正颌外科手术的计算机辅助模拟以及预测的准确性评价  

Application and Accuracy Assessment of Computer Aided Stimulation in Orthognathic Surgery

作　　者：安娜[1] 郑颖[1] 牛磊[1] 郭咏娟[1] 白璐[1] 刘帆[1] 刘奕[1] 

机构地区：[1]中国医科大学附属口腔医院正畸科,辽宁省口腔医学研究所,辽宁沈阳110002

出　　处：《口腔医学研究》2014年第6期523-527,共5页Journal of Oral Science Research

基　　金：辽宁省科学技术计划项目(2013225090);沈阳市科学计划项目(F13-262-9-07)

摘　　要：目的：计算机辅助模拟正颌外科手术术后软硬组织侧貌,分析术前预测值与术后实际值之间的差异。方法：选取预进行正颌外科手术的牙颌面畸形患者术前去代偿后的侧貌照片和头颅侧位定位片输入Winceph 8.0系统进行头影测量分析,并通过骨段移动来模拟正颌手术,预测术后软硬组织侧貌。将术后6个月以上的头颅侧位定位片输入Winceph 8.0系统进行头影测量分析,选取19项测量参数,将术前预测值和术后实际值进行配对t检验,并评价患者性别以及骨段移动距离对预测结果的影响,评价该预测系统的准确性。结果：硬组织相关的11个测量项目,其术前模拟值和术后实际值间比较均无统计学意义。软组织相关的8个测量项目术前模拟值和术后实际值间比较,仅上唇长有统计学意义（P〈0.05）,其余测量项目均无统计学意义。不同性别的测量结果比较,差异无统计学意义。下颌骨段水平向移动大于8mm组和4-6mm组、6-8mm组相比,上唇长有统计学意义（P〈0.05）。下颌骨段垂直向移动-2-0mm、0-2mm和2-4mm相比,差异无统计学意义。上颌骨段水平向移动2-4mm组与4-6mm组之间,以及垂直向移动-2-0mm与0-2mm之间相比,差异无统计学意义。结论：Winceph8.0系统对正颌手术术后硬组织侧貌的预测准确,对软组织的预测稍显不足,尤其是上唇长。预测结果不受性别影响。下颌骨段后退大于8mm的患者,上唇长的预测准确性较低。Objective： To predict lateral features of soft and hard tissue by computer aided stimulation in orthognathic surgery, analyze the differences between predicted surgical parameters and actual postsurgical parameters. Methods： 51 patients treated with orthognathic surgery （30 mandibular surgery and 21 bimaxillary surgery） were obtained. Their lateral cephalograms and color lateral photos before surgery and after 6 months of surgery were input to Winceph 8.0 system. We stimulate orthognathic surgery by bone movement, and predict lateral features of soft and hard tissue. We choose 19 parameters and compare predicted surgical parameters with actual postsurgical parameters by paired t--test. The effects of gender and distance of bone movement were analysed, the accuracy of the stimulation system were assessed. Results： Eleven parameters of hard tissue and seven parameters of soft tissue in this study were similar. There were statistical differences in only of the labral length （P〈0.05）. There was no statistically differences on gender. Compared with 4--6mm group and 6--8mm group, there was statistically significant differences in upper lip length in 〉8mm group of mandibular horizontal movement （P〈0.05）. There was no statistically difference in mandibular vertical movement and maxillary movement. Conclusion： Winceph 8.0 system is precise for the prediction of simulated hard tissue in orthognathic surgery, little shortcoming in the prediction of soft tissue, especially in upper lip length. The prediction was not affected by gender. The accuracy of upper lip length in 〉8mm group of mandibular horizontal movement was low.

关 键 词：正颌手术 侧貌 预测 

分 类 号：TP391.7[自动化与计算机技术—计算机应用技术] R783.5[自动化与计算机技术—计算机科学与技术]