骨性安氏Ⅲ类错正颌术后侧貌预测及评价

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目的预测骨性安氏Ⅲ类错患者正颌外科手术术后的面部软组织侧貌,分析侧貌美观评价的差异,为正畸治疗和正颌外科手术方案的设计提供参考。方法选择中国医科大学口腔医学院正畸科2005年2月收治的骨性安氏Ⅲ类错患者1例。模拟正颌外科手术的设计方案,对术前正畸去代偿后的侧貌照片及头颅定位侧位片进行图片叠合处理,上颌硬组织以术前影像为基准,分别前移0、2、4、6、8mm,软组织按相应比例移动,下颌后退至正常覆、覆盖关系,生成5张面部侧貌图片。选择3组评分者:医生组(正畸及正颌外科医生,41名)、口腔本科生组(中国医科大学口腔医学专业本科生,44名)和患者组(骨性Ⅲ类错畸形患者,20例)。对术前及预测的共6张图片(图2a、2b、2c、2d、2e、2f)进行随机排序,由高到低评分,比较所有图片的评分差异以及评分者性别对评分结果的影响。结果 6张图片的得分差异均具有统计学意义(P<0.05),评分由高到低的顺序为:图2c、2d、2a、2f、2b、2e。3组间及不同性别评分者的评分结果比较,差异均无统计学意义(P>0.05)。结论比较评分者对术后预测图片的评价结果,直面型满意度最高,凸面型其次,凹面型最低;评价结果不受性别影响。 Objective To predict the facial soft tissue appearance of patients with skeletal Class Ⅱ malocclusion after orthognathic surgery, and to analyze the difference of facial appearance evaluation to provide reference for the orthodontic treatment and the design of orthognathic surgery. Methods One case of skeletal Class Ⅱ malocclusion was admitted to Department of Orthodontics, China Medical University Stomatology in February 2005. Simulating the design of orthognathic surgery, preoperative orthodontic compensatory contouring photographs and cephalometric images were superimposed on the lateral radiographs, the maxillary hard tissue preoperative images as the base, respectively, forward 0,2 , 4,6,8 mm, the soft tissue moved according to the corresponding ratio, mandibular retreat to normal Tuo, covering the relationship to generate 5 facial profile photos. Three groups were selected: physician group (orthodontics and orthognathic surgeon, 41), oral undergraduate group (44 stomatology undergraduates from China Medical University) and patients (skeletal Class Ⅲ malformation patients , 20 cases). The preoperative and predicted total of 6 images (Figure 2a, 2b, 2c, 2d, 2e, 2f) were randomly sorted from high to low, and the differences between the scores of all the pictures and the gender of the scorers were compared. Results The scores of the 6 images were statistically significant (P <0.05). The order of the scores from high to low was: Figure 2c, 2d, 2a, 2f, 2b, 2e. There was no significant difference between the three groups and between different gender scorers (P> 0.05). Conclusion Compared with the results of the evaluation of the postoperative predictive pictures, the grading satisfaction is the highest among the grading comparisons, followed by the convex type and the lowest concave type. The evaluation results are not affected by the gender.
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