Seifi Massoud, Jafarpour Boroujeni Mahsa, Tabrizi Reza, Tahmasbi Soodeh
Department of Orthodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Oral and Maxillofacial Surgery, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
World J Plast Surg. 2020 Sep;9(3):282-289. doi: 10.29252/wjps.9.3.282.
Since aesthetic issues are the most important causes of referring skeletal class III patients to surgeons, investigating the impact of orthognathic surgeries on improving patient profiles increases the quality of treatment and quality of life.
In a retrospective observational-analytical study, 25 patients older than 18 years with class III skeletal malocclusion who had gone under both orthodontic and double-jaw orthognathic treatment were enrolled. Cephalometric imaging interval was before and at least 6 months after surgery. By defining a number of points and coordinate axes (X-Y), a criterion for comparing hard and soft tissue changes was obtained. These measurements were coordinated, linear and angular. The quantitative data were compared with data obtained using the Likert Scale Questionnaire by means of electronic "Google Forms" that was completed by orthodontists (n=5) and maxillofacial surgeons (n=5) to rank improvement in post-surgical profiles for both cephalometry and photography from poor to pleasant. Spearman Correlation Analysis was conducted between the quantitative and qualitative data.
Vertical changes of point B and horizontal changes of point PNS showed correlation with improvement of patient profile. Changes in N-Pog line (R=-0.4), mandibular plane angle (R=-0.4) and nasolabial angle (NLA) (R=0.38) were significantly correlated with improvement of profiles.
In orthognathic double-jaw surgery on patients with skeletal Class III, forward movement of maxilla, upward positioning of mandible (decreasing anterior facial height), decreasing mandibular plane angle and increasing nasolabial angle would result in a better profile.
由于美观问题是骨骼Ⅲ类患者转诊至外科医生的最重要原因,研究正颌手术对改善患者面部轮廓的影响可提高治疗质量和生活质量。
在一项回顾性观察分析研究中,纳入了25例年龄超过18岁、患有Ⅲ类骨骼错牙合畸形且接受过正畸和双颌正颌治疗的患者。头影测量成像间隔为术前及术后至少6个月。通过定义一些点和坐标轴(X-Y),获得了比较硬组织和软组织变化的标准。这些测量包括坐标、线性和角度测量。定量数据与正畸医生(n = 5)和颌面外科医生(n = 5)通过电子“谷歌表单”使用李克特量表问卷获得的数据进行比较,以对头影测量和摄影术后面部轮廓从差到好的改善进行排名。对定量和定性数据进行斯皮尔曼相关性分析。
点B的垂直变化和PNS点的水平变化与患者面部轮廓的改善相关。N-Pog线变化(R = -0.4)、下颌平面角(R = -0.4)和鼻唇角(NLA)(R = 0.38)与面部轮廓的改善显著相关。
在对骨骼Ⅲ类患者进行正颌双颌手术时,上颌向前移动、下颌向上定位(降低前牙面部高度)、减小下颌平面角和增加鼻唇角会使面部轮廓更好。