采用聚类分析对接受正颌外科治疗的韩国成年患者Ⅲ类骨性错牙合畸形的表型特征进行分析。

Characterization of phenotypes of skeletal Class III malocclusion in Korean adult patients treated with orthognathic surgery using cluster analysis.

作者信息

Yang Il-Hyung, Choi Jin-Young, Baek Seung-Hak

出版信息

Angle Orthod. 2022 Jul 1;92(4):537-546. doi: 10.2319/081421-635.1.

DOI:10.2319/081421-635.1

PMID:35147668

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9235389/

Abstract

OBJECTIVES

To characterize the phenotypes of skeletal Class III malocclusion in adult patients who underwent orthognathic surgery (OGS).

MATERIALS AND METHODS

The sample consisted of 326 patients with Class III malocclusion treated with OGS (170 men and 156 women; mean age, 22.2 years). Using lateral cephalograms taken at initial visits, 13 angular variables and one ratio cephalometric variable were measured. Using three representative variables obtained from principal components analysis (SNA, SNB, and Björk sum), K-means cluster analysis was performed to classify the phenotypes. Statistical analysis was conducted to characterize the differences in the cephalometric variables among the clusters.

RESULTS

Class III phenotypes were classified into nine clusters from the following four major groups: (1) retrusive maxilla group, clusters 7 and 9 (7.1% and 5.5%; severely retrusive maxilla, normal mandible, severe and moderate hyperdivergent, respectively) and cluster 6 (9.2%; retrusive maxilla, normal mandible, normodivergent); (2) relatively protrusive mandible group, cluster 2 (20.9%; normal maxilla, normal mandible, hyperdivergent); (3) protrusive mandible group, clusters 3 and 1 (11.7% and 15.3%; normal maxilla, protrusive mandible, normodivergent and hyperdivergent, respectively) and clusters 8 and 4 (15.3% and 3.7%; normal maxilla, severe protrusive mandible, normodivergent and hypodivergent, respectively); and (4) protrusive maxilla and protrusive mandible group, cluster 5 (11.4%; protrusive maxilla, severely protrusive mandible, normodivergent). Considerations for presurgical orthodontic treatment and OGS planning were proposed based on the Class III phenotypes.

CONCLUSIONS

Because the anteroposterior position of the maxilla and rotation of the mandible by a patient's vertical pattern determine Class III phenotypes, these variables should be considered in diagnosis and treatment planning for patients who have skeletal Class III malocclusion.

摘要

目的

对接受正颌手术（OGS）的成年患者Ⅲ类骨性错牙合畸形的表型进行特征描述。

材料与方法

样本包括326例接受OGS治疗的Ⅲ类错牙合畸形患者（170例男性和156例女性；平均年龄22.2岁）。利用初诊时拍摄的头颅侧位片，测量13个角度变量和1个比例头影测量变量。利用从主成分分析中获得的3个代表性变量（SNA、SNB和Björk总和），进行K均值聚类分析以对表型进行分类。进行统计分析以描述各聚类之间头影测量变量的差异。

结果

Ⅲ类表型从以下四个主要组中分为9个聚类：（1）上颌后缩组，聚类7和9（分别为7.1%和5.5%；严重上颌后缩、正常下颌、严重和中度高角型）以及聚类6（9.2%；上颌后缩、正常下颌、均角型）；（2）下颌相对前突组，聚类2（20.9%；正常上颌、正常下颌、高角型）；（3）下颌前突组，聚类3和1（分别为11.7%和15.3%；正常上颌、下颌前突、均角型和高角型）以及聚类8和4（分别为15.3%和3.7%；正常上颌、严重下颌前突、均角型和低角型）；（4）上颌前突和下颌前突组，聚类5（11.4%；上颌前突、严重下颌前突、均角型）。基于Ⅲ类表型提出了术前正畸治疗和OGS计划的注意事项。