Andrews六要素指导下不同治疗方案对骨性Ⅱ类患者审美评价的影响

Influence of different treatment methods by Andrews Six Elements on facial attractiveness in skeletal ClassⅡpatients

目的评价依据Andrews六要素制定的不同治疗方案对骨性Ⅱ类患者侧貌美观的影响,并研究正畸医生与非专业人员审美评价的差异。方法选取一名符合实验标准的骨性Ⅱ类患者作为研究对象,使用Dolphin Imaging导入试验对象头颅侧位片,与侧貌照片进行重叠,以Andrews六要素理论为指导制定正畸掩饰性治疗方案、正畸代偿结合颏成形方案及正畸-正颌方案,得到相应的侧貌彩图后用Photoshop转变成侧貌剪影图,选取正畸医生和非专业人员根据Likert量表对6张剪影图进行评分。结果两组评分者均认为根据Andrews六要素制定的正畸正颌双颌手术方案侧貌最美观,正畸代偿结合颏成形方案中颏部前移8 mm次之。在专业组中,原始侧貌得分明显低于非专业组,而双颌手术侧貌得分明显高于非专业组。结论对于下颌后缩的骨性Ⅱ类患者,根据Andrews六要素制定的正畸正颌双颌手术方案是最佳治疗方式,而在正畸代偿辅以颏成形术方案中,通过Andrews六要素制定的颏部前移量最有利于患者改善侧貌美观。专业组与非专业组之间存在审美差异。

Objective Using Andrews Six Elements to develop multiple treatment options for adult skeletal ClassⅡpatients and study the influence of different treatment methods on facial profile attractiveness,and to assess the differences in preference between orthodontists and laypeople.Methods A skeletal ClassⅡpatient who met the experiment standards was selected as the subject.The facial profile photos and lateral cephalometric radiographs of the subject were input to the Dolphin Imaging program.Andrews Six Elements theory was used to develop orthodontic camouflage treatment,genioplasty with different advancement ranges and orthognathic surgery.The digital images were modified to obtain these treatments comprising 6 profile silhouettes by the Dolphin Imaging program and Photoshop software.These images were rated by clinicians and laypersons according to Likert scale.Results Both two groups agreed that the bimaxillary surgery plan based on Andrews Six Elements was the most attractive in profile,followed by the picture with genioplasty(advancement of 8 mm).The initial image score of the clinician group was lower than that of the non-professional group,while the image of bimaxillary surgery got higher scores in the clinician group than the non-professional group.Conclusion For skeletal ClassⅡpatients with mandibular retrusion,bimaxillary surgery with Andrews six elements is the best treatment method.Genioplasty with the most appropriate advancement range obtained by using Andrews Six Elements is the most beneficial to improve profile aesthetics.There is aesthetics difference between orthodontists and laypeople.