偏突颌畸形患者手术前后面型分析及疗效评价

Analysis of the facial pattern and evaluation of the effect on patients with laterognathism deformity

目的:通过对偏突颌畸形患者手术前后的面型比较分析,同时结合医患双方的满意度调查,评价该类型患者的手术疗效。方法:对30例偏突颌畸形患者通过手术前后头颅正侧位片上测量的变化并结合医生和患者的满意度调查评价手术疗效,并将满意度分值与SNA、SNB、ANB等指标进行相关性研究,所得数据以SPSS13.0软件包进行统计处理。结果:术后6个月随访时,24例患者对自身面型感到满意,18例患者在医生的满意度评估中达到满意效果。对患者的面型分析发现,硬组织变化主要集中在面下部,测量值与术前相比,SNA角增加2.5°、ANB角增加4.1°、面角下降3.0°、颏点距面中线水平距离内移6.6mm。软组织形态较术前也有明显改善:S-NS-SB角降低2.0°、S-NS-TC角降低1.8°、TUL及TLL距E线的距离分别增加3.0mm、减小1.0mm。患者的满意度分值与颏点偏距、左右下颌体长度之差呈明显的负相关关系,医生的满意度分值与各指标均无相关关系。结论:对于偏突颌畸形患者采用正畸-正颌联合治疗,可有效改善患者的面型偏斜情况;颏点是否居中及左右下颌体长度的对称性对患者的满意度影响较大。

PURPOSE：This study was conducted to analyze the facial pattern changes referring to the satisfaction of the doctor and patient,in order to evaluate the effect of the operation and summarize clinical experience for every patient with laterognathism deformity.METHODS：Thirty patients treated in the past 2 years were included in the study.The posterior-anterior film and lateral projection taken at the beginning and the end of the treatment were analyzed for hard and soft tissues changes.The doctor and patient gave a mark to satisfaction,respectively.The data was analyzed using SPSS13.0 software package.RESULTS：Six months later,all the patients obtained satisfactory facial appearance.The hard tissues changes were focused on the mandible.In comparison with the preoperative data,∠SNA increased 2.5°,∠ANB increased 4.1°,facial angle decreased 3.0°,the distance from Me to facial median line decreased 6.6mm.Soft tissues had also been improved significantly：∠S-NS-SB decreased 2.0°,∠S-NS-TC decreased 1.8°,TUL-E increased 3.0mm,TLL-E decreased 1.0mm.The patient＇s rather than the doctor＇s satisfaction has negative correlation with the distance from Me to facial median line.CONCLUSION：Combined orthodontic and surgical treatment is a very effective way to treat patients with laterognathism deformity.Whether the mental region is in accordance with facial median line has influence upon the satisfaction of patients.