3D数字化设计在骨性Ⅲ类错颌畸形正颌手术中的精准性分析  

Accuracy analysis of 3D digital design in ClassⅢorthognathic surgery

作　　者：周明辉 Zhou Minghui(Department of Orthodontics,Zhongshan People's Hospital,Zhongshan 528400,China)

机构地区：[1]广东省中山市人民医院口腔正畸科,528400

出　　处：《临床医学》2022年第5期1-4,共4页Clinical Medicine

基　　金：2020年中山市医学科研项目基金(编号2020J036)。

摘　　要：目的研究3D数字化设计在骨性Ⅲ类错颌畸形正颌手术中的精准性。方法选取2016年至2021年在广东省中山市人民医院就诊的正畸-正颌联合治疗的14例骨性Ⅲ类错颌畸形患者,采用3D数字化设计的双颌正颌手术,术前运用3D数字化手术设计定位上下颌骨,通过15个不同部位的测量指标来对比研究术前虚拟化手术设计与术后真实颌骨位移之间的差异。结果在15项测量指标中有12项手术前后比较,差异未见统计学意义(P>0.05),SNA(P=0.008)、SNB(P=0.006)及前面高(P=0.033)手术前后比较,差异有统计学意义。结论3D数字化设计的颌骨虚拟手术具有较强的精准性,术前设计与术后呈现的手术效果在大部分参考指标上都保持了较好的一致性。术后主要差异在于上下颌骨矢状位置和前面高的不同。术中即时修正和调整是必要的,尤其是在上下颌骨矢状向位置的确定和颏部成形术中需要密切的人为监控和即时调整。Objective To study the accuracy of 3D digital design in classⅢorthognathic surgery.Methods Fourteen patients with skeletal ClassⅢmalocclusion treated with orthodontic orthognathic combination in Zhongshan People’s Hospital of Guangdong Province from 2016 to 2021 were selected,the 14 patients underwent bimaxillary orthognathic surgery with 3D digital design.The mandible was designed and positioned by 3D digital surgery before surgery.Fifteen measurements were used to compare the differences between the preoperative virtual surgical design and the postoperative real jaw displacement.Results There was no significant difference in the 12 of the 15 measurement indexes before and after surgery,and the significant difference was mainly in SNA(P=0.008),SNB(P=0.006)and anterior facial height AFH(P=0.033).Conclusions The 3D digital design in classⅢorthognathic surgery is accurate.The preoperative design and postoperative surgical are consistent in most of the reference indexes.The major postoperative differences were the sagittal position and anterior height of the mandible.Intraoperative correction and adjustment are necessary.In particular,the sagittal position of the maxilla and mandibular and the genioplasty need clinical monitoring and immediate adjustment.

关 键 词：正颌手术 3D数字化 骨性Ⅲ类 颌骨畸形 

分 类 号：R783.5[医药卫生—口腔医学]