矢状向颌骨关系对全口重建颌位关系及排牙指导的初步研究

A preliminary study on sagittal jaw relationship for reconstruction of jaw relation and tooth arrangement

目的分析Ⅰ、Ⅱ、Ⅲ类颌骨关系患者面部软、硬组织标志点的差异,为咬合重建或无牙颌患者修复治疗提供参考。方法收集2019年1月—2020年9月至同济大学附属口腔医院就诊拍摄头颅定位侧位片的患者,共计329例。根据ANB大小分为Ⅰ类(2°~5°)、Ⅱ类(>5°)和Ⅲ类患者(<2°);根据下颌平面角(FH-MP)大小分为高角型(>32°)、均角型(22°~32°)和低角型(<22°)。对其进行面部软、硬组织高度、角度及比例的头影测量分析。结果 (1)总人群中Ⅰ、Ⅱ、Ⅲ类患者共有22个测量值显示出统计学差异(P<0.05),其中前下面高(ANS-Me)满足Ⅲ类患者>Ⅰ类患者>Ⅱ类患者。(2)在高角型、均角型和低角型中,Ⅰ、Ⅱ、Ⅲ类患者仍有11个测量值具有统计学差异(P<0.05)。(3)相关性分析显示ANS-Me与其余测量值均具有相关性,其中患者关节点到髁顶点的距离(Ar-Gn)与ANS-Me的相关系数|r|_(Ⅰ)=0.839,|r|_(Ⅱ)=0.732,|r|_(Ⅲ)=0.806,均具有高度相关性。结论Ⅰ、Ⅱ、Ⅲ类颌骨关系患者的面部测量值具有差异性,修复治疗时应该把颌骨关系作为考量之一。

Objective To analyze the differences in the marks of soft and hard facial tissues in patients with the jaw relationships of ClassⅠ,Ⅱ,Ⅲ,and provide references for occlusal reconstruction or restoration treatment of edentulous patients.Methods A total of 329 cases were collected from January 2019 to September 2020 who went to the Affiliated Stomatological Hospital of Tongji University to take lateral cephalometric radiograph.According to ANB,they were divided into ClassⅠpatients(2°~5°),ClassⅡpatients(>5°),and ClassⅢpatients(<2°).According to the mandibular plane angle(FH-MP),they were divided into hyperdivergent patients(>32°),normal patients(22°~32°),and hypodivergent patients(<22°).Cephalometric analysis was performed to measure and analyze the height,angle and proportion of soft and hard tissues.Results(1)In the total population,22 measured values of ClassⅠ,ⅡandⅢpatients showed statistical differences(P<0.05).The ANS-Me was the largest in ClassⅢpatients,followed by Class I patients,and ClassⅡpatients were the smallest.(2)In the hyperdivergent patients,normal patients and the hypodivergent patients,there were still 11 measured values showing statistical differences in ClassⅠ,ⅡandⅢpatients(P<0.05).(3)Correlation analysis showed that ANS-Me was correlated with other facial measurements,and the correlation coefficient of Ar-Gn was 0.839 in ClassⅠpatients,0.732 in ClassⅡpatients,and 0.806 in ClassⅢpatients,all of which had a high correlation.Conclusion There are differences in the facial measurements of people with the jaw relationships of ClassⅠ,Ⅱ,Ⅲ,so relationship should be considered during restoration treatment.