外科矫治男性上颌前突术后面部软组织侧貌改变的临床研究

Changes and its stability of soft tissue following anterior maxillary in adult males

目的:回顾性研究上颌前份节段性骨切开术矫治男性上颌前突畸形对软组织侧貌的影响。方法:对19例上颌前份节段性骨切开成年男性患者术前、术后半年及术后1年的X线头影测量进行对比研究,并进行统计学分析。结果:术后软组织侧貌改变:上中切牙切缘点Is平均后移(6.8±2.2)mm(P<0.01),上唇突点Ls平均后移(5.2±1.7)mm(P<0.01),鼻唇角Cm-Sn-Ls平均增加(7.7±5.7)°(P<0.01),上下唇间隙St ms-Stmi平均缩小(4.9±3.7)mm(P<0.01),露齿程度Is-St ms平均减小(2.5±2.3)mm(P<0.05),上唇突度减小,上唇厚度、长度及软组织面型角G-Sn-Pg无显著改变(P<0.05)。术后1年颜面软组织侧貌改变的稳定性;与术后半年相比,在水平方向上,所有指标复发率均超过10%。在垂直方向上,各项指标复发率均在10%以内。结论:上颌前份节段性骨切开是矫正上颌前突畸形有效的手术方法,术后患者颜面软组织侧貌的改善明显而且效果稳定。

Objective To investigate the profile changes and stability of soft tissues following anterior maxillary osteotmy in adult males. Methods Cephalometric data from 19 adult male patients who were treated wite anterior maxillary osteotomy with or without a concurrent mandibular were analyzed retrospectively. These patients were followed up at three time points.The preoperative radiograph （TO） was taken before surgery. The immediate postoperative radiograph （T1） was taken within one month after surgery. The third radiograph （T2） was taken 1 year after surgery. The data were analyzed statistically. Results （1）The soft tissue profile response to anterior maxillary osteotomy appeared to be effective. Incision superius decreased （6.8±2.2）mm. Labrale inferius decreased （5.2±1.7）mm. The postoperative Cm- Sn-Ls was larger （7.7±5.7）mm than pre-operation. Stms-Stmi and Is-Stms decreased （4.9±3.7）mm and （2.5±2.3）mm respectively. The other data changed non-statistically. （2）One-year stability data. A greater than 10% changed was seen for all soft tissue landmarks in a horizontal direction. In a vertical direction, all data of change showed less than10%. In a horizontal direction, all data of change also are less than 10%. Conclusions The soft tissue profile respond well to anterpond at Subnasal and Superior maxillary osteotomy for anterior maxillary protrusion patients. The effect was stable.