Investigation into Pre and Post Operative Functional Changes of Jaw Movement and Oral Cavity Related Muscles of Maxillofacial Deformaties.

我们采用计算机图形学（CG）、超声心动图和肌电图技术，建立了牙面畸形综合测量系统，以评估正颌手术后硬、软组织的形态学变化，并阐明颞下颌关节（TMJ）、舌部和咀嚼肌的功能变化。颌面部区域三维测量与显示系统的开发：除了我们已经开发的CT图像三维重建与显示系统外，我们还开发了面部石膏模型三维自动测量、评估与显示系统（5,6,16,19）。该系统实现了自动、精确的三维测量，并可在cg上显示测量结果。它具有“Best Fit”功能，可以检测到面部的细微形态学变化，并可以定量测量和显示面部各个部位在手术后或生长过程中的形态学变化。一种功能性颌部运动评价方法的建立：我们开发了一种颌部运动时咀嚼肌肌电图和超声图同步采集系统（7,17）。这种系统和分析是非常独特的，将为研究肌肉的功能形态变化提供一种有用的方法。临床研究及手术方法的改进：我们对颌面部畸形进行了多种正颌手术，观察手术后形态学和功能的变化（1,8,9,12,13,15,20）。然后，我们澄清如下；下颌突髁在下颌窝内呈微前位（18），舌骨上肌和舌骨下肌参与下颌支矢状劈开截骨后的复发（3,4），舌的位置对骨骼稳定性有较大影响（1,12）。参考以上数据，我们开发了下颌支矢状劈裂截骨近段定位系统，减少了复发。我们还开发了一种人工TMJ，并对因TMJ破坏而出现咀嚼和呼吸障碍的患者进行了TMJ全置换（10,11,14）。此外，我们利用上述三维测量系统定量地指出了唇腭裂患者面部畸形的特征，并展示了该系统的实用性（5,16,19）。少

We developed a total measuring system for dento-facial deformities using computer graphics (CG), ultrasonic echogram and electromyogram to evaluate morphological change of the hard and soft tissue after orthognathic surgery, and to clarify functional change of the temporo-mandibular joint (TMJ), tongue and masticatory muscle.1.Development of a three dimensional measuring and display system for maxillofacial region : In addition to the three dimensional reconstruction and display system for CT images already developed by ourselves, we developed an automatic three dimensional measuring, evaluating and display system for facial plaster models 5,6,16,19). This system realizes the automatic and accurate three dimensional measuring, and can display the result with CGs. It has the "Best Fit" function which detects even slight morphological change of the face, and can measure and display morphological changes after surgey or with growth at every part of the face quantitively.2.Development of a … More evaluating method of the functional jaw movement : We developed a system which can get the electromyogram and ultrasonic echogram of the masticatory muscles synchronously at the jaw movement7,17). This kind of system and analysis is very unique, and will be a useful method for the investigation into the functional morphological changes of the muscles.3.Clinical research and improvement of the operation method : We performed various orthognathic surgery for maxillofacial deformities, and observed the morphological and functional changes after surgery 1,8,9,12,13,15,20). Then, we clarified as following ; the condyle of the mandibular protrusion takes slight anterior position in the mandibular fossa 18), the supra- and infrahyoid muscles take part in the relapse after mandibular ramus sagittal split osteotomy 3,4), and the position of the tongue has great influence on the skeletal stability 1,12). And we developed proximal segment positioning system for mandibular ramus sagittal split osteotomy which cause less relapse referring to above data 2). We also developed an artificial TMJ and performed the total replacement of TMJ for the patients who were suffering from masticatory and respiratory disturbance due to TMJ destruction 10,11,14). In addition, we pointed out the characteristics of the facial deformities in the cleft lip and palate patients quantitively using above three dimensional measuring system and showed usefulness of the system 5,16,19). Less