骨性Ⅲ类错畸形正畸-正颌联合治疗前后颌面部的特征变化及侧貌影响因素分析

Influence factor analysis of facial profile and features of skeletal class Ⅲ malocclusion before and after combined orthodontic and surgical treatments

目的:通过对比研究骨性Ⅲ类错畸形患者正畸-正颌联合治疗前后颌面部软硬组织、侧貌变化情况,对正畸-正颌联合治疗骨性Ⅲ类错畸形提供进一步参考。方法:选择73例骨性Ⅲ类错畸形患者,分别在正畸-正颌联合治疗前后影像学资料中选择21项能够反映颌面部软硬组织、侧貌形态的参数进行对照分析,并通过相关性分析其影响因素。结果:骨性Ⅲ类错畸形患者治疗后相比治疗前硬组织参数中除MP-SN(°)、ANS-Me/N-Me(%)、L1-NB(mm)以及Y轴角(°)外,余下17项参数差异均有统计学意义(P<0.05);通过将部分硬组织参数及其相应的软组织参数进行相关性分析,可得出大部分硬组织参数与其相应的软组织参数存在相关性,尤其软组织面角FH-N`Pg`(°)与面角NP-FH(°)、Y轴角(°)及SNA(°)相关系数达到0.914、-0.883和-0.742,可见两者存在较高相关性。结论:骨性Ⅲ类错畸形患者正畸-正颌联合治疗前影响其软组织侧貌最为主要的因素为骨性因素,其他因素为牙性因素和软组织厚度因素。该类患者侧貌特点主要体现为面下三分之一部分在矢状向发育过度畸形,常伴有颏部后缩,而垂直向一般无明显异常。通过正畸-正颌联合治疗可使侧貌改善。

Objective To provide further and effective reference for the combined orthodontic and surgical treatments of patients with skeletal class Ⅲ malocclusion.through studying the changes between the characteristics of soft and hard tissue profile before and after combined orthodontic and surgical treatments. Methods The study included 73 skeletal class Ⅲ malocclusion patients.Chose 21 indexes which pertaining to the characteristics of soft and hard tissue profile from the imaging data before and after combined orthodontic and surgical treatments.then research the influencing factors through contrast analysis and correlation analysis. Results There was significant differences between the before and after combined orthodontic and surgical treatments in the 17 of above mentioned indexes,except for ANS-Me/N-Me（%）,L1-NB（mm）,Y-axis angle（°） and MP-SN（°）.High correlation was found in several hard tissue indexes and their corresponding soft tissue indexes, the correlation coefficient of NP-FH（°） and Y-axis angle（°）,SNA（°） and FH- NPg（°） attain to 0.914,-0.883,-0.742 respectively. Conclusion According to skeletal class Ⅲ malocclusion patients,osseous factor is the main influencing factors on facial profile,others are dental factor and soft tissue thickness.Cephalometric characteristics of these patients mainly reflected the lower one third of the face to the overgrown in the sagittal deformity, often accompanied by receding chin, while the vertical to the general has no obvious abnormalities. Through combined orthodontic and surgical treatments can improve the side appearance.