无牙颌患者修复后的面部美学评估研究进展

Research progress on orofacial aesthetic evaluation in edentulous patients after prosthetic rehabilitation

牙列缺失不仅会导致患者咀嚼、发音等功能障碍,还会继发软、硬组织退行性变,如唇颊部向内凹陷、面下1/3垂直距离变短等,影响面部美观。以往的大量研究侧重于无牙颌患者对修复效果的主观满意度,而通过标记面部客观标志点对无牙颌患者修复后效果进行审美评价的研究较少。本文从三个维度,即垂直轴、矢状轴、冠状轴探讨面型相关的美学参数在无牙颌患者的诊断及治疗计划中的应用,就无牙颌患者在进行不同类型全口义齿修复前后的面部美学评估对比的研究进展进行综述,本文对数字化美学诊断和预测进行阐述与展望,并指出对面部美学指标的评估,可以通过X线头影测量分析、二维平面摄影、三维立体摄影测量技术等方式进行定性及定量的测量,而美学评估的标准不应因修复方式的不同而改变,最终总结了与面部美学相关的22个面部标志点、11个线性指标和7个角度指标,为临床研究和工作中更好地实现全口义齿修复的个性化面部美学重建提供参考。

Dentition defect will not only lead to mastication,pronunciation and other functional disorders,but also generates secondary degeneration of soft and hard tissue,affecting orofacial aesthetics.A large number of previous studies have focused on edentulous patients'subjective satisfaction after restoration,but there were few researches on the aesthetic evaluation in edentulous patients after prosthetic rehabilitation by objectively marking facial landmarks.In this paper,we discuss the application of profile-related aesthetic parameters in the diagnosis and treatment plan of edentulous patients from three dimensions,namely,vertical axis,sagittal axis and coronal axis.There mainly reviews the research progress on the comparison of orofacial aesthetic evaluation of edentulous patients before and after different types of complete denture treatments.This paper expounds and provides forecast on diagnosis and prediction of digital aesthetics,it also points out that the evaluation of facial aesthetic indexes can be measured qualitatively and quantitatively by means of cephalometric radiography,two-dimensional(2D)images and three-dimensional(3D)stereophotogrammetry.The standard of aesthetic evaluation should not be changed according to different ways of restoration.Finally,22 facial landmarks,11 linear indexes and 7 angle indexes related to facial aesthetics are summarized,which provide a reference for the personalized facial aesthetic reconstruction of complete denture restoration in clinical research and work.