Assistant Professor, Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan.
PhD candidate, Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
J Oral Maxillofac Surg. 2021 Aug;79(8):1750.e1-1750.e10. doi: 10.1016/j.joms.2021.03.015. Epub 2021 Mar 26.
To assess the condylar hypoplasia and its correlation with craniofacial deformities in adults with unilateral craniofacial microsomia (CFM).
Pretreatment cone-beam computed tomography scans of consecutive adults (mean age: 20.4 ± 3.0 years; range: 17.3 to 31.4 years) with Pruzansky-Kaban type I and IIA CFM were reconstructed in 3D. Both condyles were segmented. Asymmetry ratios (affected side/contralateral side) of condylar volume were calculated to indicate the extent of condylar hypoplasia. 3D cephalometry was performed to quantify the maxillomandibular morphology and facial asymmetry. The correlations in between were assessed by using Pearson's or Spearman's correlation coefficients.
Thirty-six subjects were enrolled, consisting of 22 subjects with Pruzansky-Kaban type I and 14 subjects with type IIA. The condyles in type IIA group were significantly more hypoplastic in height (asymmetry ratio: 40.69 vs 59.95%, P = .006) and volume (18.16 vs 47.84%, P < .001) compared to type I group. Type IIA group had a significantly smaller SNB value than type I group (72.94° vs 77.41°, P = .012), and a significantly greater facial asymmetry (P < .05). The hypoplastic extent of condylar volume and Pruzansky-Kaban types were significantly correlated with SNB (r = 0.457 and ρ = -0.411, respectively), upper incisor deviation (r = -0.446 and ρ = 0.362), chin deviation (r = -0.477 and ρ = 0.527), upper occlusal plane cant (r = -0.672 and ρ = 0.631), and mandibular plane cant (r = -0.557 and ρ = 0.357, P < .05).
For unilateral CFM adults, greater condylar hypoplasia in volume along with more severe mandibular retrusion and facial asymmetry objectively indicated a higher scale of Pruzansky-Kaban classification (type IIA). These quantitative distinctions are expected to enhance the diagnostic reliability of CFM.
评估单侧颅面小颌畸形（CFM）成人患者髁突发育不良及其与颅面畸形的相关性。
对连续的单侧颅面小颌畸形（Pruzansky-Kaban Ⅰ型和ⅡA型）成年患者（平均年龄：20.4±3.0 岁；范围：17.3 至 31.4 岁）的预处理锥形束 CT 扫描进行三维重建。分割双侧髁突。计算髁突体积的不对称比（患侧/对侧侧），以表示髁突发育不良的程度。进行三维头影测量以量化上下颌骨形态和面部不对称性。使用 Pearson 或 Spearman 相关系数评估它们之间的相关性。
共纳入 36 名患者，其中 22 名患者为 Pruzansky-Kaban Ⅰ型，14 名患者为ⅡA型。ⅡA型组髁突在高度（不对称比：40.69%比 59.95%，P=0.006）和体积（18.16%比 47.84%，P<0.001）方面明显更发育不良。ⅡA型组 SNB 值明显小于Ⅰ型组（72.94°比 77.41°，P=0.012），且面部不对称性明显更大（P<0.05）。髁突体积发育不良程度和 Pruzansky-Kaban 分型与 SNB（r=0.457 和 ρ=-0.411）、上颌切牙偏斜（r=-0.446 和 ρ=0.362）、颏部偏斜（r=-0.477 和 ρ=0.527）、上颌牙合平面倾斜（r=-0.672 和 ρ=0.631）、下颌牙合平面倾斜（r=-0.557 和 ρ=0.357）显著相关（P<0.05）。
对于单侧 CFM 成人患者，体积较大的髁突发育不良以及更严重的下颌后缩和面部不对称客观上表明 Pruzansky-Kaban 分类（ⅡA型）的严重程度更高。这些定量差异有望提高 CFM 的诊断可靠性。
