Sun X T, He W, Liu X J, Li Z L, Wang X
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2020 Feb 18;52(1):90-96. doi: 10.19723/j.issn.1671-167X.2020.01.014.
There is no universally accepted method for determining the ideal sagittal position of the maxilla in orthognathic surgery. The purpose of this study was to compare how well the Delaire's cephalometric analysis correlated with postoperatively findings in patients who underwent orthognathic surgery planned using other cephalometric analyses, as well as to evaluate the feasibility of the Delaire's cephalometric analysis in predicting the ideal sagittal position of the maxilla and chin.
In the study, 35 patients with skeletal Class III malocclusion were involved and met the criteria. Treatment plans were developed using photographs, 3-D photographs, radiographs, and standard cephalometric measurements. The Delaire's cephalometric analysis data, like the phase measurements (∠C1-L1 and ∠C1-L2) of the sagittal positions of the maxillary and the chin separating the reference line (L1) of NP point and the reference line (L2) of Me point, were analyzed using Dolphin Imaging software. At the same time, the analyses on standard measurements were also performed. Four orthognathic doctors, 4 orthodontic doctors and 4 college students from non-medical majors were selected as aesthetic evaluators to assess the patients' profile aesthetic by visual analogue scale (VAS). The results through the Delaire's cephalometric analysis were statistically compared with that through standard methods.
The mean of ∠C1-L1 was 83.93°±2.99° and∠C1-L2 was 89.08° ±2.48° for males postoperatively, and 85.67° ±3.60° and 88.30° ±4.20° for females postoperatively. Compared with the reference values of Chinese goodlooking people, there was no significant difference of NP point, whereas there was a significant difference of Me point. The postoperative aesthetic scores were: the mean was 6.71±0.25 of upper jaws, 6.81±0.30 of chins and 6.90±0.29 of the overall for males; and 7.19±0.22, 7.26±0.34 and 7.39±0.29 for females. Compared with preoperative scores, there was a significant improvement. Furthermore, the scores of chins and the overall scores were related to the sagittal position of the chins.
Compared with standard cephalometric analysis, the Deliare's cephalometric analysis well unravel the preoperative deformity and the final esthetic sagittal positions of maxillary and chin in the present sample, and could be a useful tool for the planning of surgery-first approach in orthognathic surgery.
在正颌外科手术中,目前尚无普遍认可的确定上颌骨理想矢状位的方法。本研究旨在比较在采用其他头影测量分析方法进行手术规划的正颌手术患者中,德莱尔头影测量分析与术后结果的相关性,并评估德莱尔头影测量分析在预测上颌骨和颏部理想矢状位方面的可行性。
本研究纳入35例符合标准的骨性III类错牙合患者。利用照片、三维照片、X线片及标准头影测量制定治疗计划。使用Dolphin Imaging软件分析德莱尔头影测量分析数据,如将鼻根点参考线(L1)与颏点参考线(L2)分开的上颌和颏部矢状位的相位测量值(∠C1-L1和∠C1-L2)。同时,也对标准测量值进行分析。选取4名正颌医生、4名正畸医生和4名非医学专业大学生作为美学评估者,通过视觉模拟评分法(VAS)评估患者的侧貌美学。将德莱尔头影测量分析结果与标准方法的结果进行统计学比较。
男性术后∠C1-L1的平均值为83.93°±2.99°,∠C1-L2为89.08°±2.48°;女性术后分别为85.67°±3.60°和88.30°±4.20°。与中国美貌人群的参考值相比,鼻根点无显著差异,而颏点有显著差异。术后美学评分:男性上颌平均为6.71±0.25,颏部为6.81±0.30,整体为6.90±0.29;女性分别为7.19±0.22、7.26±0.34和7.39±0.29。与术前评分相比,有显著改善。此外,颏部评分和整体评分与颏部矢状位有关。
与标准头影测量分析相比,德莱尔头影测量分析能很好地揭示本样本中术前畸形以及上颌和颏部最终的美学矢状位,可作为正颌外科手术优先手术方案规划的有用工具。