三维测量法分析上颌骨垂直向发育不足患者正颌术后稳定性

doi:10.19438/j.cjoms.2019.06.009

中国口腔颌面外科杂志 ›› 2019, Vol. 17 ›› Issue (6): 526-530.doi: 10.19438/j.cjoms.2019.06.009

三维测量法分析上颌骨垂直向发育不足患者正颌术后稳定性

王舒泽, 王旭东

上海交通大学医学院附属第九人民医院·口腔医学院口腔颅颌面科,国家口腔疾病临床医学研究中心, 上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011

收稿日期:2019-03-25 出版日期:2019-11-20 发布日期:2019-12-16
通讯作者: 王旭东,E-mail: xudongwang70@hotmail.com
作者简介:王舒泽（1993-）,男,硕士,E-mail: 2623959569@qq.com

Evaluation of postoperative maxillary stability of orthognathic surgery in patients with maxillary vertical dysplasia using three-dimensional measurement

WANG Shu-ze, WANG Xu-dong

Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Center for Clinical Research of Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai Institute of Stomatology. Shanghai 200011, China

Received:2019-03-25 Online:2019-11-20 Published:2019-12-16

摘要/Abstract

摘要： 目的: 采用三维重建方法评价上颌骨垂直向发育不足患者正颌术后上颌骨位置变化,以探讨该类患者术后颌骨的稳定性及其影响因素。方法: 选取2016 年1月—2016年9月上海交通大学医学院附属第九人民医院口腔颅颌面科应用Le Fort I型截骨术矫治上颌骨垂直向发育不足的患者50例,收集术前2个月（T0）、术后3 d（T1）、术后6个月（T2）的三维CT图像,分别利用Proplan CMF 3.0软件对前鼻嵴点（ANS）、腭大孔点（GPL/R）进行测量,采用SPSS 13.0软件包对上述测量值进行样本均数t检验,比较该类患者术后上颌骨的稳定性;并对具有明显复发倾向者进行回归分析以及工作特征曲线分析,以探索其影响因素。结果: 统计学分析发现,ANS-FH（T2-T1）出现显著变化,平均上移1.11 mm（P<0.05）。术后垂直向复发现象主要与上颌骨术中的垂直向移动距离以及上颌骨后部的术中垂直向移动有关。结论: 应用Le Fort I 型截骨术矫治上颌骨垂直向发育不足患者具有一定复发倾向,其稳定性受到上颌骨术中位移距离及术后随访时间的影响。

关键词: 正颌外科, 三维测量法, 上颌骨垂直向发育不足, 稳定性, ROC分析

Abstract: PURPOSE: To evaluate maxillary skeletal stability after downward Le Fort I (LF1) osteotomy and to use three-dimensional measurements to investigate the effects of factors on postoperative stability. METHODS: Fifty patients were treated with LF1 osteotomy with downward and setback bilateral sagittal split osteotomy. The position of the maxilla was measured using spiral computed tomography data from preoperative (T0), 3 days postoperatively (T1), and more than 6 months postoperatively (T2) time points. To assess the postoperative maxillary changes, there 3-dimensional alterations in the landmarks [bilateral greater palatine foramen (GP), anterior nasal spine (ANS)at follow-up were measured. Statistical analysis was performed using SPSS 12.0 software package. RESULTS: In all 50 cases of downward LF1 osteotomy, the vertical dimensional relapse of the ANS from T2-T1 was 1.11 mm. The relapse was correlated with the amount of anterior maxillary vertical surgical movement and type of posterior vertical movement. CONCLUSIONS: LF1 osteotomy to move the maxilla downward is a high-risk surgical procedure that might result in relapse. Some factors contributing to relapse patterns include the amount of downward surgical movement, movement in the posterior maxilla. All of these factors should be considered during surgical treatment planning.

Key words: Orthognathic surgery, Three-dimensional measurement: Maxiilary vertical dysplasia, Stability, ROC analysis

中图分类号:

R782.2

王舒泽, 王旭东. 三维测量法分析上颌骨垂直向发育不足患者正颌术后稳定性[J]. 中国口腔颌面外科杂志, 2019, 17(6): 526-530.

WANG Shu-ze, WANG Xu-dong. Evaluation of postoperative maxillary stability of orthognathic surgery in patients with maxillary vertical dysplasia using three-dimensional measurement[J]. China J Oral Maxillofac Surg, 2019, 17(6): 526-530.

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三维测量法分析上颌骨垂直向发育不足患者正颌术后稳定性

Evaluation of postoperative maxillary stability of orthognathic surgery in patients with maxillary vertical dysplasia using three-dimensional measurement

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