多平面重建颧骨上颌骨复合体部软硬组织结构的测量分析  

Measurement of hard and soft tissues of the zygomaticomaxillary region by multi-planner reconstruction

作　　者：谢慧 秦波 王薮馨 莫朝伦 张军梅 Xie Hui;Qin Bo;Wang Souxin;Mo Chaolun;Zhang Junmei(School of Stomatology,Guizhou MedicalUniversity,Guiyang 550004,Guizhou Province,China;Department of Orthodontics,the Affiliated Stomatological Hospital of Guizhou Medical University,Guiyang 550004,Guizhou Province,China)

机构地区：[1]贵州医科大学口腔医学院,贵州省贵阳市550004 [2]贵州医科大学附属口腔医院口腔正畸科,贵州省贵阳市550004

出　　处：《中国组织工程研究》2019年第31期4945-4949,共5页Chinese Journal of Tissue Engineering Research

基　　金：贵阳市科技攻关项目基金[筑科合同GG字(20141001)40号],项目负责人:张军梅~~

摘　　要：背景:研究表明骨性Ⅲ类错畸形涉及到患者整个颅颌面部的软硬组织异常,严重者需行正畸正颌联合治疗。对于上颌发育不足的骨性Ⅲ类错患者常伴有面中部组织的塌陷,颧上颌复合体作为面中部的重要骨性支撑影响面部外形,因此正畸或正颌治疗设计需将该部分的软硬组织形态特征作为重要参考。目的:通过锥形束CT多平面重建视野测量上颌发育不足的骨性Ⅲ类患者与正常对照组人群颧上颌复合体部软硬组织形态差异。方法:选择30例上颌发育不足骨性Ⅲ类患者为试验组,另取30例正常人群为对照组。收集所有患者锥形束CT图像,所得图像以DICOM格式导入MIMCS19.0进行多平面重建,确定参考平面后,定义矢状向水平向共6个测量平面,其并与颧上颌复合体前表面相交于8点,在水平位图像上测量各点处的软硬组织厚度、在轴向和矢状向测量角度。结果与结论:(1)试验组颧上颌复合体表面各测量位点硬组织厚度小于正常对照组(P <0.05),软组织厚度差异无显著性意义(P> 0.05);(2)试验组S2,S3,I1处测量角度矢状向上颌角、矢状向颧突角小于对照组,而IMTA大于对照组(P <0.05);(3)伴上颌发育不足的骨性Ⅲ类患者颧骨上颌骨复合体各测量位点处硬组织矢状向发育不足,表面软组织厚度两组间差异不显著,因此推测伴上颌发育不足的骨性Ⅲ类患者颧上颌部外观可能更显平坦。BACKGROUND: Skeletal class III malocclusion has been shown to involve the whole eranio-maxillofacial soft and hard tissues, and severe cases require orthodonti-orthognathic surgery treatment. The zygomaticomaxillary complex, as an important bone support in the middle of the face, affects the facial appearance. Therefore, the morphological characteristics of soft and hard tissues in this part should be taken as an important reference in the design of orthodontic or orthodonti-orthognathic surgery.OBJECTIVE: To measure the morphological differences of soft and hard tissues in the zygomaticomaxillary complex between skeletal class III malocclusion with maxillary deficiency patients and the normal control group by cone-beam CT multi-planner reconstruction technique.METHODS: Thirty patients with skeletal class III malocclusion and maxillary deficiency were selected as the trial group and 30 normal people as the control group. Cone-beam CT images of all subjects were collected, and the Mimics 19.0 software was used to reconstruct the original image. A total of six horizontal and sagittal planes, intersection points were determined to analyze the thickness of hard and soft tissues and angle of zygomaticomaxillary complex.RESULTS AND CONCLUSION:(1) The thickness of hard tissue at each measurement site on the surface of zygomaticomaxillary complex in the trial group was less than that in the normal control group(P < 0.05), and there was no significant difference in soft tissue thickness(P >0.05).(2) The measurement angles of sagittal maxillary angle, and sagittal zygomatic angle at S2, S3, and I1 in the trial group were smaller than those in the normal control group, but IMTA was larger than that in the normal control group(P < 0.05).(3) Compared with the normal control group, the development of the zygomaticomaxillary complex in the patients with skeletal class III malocclusion and maxillary deficiency was insufficient and zygomatic appearance was more flat. The difference in surface soft tissue thickness between the two

关 键 词：锥形束CT 骨性Ⅲ类 上颌发育不足 颧上颌复合体 正畸 骨面型 多平面重建 头影测量 

分 类 号：R445[医药卫生—影像医学与核医学] R783.5[医药卫生—诊断学]