Delaire头影测量分析指导下颌前突畸形正颌矫正:重建颅颌面颈平衡结构

Orthognathic correction of mandibular prognathism guided by Delaire cephalometric analysis: reconstruction of cranio-maxillo-facial structure

背景:下颌前突畸形最有效的治疗方法为正畸-正颌外科联合治疗,但术后复发为常见并发症,影响治疗效果。Delaire头影测量分析法以个体颅颌面整体平衡结构为基准,构建理想的颅颌面结构,能够据此指导设计正颌手术方案,增加术后稳定性。目的:分析Delaire头影测量指导设计下颌前突畸形患者的正颌方案治疗后的效果及稳定性。方法:对20例下颌前突畸形患者采用Delaire头影测量分析法设计外科治疗方案,于正颌治疗前、治疗后6-8个月及治疗后12-16个月进行Delaire头影测量分析,测量并统计分析19项相应指标的变化情况。结果与结论:1下颌角点至颏下点距离(Go-Me)、下颌角点至下齿槽基座点距离(Go-LA)正颌治疗后无统计学意义上复发。2实际下颌体平面与理论下颌体平面交角(∠Mp-F7)、实际咬合平面与理论咬合平面交角(∠Op-F8)正颌治疗后较治疗前显著减小。3理想下颌角角度(∠F3-F7)、理想腭平面与理想下颌体平面交角(∠F4-F7)、理想下颌体平面与理想牙合平面交角(∠F7-F8)在3个时间点变化差异均无显著性意义。4颅颈角(∠cc-SN)正颌治疗后较治疗前增大。结果表明,由Delaire头影测量分析法指导下颌前突畸形外科正颌治疗后,患者颅颌面颈平衡结构根据新的颌骨形态作出适应性调整,无明显复发,具有相对稳定性。

BACKGROUND： The most effective treatment of mandibular prognathism is orthodontic-orthognathic surgical treatment, but the postoperative relapse is the common complication that influences the surgical effects. Based on the individual integral cranio-maxillo-facial structure, Delaire cephalometric analysis can establish the ideal cranio-maxillo-facial structure that can be applied to design the operative schemes thereby promoting postoperative stability. OBJECTIVE： To analyze the stability and effect of orthognathic operations according to the schemes designed by Delaire cephalometric analysis. METHODS： Twenty mandibular prognathism patients were subjected to the orthognathic operations designed by Delaire cephalometric analysis, to analyze their lateral cephalometric radiographs before operations, 6-8 months after operations and 12-16 months after operations. Then measurement data of 19 relevant items were measured and analyzed statistically. RESULTS AND CONCLUSION： （1） There was no statistical significance in relapse of Go-Me and Go-LA after surgery; （2） The LMp-F7 and LOp-F8 were reduced significantly after orthognathic treatment; （3） LF3-F7, LF4-F7 and LF7-F8 had no significant difference at these three time points; （4） Lcc-SN was increased after orthognathic treatment. The results show that the orthognatic operations for mandibular prognathism patients guided by Delaire analysis can keep relative stability after treatment, the cranio-maxillo-facial structure can adapt to the new jaw morphology, and there is no obvious relapse after treatment.