成人骨性Ⅲ类颜面部不对称上颌骨三维特征的CBCT探究

Three-dimensional Morphological Features of the Maxilla in the Skeletal ClassⅢ Patients with Facial Asymmetry:A Cone-beam Computed Tomography Analysis

目的:本研究的目的是通过锥形束CT(cone-beam computed tomography,CBCT)研究成人骨性Ⅲ类颜面部不对称患者上颌骨的三维特征。方法:选取正畸临床成人骨性Ⅲ类患者62名,按照颏点的偏离程度分为颜面部不对称组(n=30)和颜面部对称组(n=32)。62名患者拍摄CBCT,采用Dolphin 11.0对骨组织进行三维重建,描记上颌骨20个骨性结构特征的标志点,测量分析35个变量。结果:相对于颜面部对称组,在颜面部不对称组内,偏斜侧所有测量项目在水平向上与非偏斜侧均有明显差异(P<0.05),矢状向上仅颧牙槽嵴点与非偏斜侧有明显差异(P<0.05),冠状向上偏斜侧与非偏斜侧无明显差异。结论:成人骨性Ⅲ类颜面部不对称患者上颌骨主要表现为水平向的不调,且偏斜侧的位置较高,这是生物体在生长型、环境因素尤其是口颌系统的共同作用下的结果,在水平向量上失代偿,而在另一些向量上发生了补偿。

Objective： To study three--dimensional maxillary features in adults with facial asymmetry and skeletal Class Ⅲ malocclusion by cone--beam computed tomography （CBCT）. Methods： Thirty subjects with facial asym- metry and thirty subjects with facial symmetry from Department of Orthodontics were assigned to two groups sepa- rately according to Menton deviation. Sixty two patients took CBCT tests and use the software Dolphin 11.0 （Dol- phin Imaging. LISA） to reconstruct the three--dimensional images of the maxilla. Twenty landmarks concerning maxillary bony features were chosen and Statistical analysis was taken among thirty five variables total from maxil la. Results： Compared with facial symmetry group. All measurements in horizontal plane showed significant differ enees between the deviated and opposite side in facial asymmetry group, merely MxR had significant difference in sagittal plane, and there were no significant differences presented in coronal plane. Conclusion： The maxillary asym merry presented in adults with facial asymmetry skeletal Class Ⅲ was most horizontal with deviated part being high- er, which is the end product of growth form and environment, especially the stomatognathic system. With horizon- tal decompensation, and some other vectors must repair.