三维头影测量分析法在正颌外科术前测量中的应用  

APPLICATION OF THREE-DIMENSIONAL CEPHALOMETRIC ANALYSIS IN ORTHOGNATHIC SURGERY

作　　者：王瑞晨[1] 李桂珍[2] 柳春明[2] 贾赤宇[1] 

机构地区：[1]解放军第309医院烧伤整形科,北京100091 [2]解放军总医院整形外科

出　　处：《中国修复重建外科杂志》2014年第7期873-878,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家重点基础研究发展计划(973)资助项目(012CB518104);北京市自然科学基金资助项目(7072075);全军医学科技"十二五"重点课题(BWS11C061)~~

摘　　要：目的建立一套基于CT三维重建影像研究牙颌面畸形的三维头影测量分析法。方法以2012年1月-2013年10月收治的15例牙颌面畸形拟行正颌手术的患者作为实验对象,其中男7例,女8例;年龄17~37岁,平均23.6岁。下颌前突伴上颌发育不足4例,上颌前突伴下颌发育不足4例,长面综合征2例,颜面不对称畸形5例。术前采用16排螺旋CT扫描获得头颅数据,以DICOM3.0格式输入Mimics进行骨骼三维重建,以法兰克福平面为水平基准平面,建立以鼻根点为原点的三维坐标系,对牙颌面硬组织的三维空间关系进行测量分析。结果应用CT三维重建影像进行三维头影测量,可获得相应标志点及定义的测量平面间的三维空间关系准确数值,测量结果全面、直观,减少了术前测量分析工作量。结论建立的三维头影测量分析法可以全面评估牙颌面硬组织形态和三维空间关系,对准确量化牙颌面畸形具有实际指导作用。Objective To establish a model of three-dimensional（3-D） cephalometric analysis to study dentomaxillofacial deformities. Methods Between January 2012 and October 2013, 15 patients with dentomaxillofacial deformities were treated using 3-D cephalometric analysis in orthognathic surgery plan. There were 7 males and 8 females with an average age of 23.6 years（range, 17-37 years）, including 4 cases of mandibular protrusion with maxillary dei ciency, 4 cases of maxillary protrusion with mandibular dei ciency, 2 cases of long face syndrome, and 5 cases of facial asymmetry. CT images were reconstructed by Mimics software. The anatomical landmarks were located, the reference planes and analysis planes were dei ned and the 3-D coordinate was established. The distance and degree between landmarks and analysis planes which dei ned in the measure project were measured. Results Based on the 3-D CT quantitative analysis methods, cephalometric analysis project was dei ned in the 3-D coordinate. 3-D cephalometric analysis provided a convenient and precise method for the clinical measurement of dentomaxillofacial morphology, and reduce the time in preoperation analysis. Conclusion The model of 3-D CT cephalometric analysis can provide precise information in the diagnosis and treatment planning of orthognathic surgery.

关 键 词：CT三维重建 牙颌面畸形 三维头影测量分析 

分 类 号：R783.5[医药卫生—口腔医学]