国际口腔医学杂志 ›› 2023, Vol. 50 ›› Issue (3): 293-301.doi: 10.7518/gjkq.2023028
李沛然(),毕瑞野,王旻,王瑞宇,刘尧,姜楠,曹品银,祝颂松(
)
Li Peiran(),Bi Ruiye,Wang Min,Wang Ruiyu,Liu Yao,Jiang Nan,Cao Pinyin,Zhu Songsong.(
)
摘要:
目的 测量不同上颌骨正颌术式前后鼻唇区域软组织变化,分析可能导致变化的因素。 方法 2017—2021年于四川大学华西口腔医院正颌及关节外科住院行正颌手术的患者37例,其中因上颌后缩行上颌骨Le Fort Ⅰ型骨切开前徙术(LFIA)的患者18例,因上颌前突行上颌骨前份根尖下截骨后退术(AMOS)的患者19例。收集其术前即刻和术后6~12个月的螺旋CT影像,通过Mimics和3-Matic软件进行三维重建和匹配,测量软硬组织标志点变化。使用GraphPad Prism软件进行统计学分析,显著性水平α=0.05。 结果 2种术式术后最主要的软组织变化均发生在上唇区域且改变方向与骨组织移动方向相同。在前后向软组织改变上,LFIA组软硬组织改变的比例为0.628,而AMOS组为0.465。颊部和鼻尖软组织在2种术式后均发生了前移,其中AMDS组中颊部软组织前移的量与软组织厚度的改变具有显著正相关性。在垂直向软组织变化上,LFIA组鼻尖点发生上抬且其距离与颌骨前徙距离具有显著正相关性,AMOS组上唇缘点发生下降且其距离与颌骨后退距离具有显著正相关性。在水平向软组织变化上,鼻翼宽度在行2种术式后均出现增宽,但在AMOS组中鼻翼宽度增宽量与后退距离呈显著负相关。 结论 AMOS和LFIA术后的鼻唇区域软组织改变与颌骨移动量及方向具有显著相关性。上唇前后向改变与颌骨移动距离具有显著正相关性,鼻翼宽度改变与上颌骨后退距离具有相关性。以上相关性的发现可能帮助临床医生更准确地判断鼻唇区域的软硬组织改变。
中图分类号:
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