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正颌手术后不对称颌骨畸形患者的颌面对称性改善的三维评估。

Three-dimensional evaluation of maxillofacial symmetry improvement following orthognathic surgery in patients with asymmetrical jaw deformities.

机构信息

Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, 2-5274 Gakkocho-Dori, Chuo-Ku, Niigata-Shi, Niigata, 951-8514, Japan.

Division of Orthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, 2-5274 Gakkocho-Dori, Chuo-Ku, Niigata-Shi, Niigata, 951-8514, Japan.

出版信息

Oral Maxillofac Surg. 2024 Nov 7;29(1):8. doi: 10.1007/s10006-024-01297-0.

Abstract

PURPOSE

The aim of this study was to clarify the three-dimensional changes in maxillofacial morphology following orthognathic surgery using 3D-CT in patients with asymmetrical jaw deformities.

METHODS

The subjects were 30 patients with asymmetrical jaw deformities. Three-dimensional images taken preoperatively and 6 months postoperatively were re-aligned using image processing software with the horizontal plane, coronal plane, and midsagittal plane as reference axes. Thirty-nine measurements including 28 distances, nine angles, and two volumes were recorded, and differences between preoperative and postoperative measurements and percentage differences between paired measurements on the deviated and unevolved sides were calculated.

RESULTS

Translational and rotational movements of the maxillary dentition and mandibular body and the mandibular ramus internally rotating contributed to improved symmetry of the maxillofacial morphology, but the degree and proportion of these changes varied from case to case and mild asymmetry remained even after surgery.

CONCLUSIONS

3D-CT analysis of maxillofacial morphology is essential to accurately evaluate the asymmetry of hard and soft tissue morphology in the maxillofacial region and the degree of improvement after orthognathic surgery, and the tooth movement during preoperative orthodontic treatment should be determined taking into account the movement of the upper and lower jaws during orthognathic surgery.

摘要

目的

本研究旨在通过三维 CT 明确颌骨畸形患者正颌手术后颌面形态的三维变化。

方法

研究对象为 30 例颌骨不对称畸形患者。使用图像处理软件,以水平面、冠状面和正中矢状面为参考轴,对术前和术后 6 个月的三维图像进行重新配准。记录包括 28 个距离、9 个角度和 2 个体积的 39 个测量值,并计算术前与术后测量值的差异以及偏侧和未偏侧配对测量值的百分比差异。

结果

上颌牙列和下颌体的平移和旋转运动以及下颌支的内旋转有助于改善颌面形态的对称性,但这些变化的程度和比例因病例而异,即使手术后仍存在轻度不对称。

结论

三维 CT 分析颌面形态对于准确评估颌面部软硬组织形态的不对称性以及正颌手术后的改善程度至关重要,并且在术前正畸治疗中应考虑到上下颌骨在正颌手术中的运动来确定牙齿的移动。

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