Aoyama Iyo, Oikawa Takashi, Nakaoka Kazutoshi, Sekiya Toshiko, Hamada Yoshiki, Nakamura Yoshiki
Clinical Fellow, Department of Orthodontics, Tsurumi University School of Dental Medicine, Tsurumi University, Yokohama, Japan.
Lecturer, Department of Orthodontics, Tsurumi University School of Dental Medicine, Tsurumi University, Yokohama, Japan.
J Oral Maxillofac Surg. 2018 Nov;76(11):2404-2410. doi: 10.1016/j.joms.2018.04.017. Epub 2018 Apr 26.
Surgical orthodontic patients with facial asymmetry frequently show asymmetry of the lips, and this is often a major complaint of patients. This study investigated whether lip asymmetry associated with the maxilla and mandible was improved when 2-jaw surgery was performed in surgical orthodontic treatment.
Inclusion criteria for this retrospective cohort study were 1) an anteroposterior maxillary relation defined as skeletal Class I; 2) menton (Me) tranverse deviation greater than 5.0 mm; 3) maxillary cant greater than 3.0°; and 4) 2-jaw surgery. Primary predictor variables in this study were skeletal morphologic measurements (Me deviation, maxillary cant, and maxillary distance ratio) before and after treatment. Outcome variables were lip morphology measurements (labial commissure distance, lip angle, and lip area). Additional variables included age and gender. Vertical distances, angles, and area of the upper and lower lips were measured and compared before and after treatment. Hard tissues were measured using posteroanterior cephalograms. Paired t test and correlation coefficients were calculated.
Fourteen patients (4 men [28.5%] and 10 women [71.5%]; mean age, 29 yr) were included. Meaningful changes were observed in distance and angle measurements of the lips from before to after treatment. In area measurement, ratios of the area on the deviated side to that on the contralateral side for the upper and lower lips changed markedly and were close to 1.0 compared with before treatment. A relevant correlation was found between change in Me deviation and change in ratio of the height of the labial commissure.
In cases of facial asymmetry caused by deviation of the maxilla and mandible, lip asymmetry can be adequately corrected by leveling the canted occlusal plane and positioning the Me toward the midline with 2-jaw surgery.
面部不对称的外科正畸患者常表现出唇部不对称，这也是患者的主要诉求之一。本研究调查了在外科正畸治疗中进行双颌手术时，与上颌骨和下颌骨相关的唇部不对称是否得到改善。
本回顾性队列研究的纳入标准为：1）上颌骨前后关系为骨骼Ⅰ类；2）颏点（Me）横向偏差大于5.0毫米；3）上颌骨倾斜度大于3.0°；4）双颌手术。本研究的主要预测变量为治疗前后的骨骼形态学测量值（Me偏差、上颌骨倾斜度和上颌骨距离比）。结果变量为唇部形态测量值（口角距离、唇角和唇面积）。其他变量包括年龄和性别。测量并比较治疗前后上下唇的垂直距离、角度和面积。使用正位头影测量片测量硬组织。计算配对t检验和相关系数。
纳入14例患者（4例男性[28.5%]和10例女性[71.5%]；平均年龄29岁）。治疗前后唇部的距离和角度测量值有显著变化。在面积测量中，上下唇患侧与对侧的面积比变化明显，与治疗前相比接近1.0。发现Me偏差的变化与口角高度比的变化之间存在显著相关性。
在上颌骨和下颌骨偏差导致面部不对称的病例中，通过双颌手术使倾斜的咬合平面平整并将Me向中线定位，可充分纠正唇部不对称。
