Soft tissue facial planes and masticatory muscle function in skeletal class III patients before and after orthognathic surgery treatment
Soft tissue facial planes and masticatory muscle function in skeletal class III patients before and after orthognathic surgery treatment
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DOI：
10.1016/j.joms.2007.06.645
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发表时间：
2008-04-01
影响因子：
1.9
通讯作者：
Ferrario, Virgilio F.
中科院分区：
文献类型：
--
作者：
Sforza, Chiarella;Peretta, Redento;Ferrario, Virgilio F.
目的：对正颌手术前后的面部软组织和咀嚼肌功能进行无创评估。患者和方法：8例年龄在18至36岁之间，均为骨骼III类和下颌不对称的患者，在手术干预（矢状劈开截骨下颌复位和Le Fort I上颌推进）之前（平均2个月）和之后（平均10.5个月）进行评估。根据软组织面点的三维坐标，计算面点平面的倾斜度。观察咀嚼肌表面肌电图，计算肌肉活动指数。将数据与相同性别、年龄和种族的健康受试者收集的参考值进行比较。结果：术前面部平面水平（额平面）明显低于对照组（P < 0.05）。下颌平面矢状面相对于正常值更倾斜（P < 0.001）。在咬牙过程中，标准化肌肉对称性、扭矩和活动性指标均小于参考值（P < 0.05）。手术治疗后，面部平面的倾斜度更加均匀（P < 0.05）。额、矢状面倾斜度与参考值相近，但患者间差异有统计学意义（P < 0.05）。咬肌的平均对称指数、扭矩系数和合并肌肉活动增加，但患者值仍明显低于参考值（P < 0.05）。结论：本研究中使用的形态学和功能方法被证明是一种有用的辅助诊断手段，可以对手术的最终结果进行定量评估，而无需让患者接受侵入性手术。(C) 2008年美国口腔颌面外科医师协会。
Purpose: To noninvasively assess the facial soft tissues and masticatory muscle function before and after orthognathic surgery.Patients and Methods: Eight patients aged 18 to 36 years, all with a skeletal Class III and mandibular asymmetry, were assessed both before (on average, 2 months) and after (on average, 10.5 months) surgical intervention (mandibular reduction by sagittal split osteotomy and Le Fort I maxillary advancement). From the 3-dimensional coordinates of soft tissue facial landmarks, the inclination of facial planes was calculated. Surface electromyography of the masticatory muscles was performed and indices of muscular activity computed. Data were compared with reference values collected in healthy subjects of the same gender, age, and ethnic group.Results: Before surgery, facial planes were significantly less horizontal (frontal plane) than in the reference subjects (P < .05). The sagittal projection of the mandibular plane was more inclined relative to the norm (P < .001). During teeth clenching, all indices of standardized muscular symmetry, torque, and activity (P < .05) were smaller than the reference values. After surgical treatment, the inclinations of facial planes became more homogenous (P < .05). The inclination of the frontal and sagittal planes came next to the reference values, but still differed significantly in the patients (P < .05). The mean symmetry index of masseter muscle, torque coefficient, and pooled muscle activity increased, but the patient values remained significantly under the reference values (P < .05).Conclusion: The morphologic and functional approach used in this study proved useful as a complementary diagnostic aid, enabling quantitative evaluation of the final results of surgery, without submitting the patients to invasive procedures. (C) 2008 American Association of Oral and Maxillofacial Surgeons.