Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, 02447, Seoul, Republic of Korea.
Head Face Med. 2018 Oct 5;14(1):21. doi: 10.1186/s13005-018-0179-z.
To evaluate the nasolabial soft tissue change three-dimensionally after orthognathic surgery, using a structured light scanner.
Thirty-two malocclusion patients, who underwent orthognathic surgery, were evaluated. CBCT and 3D facial scans were obtained before surgery and 3 months after surgery. The 3D changes in the 26 landmarks, and the relative ratio of the soft tissue movement to the bony movement, were evaluated.
In the Le Fort I advancement patients, the nasal tip moved 17% forward, compared to the maxillary bony movement, but the nasal prominence decreased 15%. The alar width increased 4 mm after the advancement, and the width decreased 4.7 mm after Le Fort I setback. The relative ratio of the soft tissue movement to the bony movement after bilateral sagittal split osteotomy was about 66% at the Li point in the anteroposterior direction, and it was 21% in the Le Fort I advancement and 14% in Le Fort I setback at the Ls point.
Alar cinch suturing may not be sufficient to overcome the effect of the maxilla advancement compressing the nasal complex. Alar width widening was prevented in Le Fort I setback. However, it is uncertain that the alar cinch suturing was solely responsible. The soft tissue around the mandible tends to accompany the bony movement more than the maxillary area. In addition, structured light scanning system proved to be a useful tool to evaluate the nasolabial soft tissue.
使用结构光扫描仪评估正颌手术后的鼻唇软组织的三维变化。
对 32 例接受正颌手术的错畸形患者进行评估。在术前和术后 3 个月分别获得 CBCT 和 3D 面部扫描。评估了 26 个标志点的 3D 变化以及软组织运动与骨运动的相对比率。
在 Le Fort I 前徙患者中，与上颌骨的骨运动相比，鼻尖向前移动了 17%，但鼻突却减少了 15%。前徙后鼻翼宽度增加了 4mm，Le Fort I 后退后宽度减少了 4.7mm。双侧矢状劈开截骨术后，Li 点前后向的软组织运动与骨运动的相对比率约为 66%，Le Fort I 前徙和 Le Fort I 后退时 Ls 点的比率分别为 21%和 14%。
鼻翼缩窄缝合可能不足以克服上颌前徙对鼻复合体的压缩作用。Le Fort I 后退术可防止鼻翼增宽。然而，鼻翼缩窄缝合是否是唯一的原因尚不确定。下颌周围的软组织往往比上颌区域更伴随骨运动。此外，结构光扫描系统被证明是评估鼻唇软组织的有用工具。
