Department of Orthodontics, New York University, New York, NY.
Graduate Orthodontics, School of Dentistry, University of Detroit Mercy, Detroit, Mich.
Am J Orthod Dentofacial Orthop. 2023 Sep;164(3):377-385. doi: 10.1016/j.ajodo.2023.02.010. Epub 2023 Mar 30.
This study investigated the interrelationship between FMIA and soft-tissue profile changes in skeletal Class I and II white adolescents with 3 different vertical skeletal patterns.
Two hundred seventy cephalometric images were constructed from pretreatment and posttreatment cone-beam computed tomography images of 135 white adolescents (69 females and 66 males with a mean age of 12.8 ± 1.4 years pretreatment and 15.0 ± 1.4 years posttreatment). SNA, SNB, ANB, Frankfort Mandibular Angle [FMA], Incisor Mandibular Plane Angle [IMPA], Frankfort-Mandibular Incisor Angle [FMIA], and Z angle were measured. A mixed-model analysis of variance was performed for patients with an increased posttreatment Z angle to evaluate within-subject and between-subject effects of variables in relation to horizontal and vertical skeletal patterns. Post-hoc tests were conducted to identify statistical significance among the 3 different divergent subgroups.
Patients with a skeletal Class I relationship had straighter facial profiles and a larger FMIA than patients with a skeletal Class II relationship before and after treatment. FMA, FMIA, IMPA, and Z angle treatment changes were similar between the skeletal Class I and II groups. The final FMIA means of the 3 divergent subgroups converged at 65° in the skeletal Class I group and 60° in the skeletal Class II group. The mandibular incisors were uprighted during treatment in the hyperdivergent patients whose Z angle values increased after treatment.
Horizontal skeletal relationships seem more suitable for determining the desired FMIA in Tweed's total space analysis than vertical skeletal divergencies.
本研究调查了 FMIA 与 3 种不同垂直骨骼模式的骨骼 I 类和 II 类白种青少年的软组织侧貌变化之间的相互关系。
从 135 名白种青少年(69 名女性和 66 名男性,治疗前平均年龄为 12.8 ± 1.4 岁,治疗后平均年龄为 15.0 ± 1.4 岁)的预处理和后处理锥形束 CT 图像中构建了 270 个头颅侧位片。测量 SNA、SNB、ANB、法兰克福下颌角 [FMA]、切牙下颌平面角 [IMPA]、法兰克福-下颌切牙角 [FMIA] 和 Z 角。对治疗后 Z 角增加的患者进行混合模型方差分析,以评估变量与水平和垂直骨骼模式的个体内和个体间效应。进行事后检验以确定 3 个不同发散亚组之间的统计学意义。
与骨骼 II 类关系的患者相比,治疗前和治疗后骨骼 I 类关系的患者具有更直的面部轮廓和更大的 FMIA。FMA、FMIA、IMPA 和 Z 角的治疗变化在骨骼 I 类和 II 类组之间相似。3 个发散亚组的最终 FMIA 平均值在骨骼 I 类组中收敛到 65°,在骨骼 II 类组中收敛到 60°。在 Z 角值增加的超发散患者中,下颌切牙在治疗期间直立,治疗后 Z 角增加。
与垂直骨骼差异相比,水平骨骼关系似乎更适合确定 Tweed 总空间分析中所需的 FMIA。