国际口腔医学杂志

国际口腔医学杂志 ›› 2020, Vol. 47 ›› Issue (2): 182-188.doi: 10.7518/gjkq.2020050

• 论著 • 上一篇    下一篇

300例不同年龄段有牙颌人群上唇软组织侧貌的锥形束CT三维测量分析

章婷婷,胡常红,彭燕,周文翘,张慧聪,刘蝶()   

  1. 重庆医科大学附属口腔医院全口义齿诊疗室 口腔疾病与生物医学重庆市重点实验室重庆市高校市级口腔生物医学工程重点实验室 重庆 401147
  • 收稿日期:2019-06-15 修回日期:2019-10-22 出版日期:2020-03-01 发布日期:2020-03-12
  • 通讯作者: 刘蝶 E-mail:500315@hospital.cqmu.edu.cn
  • 作者简介:章婷婷,硕士,Email： 2017110876@stu.cqmu.edu.cn
  • 基金资助:
    重庆医科大学附属口腔医院重点科研培育项目(PYZD2016-03);2016年重庆市高校创新团队建设计划资助项目(CXTDG201602006)

Analysis of upper lip profile features in 300 dentate subjects of different ages via three-dimensional measurement of cone beam computed tomography

Zhang Tingting,Hu Changhong,Peng Yan,Zhou Wenqiao,Zhang Huicong,Liu Die()   

  1. Complete Denture Clinic, Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, China
  • Received:2019-06-15 Revised:2019-10-22 Online:2020-03-01 Published:2020-03-12
  • Contact: Die Liu E-mail:500315@hospital.cqmu.edu.cn
  • Supported by:
    This study was supported by The Key Research Cultivating Project of Stomatological Hospital of Chongqing Medical University(PYZD2016-03);Program for Innovation Team Building at Institutions of Higher Education in Chongqing in 2016(CXTDG201602006)

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摘要：

目的 通过锥形束CT（CBCT）进行三维测量,分析不同年龄段有牙颌人群上唇软组织侧貌特征,为无牙颌患者的全口义齿修复提供面部美学的客观参考依据。方法 选择300例有牙颌人群的CBCT影像资料进行研究,按照患者年龄分为青年组（20~39岁）、中年组（40~59岁）、老年组（60岁及以上）,对上唇长度、厚度等相关指标进行测量,对上唇皮肤段侧面轮廓进行形态学分析。结果 上唇长度、厚度测量指标结果显示,随着年龄增加,上唇长度逐渐变大,唇红暴露量及唇红厚度逐渐减少,差异有统计学意义（P<0.05）。青年组、中年组和老年组上唇下缘到上中切牙切点的距离分别为（1.962 2±1.107 1）、（0.835 3±1.206 6）、（0.014 1±1.225 6）mm,上唇红部厚度分别为（12.355 8±1.950 3）、（10.634 2±1.782 4）、（9.924 9±1.951 4）mm。归纳上唇侧面轮廓表现为4种形态：凹形、直形、波浪形、凸形,不同年龄段人群的侧面轮廓表现特点有明显差异,青年组凹形比例（68%）最大,中年组凹形和直形比例（80%）最大,而老年组波浪形与凸形比例（67%）最大。结论 为老年无牙颌患者进行全口义齿修复时,应充分考虑与其衰老相关的上唇侧貌特征,人工牙排列应注意上唇下缘到中切牙切缘的距离与患者年龄相符合,上唇丰满度的恢复也应考虑与同年龄有牙颌侧貌轮廓形态表现相符合。

关键词: 老年, 上唇, 侧貌, 锥形束CT, 无牙颌, 美学修复

Abstract:

Objective To measure and analyze upper lip profile features in dentate subjects among different age groups using cone beam computed tomography (CBCT) to provide an objective reference for facial esthetics in complete denture restoration. Methods A total of 300 CBCT images were selected and divided into one of the following three groups accor-ding to age: youth group (20-39 years), middle-aged group (40-59 years), and elderly group (more than 60 years). The length and thickness of the upper lip of each image were measured, and a morphological analysis of the upper lip profile was performed. Results The upper lip lengthened with aging. Moreover, the exposure of lip vermilion and the thickness of lip vermilion gradually decreased. The distance from the edge of the upper incisor to the edge the upper lip in three groups equated to (1.962 2±1.107 1), (0.835 3±1.206 6), and (0.014 1±1.225 6) mm. Moreover, the thicknesses of the lip vermilion were (12.355 8±1.950 3), (10.634 2±1.782 4), and (9.924 9±1.951 4) mm. According to the morphological analysis of the upper lip profile, the upper lip profile was presented in the following four shapes: concave, straight, wavy, and convex. Furthermore, differences were noted between groups; that is, the young group showed the largest proportion of concave upper lip profiles (68%), the middle-aged group showed the largest proportion of concave and straight upper lip profiles (80%), and the elderly group showed the largest proportion of wavy and convex upper lip profiles (67%). Conclusion Results indicated that the upper lip changes related to aging should be fully considered when complete denture restoration is performed for edentulous patients. When arranging the artificial anterior teeth, we should pay attention to the distance from the edge of the upper incisor to the edge of the upper lip while considering patients’ ages. When plumping up the upper lip using a complete denture, we should try to make the effect consistent with that observed among dentate people of the same age.

