成人骨性Ⅲ类手术患者唇颏部软组织形态改变的回顾性研究

An retrospective study of soft tissue changes of lip and chin morphology in skeletal Class Ⅲ adult patients with orthognathic surgery

目的 研究骨性Ⅲ类成人患者唇颏部软组织形态特点及不同手术方式后软组织改变情况.方法 选取2009年1月至2013年12月第四军医大学口腔医院正畸科成年骨性Ⅲ类手术治疗患者94例,其中单纯下颌手术31例,单纯上颌手术10例,双颌手术53例.通过治疗前后X线头影测量对术前不同性别软组织形态及不同手术方式唇部软组织改变进行比较.结果 实验结果表明,男女骨性Ⅲ类成人患者在上唇长度、颏唇沟的深度及颏唇沟角度上有统计学差异.下颌后退手术组患者下唇厚度、下唇长度、颏唇沟深度、下唇倾角、颏唇沟角及软组织到参考平面的距离均有显著性变化.上颌前徙手术组患者上唇部软组厚度、上唇长度、鼻唇沟深度、鼻唇角、上唇倾角、下唇倾角、软组织到参考平面的距离也有显著性变化.双颌手术组上下唇软组织厚度、上下唇长度、颏唇沟深度、上唇倾角、鼻唇沟角、下唇倾角、颏唇沟角及软组织到参考平面的距离均有显著变化.结论 男女骨性Ⅲ类成人手术患者唇部软组织厚度差异不大,在唇长度及颏唇部形态上存在一定差异.双颌手术较单颌手术而言,能同时对上下唇部软组织形态加以改善,适合鼻唇、颏唇形态均不佳的患者.

Objective To observe the morphology characteristics of lips and chin in skeletal Class Ⅲ malocclusion patients and the soft tissue changes after different orthognathic surgery patterns.Methods The 94 adult surgery patients with skeletal Class Ⅲ malocclusion were selected,which comprised of 31 mandible-only cases,10 maxilla-only cases and 53 two-jaw cases.The gender difference on soft tissue morphology and changes of lips following different orthognathic surgeries were evaluated by cephalometric analysis.Results The gender differences were found only on the length of upper lip,the depth and degree of mentolabial fold.In the mandible-only group,the Li-LL、B＇-B、LLL、B＇-（LL-Pog＇）、B＇-LL-FH、LL-B＇-Pog＇、UL-SnPog＇、LL-SnPog＇、B＇-SnPog＇、Sn-H line、Li-H line、Sm-H line、Ns-H line、Ls-NsPog＇ in both gender have changed significantly.In maxillaonly group,the depth of the upper lip and ULL、A＇-（Sn-UL）、Cotg-Sn-Ls、A＇-UL-FH、B＇-LL-FH and the distance from some points to different reference lines have changed significantly.And in the two-jaw group,besides the differences observed in mandible-only group,the Cotg-Sn-Ls、A＇-UL-FH also have a significant change.Conclusions The gender difference is not significant in skeletal Class Ⅲ patients in the thickness of lip soft tissue,but is significant in the length of lips and the morphology of lips and chin.Two-jaw surgery is good at improving lip and chin morphology and is better for patients with unsatisfied nasolabial and mentolabial morphology both.