Hao K Y, Luo J, DI P, Guo H Z, Shen H D, Liu Y P, Zhang Y, Lin Y
Beijing Da Xue Xue Bao Yi Xue Ban. 2020 Oct 18;52(5):924-930. doi: 10.19723/j.issn.1671-167X.2020.05.022.
To explore the applicability of integration between three-dimensional (3D) facial and dental data to evaluate the nasolabial morphology variation before and after the cross-arch fixed restoration of the maxillary implant-supported prostheses.
Twelve patients (4 women and 8 men), mean age (54.82±5.50) years (from 45 to 62 years) referred to the Department of Oral Implan-tology, Peking University School and Hospital of Stomatology, were selected and diagnosed with edentulous maxilla. For all the patients, 4 to 6 implants were inserted into the maxilla. Six months later, the final cross-arch fixed prostheses were delivered. The 3D facial images were collected before and after the final restoration. The 3D data of prostheses were also captured. All the 3D data were registered and measured in the same coordinate system. Then the displacement of all the landmarks [cheilion left (CHL), cheilion right (CHR), crista philtri left (CPHL), crista philtri right (CPHR), labrale supe-rius (LS), subnasale (SN), stomion (STO), upper incisor (UI), upper flange border of the prostheses (F-point, F)], and the variation of the distances between these landmarks (SN-LS, CPHR-CPHL, CHR-CHL, LS-STO) were analyzed and compared.
The consistency test among three measurements of the length of F-SN indicated that the integration method of the dental prostheses and soft tissue had the good repetitiveness, =0.983 (95%: 0.957-0.995). After wearing the final cross-arch maxillary implant-supported prostheses, all the landmarks on the soft tissue moved forward. The nasal base area changed minimally, and the shift of SN in the sagittal direction was only (0.61±0.44) mm. But the sagittal shift of LS was (3.12±1.38) mm. In the vertical direction, SN, LS, CPHL, and CPHR moved upward. But STO, CHL, and CHR moved downward a little. Except for the slight decrease of the length of philtrum (SN-LS), the length of CHL-CHR, CPHL-CPHR, and the height of upper lip were increased together ( < 0.01). In the direction of axis, the strong correlations were found not only between the movements of SN and F (=0.904 3) but also between the movements of LS and UI (=0.958 4).
The integration method of 3D facial and dental data showed good repetitiveness. And the strong correlations between the landmarks of prostheses and nasolabial soft tissue in the sagittal direction were found by this new method.
探讨三维(3D)面部与牙齿数据整合在评估上颌种植支持修复体跨牙弓固定修复前后鼻唇形态变化中的适用性。
选取北京大学口腔医学院口腔种植科收治的12例患者(4例女性,8例男性),平均年龄(54.82±5.50)岁(45至62岁),均诊断为上颌牙列缺失。所有患者在上颌植入4至6枚种植体。6个月后,交付最终的跨牙弓固定修复体。在最终修复前后采集3D面部图像。同时获取修复体的3D数据。所有3D数据在同一坐标系中进行配准和测量。然后分析并比较所有标志点[左侧口角(CHL)、右侧口角(CHR)、左侧鼻小柱嵴(CPHL)、右侧鼻小柱嵴(CPHR)、上唇缘点(LS)、鼻下点(SN)、口裂点(STO)、上颌中切牙(UI)、修复体上缘边界点(F点,F)]的位移,以及这些标志点之间距离的变化(SN-LS、CPHR-CPHL、CHR-CHL、LS-STO)。
F-SN长度的三次测量之间的一致性检验表明,牙修复体与软组织的整合方法具有良好的重复性,ICC = 0.983(95%:0.957 - 0.995)。佩戴最终的上颌种植支持跨牙弓修复体后,软组织上的所有标志点均向前移动。鼻基底区域变化最小,SN在矢状方向上的位移仅为(0.61±0.44)mm。但LS在矢状方向上的位移为(3.12±1.38)mm。在垂直方向上,SN、LS、CPHL和CPHR向上移动。但STO、CHL和CHR略有向下移动。除鼻小柱长度(SN-LS)略有减小外,CHL-CHR、CPHL-CPHR的长度以及上唇高度均共同增加(P < 0.01)。在x轴方向上,不仅发现SN与F点的移动之间存在强相关性(r = 0.904 3),而且LS与UI的移动之间也存在强相关性(r = 0.958 4)。
3D面部与牙齿数据的整合方法显示出良好的重复性。并且通过这种新方法发现了修复体标志点与鼻唇软组织在矢状方向上存在强相关性。