多个解剖标志点建立下颌骨理想正中矢状平面的研究

The study of establishing the ideal median sagittal plane of mandible based on multipleanatomic landmarks

目的采用多个下颌骨解剖标志点建立下颌骨正中矢状平面,寻找适用于临床诊疗的下颌骨理想正中矢状平面。方法分析2020年6—12月西部战区总医院口腔科颌面部正常患者30例[男15例、女15例,年龄20~60(40.9±13.7)岁]的颌面部螺旋CT资料,用Mimics Research 21.0软件重建三维头颅模型,取不同解剖标志点建立多个下颌骨正中矢状面,以全头颅正中矢状面做参照,不同正中矢状面分别作为镜像平面建立镜像模型,通过3-Matic Research软件的重叠性三维色彩图示及Friedman检验分别定性和定量比较原模型与镜像模型的重叠度,评估不同平面作为下颌骨MSP的应用效果。结果全头颅正中矢状面与不同下颌骨正中矢状面分别作为镜像平面,下颌骨镜像模型与原模型重叠度差异有统计学意义(χ^(2)=12.34,P<0.05)。平面Mf-Go-Sim的镜像模型与原模型重叠度差异最小0.07(0.04,0.18)mm;平面N-ANS-PNS重叠度差异0.14(0.09,0.58)mm;平面ANS-SBWG-Mp重叠度差异0.12(0.04,0.40)mm;平面Me-B-Sim重叠度差异0.19(0.09,0.44)mm;平面Po-B-Go重叠度差异0.18(0.06,0.45)mm。结论全头颅正中矢状面不能完全替代下颌骨正中矢状面;平面Mf-Go-Sim可作为临床应用的下颌骨理想正中矢状面。

Objective To apply multiple mandibular anatomical landmark points to establish the mandibular median sagittal plane to find and establish the ideal median sagittal plane of the mandible that is suitable for clinical diagnosis and treatment.Methods The maxillofacial spiral CT data of 30 normal maxillofacial patients in the Western Theater General Hospital were collected,and the 3D cranial model was reconstructed by using Mimics Research 21.0 software to select different anatomical landmarks to establish multiple mandibular MSPs,and with the whole cranial MSP as a reference,the different MSPs were respectively used as the mirror planes to establish a mirror model.The overlap of the original model and the mirror model were compared qualitatively and quantitatively by the overlap three-dimensional color illustration of 3-Matic software and Friedman′s test,respectively,to evaluate the application effect of different planes as mandibular MSPs.Results There was a statistically significant degree of overlap between the mandibular mirror model and the original model with the whole head MSP and the different mandibular MSPs as mirror planes,respectively(χ^(2)=12.34,P<0.05).The mirror model of plane Mf-Go-Sim had the smallest overlap with the original model 0.07(0.04,0.18)mm;plane N-ANS-PNS was the second smallest 0.14(0.09,0.58)mm;the difference in overlap of plane ANS-SBWG-Mp 0.12(0.04,0.40)mm;the difference in overlap of plane Me-B-Sim 0.19(0.09,0.44)mm;the difference in overlap of plane Po-B-Go 0.18(0.06,0.45)mm.Conclusions Whole-head MSP cannot completely replace mandibular MSP;plane Mf-Go-Sim can be the ideal MSP for the mandible in clinical applications.