):1022-1031. doi: 10.1016/j.ijom.2018.02.014. Epub 2018 Mar 30.
The aim of this study was to compare the outcomes of traditional two-dimensional planning (2DP) and three-dimensional surgical simulation (3DS) in the surgical correction of skeletal class III with facial asymmetry. This retrospective cohort study included 37 consecutive adult Taiwanese patients. Preoperative and postoperative three-dimensional cephalometric measurements were obtained from cone beam computed tomography scans. The outcome variables were the differences in preoperative and postoperative linear and angular measurements and the differences between the two groups after surgery. When the surgical result was compared between the 2DP and 3DS groups, significant differences were found for four cephalometric variables: the distance from gonion on the non-deviated side to the midsagittal plane (MSP), mid-gonion to the MSP, upper first molar on the non-deviated side to the Frankfort horizontal plane, and the yaw angle. In the 3DS group, mandibular symmetry was achieved because the centre between the bilateral gonions was improved, and because there was no significant difference in the horizontal gonion (Go to the MSP) between the deviated and non-deviated sides after surgery. 3DS provides all the necessary information for planned surgical movements for the correction of facial asymmetry; it should be considered during surgical planning to improve surgical outcomes, particularly the achievement of bilateral mandibular contour symmetry.
本研究的目的是比较传统二维规划（2DP）和三维手术模拟（3DS）在矫治伴有面部不对称的骨性III类错颌畸形中的效果。这项回顾性队列研究纳入了37例连续的成年台湾患者。术前和术后的三维头影测量数据来自锥形束计算机断层扫描。结果变量包括术前和术后线性及角度测量的差异以及两组术后的差异。当比较2DP组和3DS组的手术结果时，发现四个头影测量变量存在显著差异：非偏斜侧下颌角点到正中矢状面（MSP）的距离、下颌角中点到MSP的距离、非偏斜侧上颌第一磨牙到法兰克福水平面的距离以及偏航角。在3DS组中，实现了下颌对称性，这是因为双侧下颌角点之间的中心位置得到改善，且术后偏斜侧与非偏斜侧在水平下颌角（Go到MSP）方面无显著差异。3DS为矫正面部不对称的计划手术操作提供了所有必要信息；在手术规划过程中应考虑使用3DS以改善手术效果，特别是实现双侧下颌轮廓对称。
