Bardet Isabelle, Goudot Patrick, Kerbrat Jean-Baptiste, Mauchamp Olivier
7 rue Étienne Forest, 38000 Grenoble, France.
Groupe Hospitalier Pitié Salpétrière - Service Stomatologie et Chirurgie Maxillo-faciale, 47-83 Boulevard de l'Hôpital, 75013 Paris, France.
Orthod Fr. 2019 Mar;90(1):37-54. doi: 10.1051/orthodfr/2019004. Epub 2019 Apr 17.
The purpose of this study was to compare two structural cephalometric analysis (Delaire and Sassouni) as surgical decision tools. These two analyses do not include dental compensation for skeletal discrepancies and have been proven reliable especially for the Sendai surgery first protocol developed by Sugawara.
The two analysis were performed on 20 surgical cases and the proposed skeletal modifications were compared in order to measure the differences and see if those differences varied according to the facial type. For 10 cases the Virtual Surgical Planning (VSP) images obtained from Dolphin 11.95 Premium software (based on the presurgical CBCT and facial photographs) allowed a comparison of the two analyses as surgical decision indicators and to the realised surgical procedure. The VSP photographs obtained were graded by two panels: one professional and the other one non professional.
Sassouni's analysis favored more forward movements for the maxilla (ENA +5,45) as well as more vertical modifications (Me 1,595). The facial type did not appear to have a significant effect. The quality of Dolphin VSP prediction was judged rather reliable above average (3.7/6) by the panels. The VSP photographs obtained from the two analyses were presented to the panels as well as the VSP obtained from the actual surgery. The three facial outcomes: Sassouni, Delaire and "Surgery Realised" called Dolphin showed some potentially interesting differences. The small size of the sample did not show any significant findings (t test) but a special analysis revealed a valid difference between the three outcomes. The most aesthetic being Dolphin (surgery realised) 17.4 then Sassouni 16.6 (diff 0.8) and finally Delaire 14 (diff 2.6).
The two structural analysis Delaire and Sassouni did not give the same surgical objectives. Sassouni favored more forward movements for the maxilla as well as more vertical modifications. The Dolphin software appeared to be the quite reliable software to predict the facial outcomes of the surgery. The VSP photographs obtained using Sassouni's analysis were more balanced than when the Delaire analysis was followed (16.4/14 = +2.6). The VSP based on the actual surgery was judged to be even more aesthetic. This shows that beyond a cephalometric analysis the facial aesthetic details and the functional analysis are very important during the phase of surgical planning.
本研究的目的是比较两种结构头影测量分析方法（德莱尔分析法和萨苏尼分析法）作为手术决策工具的效果。这两种分析方法不包括对骨骼差异的牙齿代偿，并且已被证明是可靠的，特别是对于菅原开发的仙台手术第一方案。
对20例手术病例进行了这两种分析，并比较了所提出的骨骼改变，以测量差异并观察这些差异是否因面部类型而异。对于10例病例，从Dolphin 11.95高级软件（基于术前CBCT和面部照片）获得的虚拟手术计划（VSP）图像，使得能够将这两种分析作为手术决策指标与实际实施的手术进行比较。所获得的VSP照片由两个小组进行评分：一个是专业小组，另一个是非专业小组。
萨苏尼分析法倾向于上颌骨有更多的向前移动（ENA +5.45）以及更多的垂直改变（Me 1.595）。面部类型似乎没有显著影响。小组认为Dolphin VSP预测的质量相当可靠，高于平均水平（3.7/6）。从两种分析中获得的VSP照片以及从实际手术中获得的VSP照片都展示给了小组。三种面部结果：萨苏尼分析法、德莱尔分析法和名为Dolphin的“实际手术”显示出一些潜在的有趣差异。样本量小没有显示出任何显著结果（t检验），但一项特殊分析揭示了这三种结果之间存在有效差异。最具美感的是Dolphin（实际手术）为17.4，然后是萨苏尼分析法为16.6（差异0.8），最后是德莱尔分析法为14（差异2.6）。
德莱尔和萨苏尼这两种结构分析方法给出的手术目标不同。萨苏尼分析法倾向于上颌骨有更多的向前移动以及更多的垂直改变。Dolphin软件似乎是预测手术面部结果相当可靠的软件。使用萨苏尼分析法获得的VSP照片比遵循德莱尔分析法时更均衡（16.4/14 = +2.6）。基于实际手术的VSP被认为更具美感。这表明在手术计划阶段，除了头影测量分析外，面部美学细节和功能分析非常重要。
