基于锥形束CT数据的下颌角截骨前后下颌骨形态变化的三维测量分析  

Mandibular morphology change due to mandibular angle osteotomy:a cone beam computed tomography-based three-dimensional cephalometry analysis

作　　者：王树 上官文松 张文文[1] 赵杨[1] 希吉日 乔祥 陈赫 吴国平[1] Wang Shu;Shangguan Wensong;Zhang Wenwen;Zhao Yang;Xi Jiri;Qiao Xiang;Chen He;Wu Guoping(Department of Plastic Surgery,the Affiliated Friendship Plastic Surgical Hospital,Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属友谊整形外科医院整形外科,210029

出　　处：《中华医学美学美容杂志》2021年第6期499-504,共6页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的用锥形束CT数据对下颌骨进行三维测量,探讨下颂角截骨手术对下颌骨形态变化的影响。方法2016年1月至2018年6月,南京医科大学附属友谊整形外科医院整形外科收集下领角肥大进行下颂角弧形截骨联合外板劈除术女性患者20例,年龄20〜35岁、平均25.5岁。将手术前、手术后10 d、手术后6个月锥形束CT资料导入ProPlan CMF 3.01,三维重建后分别测量反映下颌骨形态的7个项目,用SPSS 12.0软件进行线性相关分析和配对检验。结果手术前及手术后10 d各项测量指标经配对样本t检验结果显示,所有测量指标差异有统计学意义(均P<0.05)。手术后下颌角间距、下颌升支长度、角区最大宽度、下颌角外翻角缩小,而下颌体部长度、下领角开张度、下颂骨倾度增大,手术后双侧下颌骨形态基本对称。术后6个月与术后10 d测量指标相比,差异无统计学意义(均P>0.05),左右两侧同一测量项目比较差异无统计学意义(P>0.05)。结论基于锥形束CT数据三维重建的下颌骨模型可直观全面地显示三维解剖结构,对下颌骨的测量准确可靠,术前应精确规划下颁角截骨术的手术方案,术后定量评估手术效果。Objective To investigate the effect of mandibular angle osteotomy on the morphological changes of mandible by using cone beam computed tomography(CBCT)scanning data and three-dimensional cephalometry.Methods According to included and excluded criteria,the complete CBCT data of 20 female patients(aged 20-35 years with an average age of 25.5 years)from January 2016 to June 2018 who underwent curved mandibular angle osteotomy combined with splitting cortiec-tomy were selected.Seven items reflecting mandibular morphology before and after surgery were measured respectively.All the data were analyzed by the means of SPSS 12.0;linear correlation anal ysis and paired t test were used to evaluate the change of andibular morphology.Results The measurement results of the mandible pre-and post-operative 10 days showed as follows:Go-Go decreased,both sides of Cd-Go,Go-Ri and MR-MA decreased,both sides of Go-Me became longer,both sides of Ar-Go-Me and MP-PH increased.The paired t-test results showed that there was significant differ ence before and after operation(P<0.05),but there wa.s no significant difference between the left and right measurement items(P〉0.05).Compared with that in 10 days after operation,the measurement items also changed 6 months after operation.There was no statistical difference between the above measurement items 6 months after surgery and 10 days after surgery(P>0.05),and no statistical difference between the left and right sides(P>0.05).Conclusions The mandibular three-dimensional model which is reconstructed based on CBCT data,not only displays the three-dimensional anatomical structure that cannot be presented on X-ray film visually and comprehensively by means zoom,rotation and other operations,but also precisely and accurately shows the change of the shape of the mandible from the sagittal,coronal and horizontal plane with arbitrary cutting and rotation.The measurement of mandible is more accurate and reliable,and the surgical plan of mandibular angle osteotomy can be accurately planned preope

关 键 词：下颌角肥大 下颌角弧形截骨术 下颌骨外板劈除术 锥形束CT 三维重建 三维测量 

分 类 号：R782.2[医药卫生—口腔医学]