Holdaway R A
Am J Orthod. 1983 Jul;84(1):1-28. doi: 10.1016/0002-9416(83)90144-6.
This article presents a soft-tissue analysis which demonstrates the inadequacy of using a hard-tissue analysis alone for treatment planning. The material and methods used to develop this technique came from years of observation and description of patients from the private practice of the author. The findings indicate that, in general, for adolescents the normal or usual thickness of the soft tissue at point A is 14 to 16 mm. As point A is altered by tooth movement, headgear, etc., the soft tissue will follow this point and remain the same thickness. When there is taper in the maxillary lip immediately anterior to the incisor, as in protrusive dentures, the tissue will thicken as the incisors are moved lingually until the tissue approaches the thickness at point A (within 1 mm. of the thickness at point A). When the lip taper has been eliminated, further lingual movement of the incisor will now cause the lip to follow the incisors in a one-to-one ratio. These concepts are predictable in adolescents when the lip thickness at point A is within the normal range. Some exceptions are as follows: Even if there is lip taper, if the tissue thickness at point A is very thin (for example, 9 to 10 mm.), the lip may follow the incisor immediately and still retain the taper. If the tissue at point A is very thick (for example, 18 to 20 mm.), the lip may not follow incisor movement at all. Adult tissue reaction is similar to the first exception. Even though there may be lip taper, the lips will usually follow the teeth immediately. Cases are presented to demonstrate these concepts and to illustrate a normal or acceptable range of variation for facial harmony related to variations in skeletal convexity.
本文介绍了一项软组织分析，该分析表明仅使用硬组织分析进行治疗计划是不够的。开发这项技术所使用的材料和方法来自作者私人诊所多年来对患者的观察和描述。研究结果表明，一般来说，对于青少年，A点处软组织的正常或通常厚度为14至16毫米。当A点因牙齿移动、头帽等因素发生改变时，软组织会跟随该点并保持相同厚度。当上颌切牙前方的唇组织呈锥形时，如在突出的假牙中，当切牙向舌侧移动时，组织会增厚，直到组织接近A点的厚度（在A点厚度的1毫米范围内）。当唇锥度消除后，切牙进一步向舌侧移动将使唇部以一对一的比例跟随切牙移动。当A点处的唇厚度在正常范围内时，这些概念在青少年中是可预测的。一些例外情况如下：即使存在唇锥度，如果A点处的组织厚度非常薄（例如，9至10毫米），唇部可能会立即跟随切牙移动并仍保持锥度。如果A点处的组织非常厚（例如，18至20毫米），唇部可能根本不会跟随切牙移动。成人的组织反应与第一个例外情况类似。即使可能存在唇锥度，唇部通常也会立即跟随牙齿移动。文中展示了一些病例来说明这些概念，并阐述了与骨骼凸度变化相关的面部和谐的正常或可接受的变化范围。