Key words: the elderly, upper lip, profile, cone beam computed tomography, edentulous, esthetic restoration

中图分类号: 

  • R783.4

表 1

3组患者的基本资料"

组别 例数 年龄/岁 平均年龄/岁 男性 女性
青年 100 20~39 30.04±4.97 49 51
中年 100 40~59 49.04±5.16 48 52
老年 100 ≥60 72.04±5.58 50 50

图 1

测量参考标志点及参考线 1：Sn;2：Ls;3：Sm;4：Sto;5：ANS;6：A;7：UP;8：Hm;9：US;10：UI;11：Sn-Ls。"

表 2

上唇长度、厚度的线距测量项目"

测量项目 定义 测量方法
UI-US* 上唇下缘到上中切牙切点的距离 US到UI连线长度
Sn-Sto 上唇总长度 Sn到Sto连线长度
Sn-Ls 上唇皮肤长度 Sn到Ls连线长度
Ls-Sto 上唇红长度 Ls到Sto连线长度
ANS-UI 前鼻棘点到上中切牙切点的距离 ANS到UI连线长度
Sn-A 上唇基部厚度 Sn到A连线长度
Sm-Hm 上唇中部厚度 Sm到Hm连线长度
Ls-UP 上唇红部厚度 Ls到UP连线长度

表 3

上唇长度、厚度各测量项目间的比值"

测量项目 定义
Ls-Sto/Sn-Ls 上唇红长度与上唇皮肤长度的比值
Ls-Sto/Sn-Sto 上唇红长度与上唇总长度的比值
Ls-Sto/ANS-UI 上唇红长度与前鼻棘点到上中切牙切点距离的比值
Sn-Ls/ANS-UI 上唇皮肤长度与前鼻棘点到上中切牙切点距离的比值
Sn-Sto/ANS-UI 上唇总长度与前鼻棘点到上中切牙切点距离的比值
Ls-UP/Sn-A 上唇红部厚度与上唇基部厚度的比值
Sm-Hm/Sn-A 上唇中部厚度与上唇基部厚度的比值

图 2

上唇皮肤段侧面轮廓形态 A：凹形;B：直形;C：波浪形;D：凸形。"

表 4

3组上唇及上唇红长度各指标的测量结果"

测量项目 青年组 中年组 老年组
UI-US/mm 1.962 2±1.107 1 0.835 3±1.206 6 0.014 1±1.225 6
Sn-Ls/ANS-UI 0.478 3±0.063 3 0.528 7±0.066 4 0.558 1±0.062 7
Sn-Sto/ANS-UI 0.749 1±0.068 6 0.773 6±0.062 5 0.772 9±0.060 1
Ls-Sto/Sn-Ls 0.755 4±0.164 7 0.615 5±0.140 8 0.483 0±0.115 5
Ls-Sto/Sn-Sto 0.473 7±0.068 6 0.413 1±0.060 1 0.343 2±0.059 0
Ls-Sto/ANS-UI 0.354 3±0.056 6 0.319 0±0.049 9 0.264 7±0.046 6

表 5

3组上唇厚度各指标的测量结果"

测量项目 青年组 中年组 老年组
Ls-UP/mm 12.355 8±1.950 3 10.634 2±1.782 4 9.924 9±1.951 4
Ls-UP/Sn-A 0.962 8±0.132 8 0.891 2±0.135 4 0.840 5±0.145 0
Sm-Hm/Sn-A 0.898 2±0.081 4 0.883 2±0.092 5 0.873 6±0.092 4

表 6

3组患者上唇皮肤段侧面轮廓形态分型的比例"

组别 凹形 直形 波浪形 凸形 合计
青年 68 28 4 0 100
中年 49 31 11 9 100
老年 12 21 33 34 100

表 7

老年组各年龄段上唇皮肤段侧面轮廓形态分型的比例"

