SOFT-TISSUE AND DENTOSKELETAL PROFILE CHANGES ASSOCIATED WITH MANDIBULAR SETBACK OSTEOTOMY
SOFT-TISSUE AND DENTOSKELETAL PROFILE CHANGES ASSOCIATED WITH MANDIBULAR SETBACK OSTEOTOMY
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DOI：
10.1016/0889-5406(91)70068-8
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发表时间：
1991-10-01
影响因子：
3
通讯作者：
ATHANASIOU, AE
中科院分区：
文献类型：
--
作者：
GJORUP, H;ATHANASIOU, AE
本研究的目的是(1)描述下颌骨全后退截骨术后软组织和牙齿骨骼的相互关系；(2)检测是否有任何头影测量变量可以帮助准确预测手术对软组织的影响。采用双侧升支垂直截骨术联合口外入路矫治下颌前突患者50例(女性37例，男性13例)，术前、术后头颅侧位片。手术时，他们的年龄从17岁到41岁不等。所有患者都可以在手术前和大约一年后拍摄习惯性咬合牙齿的头颅侧位X线片。开发和使用了一种计算机化的头影测量评估，称为侧貌分析，包括对应于骨骼和软组织侧貌的矢状面和垂直面关系、切迹关系、软组织厚度和嘴唇形态的变量。采用配对t检验、皮尔逊乘积矩相关系数和多元回归分析等方法对数据进行统计学处理。对结果的评估显示，手术后面部发生了相当大的变化和改善。骨骼和软组织面部轮廓得到拉直，嘴唇姿势得到改善。获得的正常切牙关系影响了覆盖在两个切牙上的软组织，并导致了更好的嘴唇能力和姿势。在B点和Po点的后移伴有相应软组织的91%~103%的减少。在骨组织变量N-B和N-Po的多元回归分析中，分别存在显著相关系数(p<；0.05)和高r平方值(>；0.70)，分别或与覆盖和S-N-B角一起，反映了它们对下唇矢状面关系、下唇厚度和下巴区域软组织厚度的高预测值。皮尔逊积矩相关分析结果还表明，上唇、下唇和下巴软组织厚度的变化受术前区域厚度的影响。
The aims of the present retrospective cephalometry study were (1) to describe the interrelationships of the soft-tissue and dentoskeletal profiles after total mandibular setback osteotomies and (2) to detect whether there were any cephalometric variables that could contribute to an accurate prediction of the surgical effect on the soft-tissue profile. The presurgical and postsurgical lateral cephalograms of 50 consecutively treated patients (37 females and 13 males) were used; these patients had received combined orthodontic-surgical management of mandibular prognathism by means of a bilateral vertical ramus osteotomy with an extraoral approach. At the time of surgery, their ages ranged from 17 to 41 years. Lateral cephalograms with the teeth in habitual occlusion taken before and approximately 1 year after surgery were available for all patients. A computerized cephalometric appraisal, named profile analysis, was developed and used, including variables corresponding to sagittal and vertical relationships of skeletal and soft-tissue profiles, incisal relationships, soft-tissue thickness, and lip morphology. The statistical elaboration of the data was made by means of paired t test, Pearson's product-moment coefficient correlation, and multiple regression analyses. The assessment of the results disclosed that considerable facial changes and improvement took place after the surgical procedure. The skeletal and soft-tissue facial profiles were straightened and the posture of the lips was improved. The normal incisal relationship achieved became influential on the soft tissues overlying both incisors and led to a better lip competence and posture. Posterior movement at points B and Po was accompanied by reductions ranging from 91% to 103% of the corresponding soft tissues. The presence of both significant correlation coefficients (p < 0.05) and high r square values (> 0.70) in the multiple regression analysis for the osseous tissue variables N-B and N-Po, alone or together with the overjet and S-N-B angle, respectively, reflected their high prediction value with regard to the sagittal relationship of the lower lip, its thickness, and the soft-tissue thickness at the chin area. The findings of Pearson's product-moment coefficient correlation also indicated that the operative changes of the thickness of the upper lip, the lower lip, and the soft tissue at the chin region are influenced by the initial preoperative thickness of the area.