上海交通大学学报（医学版）

上海交通大学学报(医学版) ›› 2020, Vol. 40 ›› Issue (06): 835-840.doi: 10.3969/j.issn.1674-8115.2020.06.020

• 论著·临床研究 • 上一篇    下一篇

上颌骨Le Fort Ⅰ型截骨前移后鼻唇部软组织变化的三维测量分析

徐昱婷*，应王君子*，王舒泽，李 彪，王旭东   

  1. 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；上海市口腔医学重点实验室?上海市口腔医学研究所；国家口腔疾病临床医学研究中心，上海 200011
  • 出版日期:2020-06-28 发布日期:2020-06-28
  • 通讯作者: 王旭东，电子信箱：xudongwang70@hotmail.com。
  • 作者简介:徐昱婷（1995—），女，硕士生；电子信箱：xyt1399@163.com。应王君子（1989—），男，硕士；电子信箱：452519070@qq.com。*共同第一作者。
  • 基金资助:
    上海市卫生计生委智慧医疗专项研究项目（2018ZHYL0208）；上海市教育委员会高峰高原学科建设计划（20152225）。

Three-dimensional measurement and analysis of nasolabial soft tissue changes following maxillary anterior movement by Le Fort Ⅰ osteotomy

XU Yu-ting*, YINGWANG Jun-zi*, WANG Shu-ze, LI Biao, WANG Xu-dong   

  1. Department of Oral and Craniomaxillofacial Surgery, School of Stomatology, Shanghai Ninth People’ s Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center for Oral Diseases, Shanghai 200011, China
  • Online:2020-06-28 Published:2020-06-28
  • Supported by:
    Wisdom Medical Special Research Project of Shanghai Municipal Commission of Health and Family Planning (2018ZHYL0208); Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support (20152225).

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摘要： 目的·使用面部软组织三维测量方法分析中国颌骨畸形患者行上颌骨Le Fort Ⅰ型截骨前移后鼻唇部软组织的变化规律。方法·选择2017年1—12月于上海交通大学医学院附属第九人民医院口腔颅颌面科接受上颌骨Le Fort Ⅰ型截骨术前移下降及双侧下颌支矢状劈开术截骨后退（双颌手术）治疗的37例骨性Ⅲ类错畸形患者为研究对象。患者于术前1周内及术后6个月行全头颅螺旋CT扫描和面部软组织三维立体摄像。使用3dMD vultus软件对鼻唇部软组织的测量标志点及相关距离、角度进行标记及测量，并比较手术前后的差异。结果·双颌手术后患者鼻翼宽度平均增加0.82 mm，鼻翼基底宽度平均增加1.07 mm，上唇长度平均增加1.41 mm，鼻唇角平均增加3.09?，鼻尖角平均减小1.51?，且差异具有统计学意义（均P<0.05），而鼻高度、鼻背长度、鼻额角基本稳定。结论·经上颌骨Le FortⅠ型截骨前移后，颌骨畸形患者的面部有所改善，同时其鼻唇部软组织也有一定改变。

关键词: 正颌手术, 鼻唇部软组织变化, 三维测量分析

Abstract:

Objective · To evaluate nasolabial soft tissue changes of Chinese patients with malocclusion after maxillary anterior movement by Le FortⅠosteotomy with three-dimensional measurement. Methods · From Jan. to Dec. 2017, 37 patients with skeletal Class Ⅲ malocclusion from Department of Oral and Craniomaxillofacial Surgery of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, who underwent maxillary Le FortⅠosteotomy for anterior movement and bilateral sagittal split ramus osteotomy (bi-maxillary orthognathic surgery), were included. A full cranial spiral CT scan and three-dimensional facial soft tissue images were performed within 1 week before and 6 months after operation. Landmarks, relative distance and angle of nasolabial soft tissue were located and measured by 3dMD vultus software, and the differences before and after operation were compared. Results · After bi-maxillary orthognathic surgery, the alar width increased by an average of 0.82 mm, the subalar width increased by an average of 1.07 mm, the upper lip length increased by an average of 1.41 mm, the nasolabial angle increased by an average of 3.09?, and the pronasal angle decreased by an average of 1.51?(all P<0.05), while nasal height, nasal length and nasal frontal angle were basically stable. Conclusion · After the maxillary Le Fort I osteotomy for anterior movement, the face of patient with malocclusion is improved, and the nasolabial soft tissue is also changed.

Key words: orthognathic surgery, nasolabial soft tissue change, three-dimensional measurement and analysis

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