年龄/岁 凹形 直形 波浪形 凸形 合计
60~69 21.2 36.4 30.3 12.1 100
70~79 11.8 17.6 44.1 26.4 100
80~89 3.0 9.1 24.2 63.6 100
[1] Ellis JS, Thomason JM, McAndrew R . A pilot study examining the effects of enhanced aesthetics on oral health related quality of life and patient’s satisfaction with complete dentures[J]. Eur J Prosthodont Restor Dent, 2010,18(3):116-122.
[2] McCunniff M, Liu W, Dawson D , et al. Patients’ es- thetic expectations and satisfaction with complete dentures[J]. J Prosthet Dent, 2017,118(2):159-165.
[3] Marachlioglou CR, Dos Santos JF, Cunha VP , et al. Expectations and final evaluation of complete den-tures by patients, dentist and dental technician[J]. J Oral Rehabil, 2010,37(7):518-524.
[4] Waliszewski M . Restoring dentate appearance: a literature review for modern complete denture es-thetics[J]. J Prosthet Dent, 2005,93(4):386-394.
[5] Krajicek DD . Guides for natural facial appearance as related to complete denture construction[J]. J Pros-thet Dent, 1969,21(6):654-662.
[6] Patras M, Kourtis S, Sykaras N . Creating natural-looking removable prostheses: combining art and science to imitate nature[J]. J Esthet Restor Dent, 2012,24(3):160-168.
[7] Dai N, Yu XL, Sun YC . Gingival morphology-controlled design of the complete denture baseplate[J]. Int J Numer Method Biomed Eng, 2018,34(2). doi: 10.1002/cnm.2911.
[8] Barão VA, Ogawa ES, Moreno A , et al. Long-term clinical evaluation of the color stability and stainabi-lity of acrylic resin denture teeth[J]. J Prosthet Dent, 2015,113(6):628-635.
[9] Kamashita Y, Kamada Y, Kawahata N , et al. Influence of lip support on the soft-tissue profile of complete denture wearers[J]. J Oral Rehabil, 2006,33(2):102-109.
[10] Gu Y, McNamara JA, Sigler LM , et al. Comparison of craniofacial characteristics of typical Chinese and Caucasian young adults[J]. Eur J Orthod, 2011,33(2):205-211.
[11] Shindoi JM, Matsumoto Y, Sato Y , et al. Soft tissue cephalometric norms for orthognathic and cosmetic surgery[J]. J Oral Maxillofac Surg, 2013,71(1):e24-e30.
[12] Hwang HS, Kim WS, KMcNamaraim JA . Ethnic diffe-rences in the soft tissue profile of Korean and Euro-pean-American adults with normal occlusions and well-balanced faces[J]. Angle Orthod, 2002,72(1):72-80.
[13] Penna V, Stark GB, Eisenhardt SU , et al. The aging lip: a comparative histological analysis of age-related changes in the upper lip complex[J]. Plast Reconstr Surg, 2009,124(2):624-628.
[14] Iblher N, Kloepper J, Penna V , et al. Changes in the aging upper lip: a photomorphometric and MRI-based study (on a quest to find the right rejuvenation ap-proach)[J]. J Plast Reconstr Aesthet Surg, 2008,61(10):1170-1176.
[15] Fujimura T, Haketa K, Hotta M , et al. Loss of skin elasticity precedes to rapid increase of wrinkle levels[J]. J Dermatol Sci, 2007,47(3):233-239.
[16] Drummond S, Capelli J Jr . Incisor display during speech and smile: age and gender correlations[J]. Angle Orthod, 2016,86(4):631-637.
[17] Formby WA, Nanda RS, Currier GF . Longitudinal changes in the adult facial profile[J]. Am J Orthod Dentofacial Orthop, 1994,105(5):464-476.
[18] Vig RG, Brundo GC . The kinetics of anterior tooth display[J]. J Prosthet Dent, 1978,39(5):502-504.
[19] Wulf HC, Sandby-Møller J, Kobayasi T , et al. Skin aging and natural photoprotection[J]. Micron, 2004,35(3):185-191.
[20] Penna V, Stark GB, Voigt M , et al. Classification of the aging lips: a foundation for an integrated appr-oach to perioral rejuvenation[J]. Aesth Plast Surg, 2015,39(1):1-7.
[21] Wohlert AB . Reflex responses of lip muscles in young and older women[J]. J Speech Hear Res, 1996,39(3):578-589.
[22] Shaw RB Jr, Katzel EB, Koltz PF , et al. Facial bone density: effects of aging and impact on facial re-juvenation[J]. Aesthet Surg J, 2012,32(8):937-942.
[23] Shaw RB Jr, Katzel EB, Koltz PF , et al. Aging of the facial skeleton: aesthetic implications and rejuvena-tion strategies[J]. Plast Reconstr Surg, 2011,127(1):374-383.
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