正颌外科手术矫治骨性Ⅲ类错牙合畸形术后软硬组织变化的初步研究

A preliminary study on the changes of soft and hard tissues after treatment of Class Ⅲ skeletal malocclusion by orthognathic surgical procedures

目的探索临床同期行双颌手术的骨性Ⅲ类错牙合畸形患者水平方向上软硬组织的变化的相关关系。方法 41例骨性Ⅲ类错牙合畸形患者正颌外科手术前后的X线头颅定位侧位片,设定颅颌面部16个软硬组织标志点,建立坐标系,对相应标志点水平方向的线距变化进行统计分析。结果下颌的软硬组织之间相关性高(r>0.9),上颌除了鼻尖点(Prn)与前鼻棘点(ANS)相关性差外,其他相应标志点之间呈中度相关。具体比率为:Sn:A=0.546(r=0.622);UL:UI=0.63(r=0.79);LL:LI=1.05(r=0.94);B':B=0.9(r=0.93);Pos:Po=0.87(r=0.95)。结论骨性Ⅲ类错牙合畸形患者正颌手术前后软硬组织标志点水平方向按照一定的比率进行改变,该研究结果可为骨性Ⅲ类错牙合畸形患者正颌术前设计提供参考。

Objective To investigate the correlation of the changes of the soft and hard tissues and the treatment of patients with Class Ⅲ skeletal malocclusion through concurrent bimaxillary surgeries. Methods The X-ray lateral cephalometric radiographs before and after the orthognathic operations of altogether 41 patients suffering from Class Ⅲ skeletal malocclusion were obtained. And 16 soft and hard tissue mark points were set at the craniofacial region. A coordinate system was established and the changes in the horizontal distance from the corresponding mark points were summarized and analyzed. Results The soft and hard tissues at the lower jaw have higher correlation（r 0.9）. The correlation are medium for all the mark points at the upper jaw except for the nasal tip point（Prn） and the acanthion（ANS）, which have poor correlations. The specific ratios are Sn：A=0.546（r=0.622）： UL：UI=0.63（r=0.79）; LL：LI=1.05（r=0.94）; B＇：B=0.9（r=0.93）; Pos：Po=0.87（r=0.95）. Conclusion The changes in the horizontal distances of the mark points of the soft and hard tissues of patients suffering from Class Ⅲ skeletal malocclusion before and after orthognathic operation follow certain ratios. These study results can provide references for the design of the orthognathic operation for patients suffering from Class Ⅲ skeletal malocclusion.