成人安氏Ⅱ类1分类错牙合患者正畸前后唇部软组织测量和评估

目的 测量和评估成人安氏Ⅱ类1分类错牙合患者正畸前后的唇部软组织形态. 方法 选择30例已经完成正畸治疗的安氏Ⅱ类1分类错牙合成年患者,术后模型及头影测量的数据均在正常范围内. 对其正畸前后正面像和头颅侧位片唇红的矢状向厚度和垂直向厚度进行测量. 结果 正畸后上唇垂直向厚度有变小的趋势,下唇垂直向厚度有变大的趋势,差异有统计学意义(P<0. 05). 上唇矢状向唇红部组织厚度术后有增大的趋势,下唇矢状向唇红部组织厚度矫正后有减少的趋势,且有统计学意义(P<0. 05). 上颌上中切牙(U1C)矢状向内收量与上唇红(TUL)的内收呈显著正相关,下唇红(TLL)矢状向位置的变化与下颌切牙突点(L1C)位置变化存在正相关,下唇红(TLL)矢状向位置的变化与上颌切牙突点(U1C)位置变化存在正相关. 结论 安氏Ⅱ类1分类错牙合成人患者拔牙矫治后,可以通过切牙回收量较好地预测其唇部软组织正畸前后的矢状向厚度和垂直向厚度变化.     

高角型双颌前突矫治前后软硬组织改变分析

目的探讨正畸治疗对高角型双颌前突患者软硬组织矢状及垂直向的影响。方法对18例高角型双颌前突患者在拔除4个第一前磨牙后,采用直丝弓矫治技术进行矫治。矫治前后拍摄X线头颅侧位定位片,并对矫治前后软硬组织侧貌的变化进行分析。结果①上下颌骨矢状及垂直向关系无明显变化;②上下前牙突度和倾斜度明显减小;③上下磨牙垂直向及矢状向支抗得到较好控制,牙合平面角无明显改变;④上下唇突度明显减小,上唇长度加长,下唇长度减小。颏厚度增加1.70mm,颏唇沟加深1.13 mm。结论高角型双颌前突患者拔牙矫治后垂直向及矢状向支抗可得到较好控制,侧貌有明显改善。     

骨性安氏Ⅱ类错经外科-正畸联合治疗后颜面软组织侧貌的变化

目的:探讨骨性安氏Ⅱ类错　患者采用外科-正畸联合治疗后颜面软组织侧貌在矢状和垂直方向上的变化。方法:选用华西医科大学口腔医院正畸科连续收治的骨性安氏Ⅱ类错　患者22 例,男7 例,女15 例,年龄20～30 岁。在术前及术后6～12 个月摄取X线头侧位片, 对16 个软硬组织标志点的变化进行矢状、垂直向的分析。结果:在矢状向上,上唇沟点、上唇缘点、上唇下点后退均大于2 mm( P < 0101) ;与上切牙点后移量之比为0159∶1～0164∶1 ;颏唇沟软、硬组织点前移量之比为0183∶1 ,软组织颏前点与硬组织颏前点前移量之比为0195∶1。在垂直向上,鼻尖点、鼻底点、上唇缘点平均向上移动量均小于1 mm( P > 0105) ;但软组织颏前点、颏唇沟、下唇缘点、下唇上点向上移动量均大于2 mm( P < 0105) ,与相应的硬组织移动量之比为1107∶1～1134∶1。结论:骨性安氏Ⅱ类错牙合患者经外科-正畸联合治疗后颜面软组织侧貌改善明显。在矢状方向,上下颌软组织改变量均小于硬组织;但在垂直方向,下颌软组织的改变却比硬组织更明显。     

骨性安氏Ⅱ类错(牙合)经外科——正畸联合治疗后颜面软组织侧貌的变化

目的:探讨骨性安氏Ⅱ类错患者采用外科-正畸联合治疗后颜面软组织侧貌在矢状和垂直方向上的变化.方法:选用华西医科大学口腔医院正畸科连续收治的骨性安氏Ⅱ类错患者22例,男7例,女15例,年龄20～30岁.在术前及术后6～12个月摄取X线头侧位片,对16个软硬组织标志点的变化进行矢状、垂直向的分析.结果:在矢状向上,上唇沟点、上唇缘点、上唇下点后退均大于2mm(P<0.01);与上切牙点后移量之比为0.59:1～0.64:l;颏唇沟软、硬组织点前移量之比为0.83:1,软组织颏前点与硬组织颏前点前移量之比为0.95:1.在垂直向上,鼻尖点、鼻底点、上唇缘点平均向上移动量均小于1mm(P>0.05);但软组织颏前点、颏唇沟、下唇缘点、下唇上点向上移动量均大于2mm(P<0.05),与相应的硬组织移动量之比为1.07:l～1.34:1.结论:骨性安氏Ⅱ类错患者经外科-正畸联合治疗后颜面软组织侧貌改善明显.在矢状方向,上下颌软组织改变量均小于硬组织;但在垂直方向,下颌软组织的改变却比硬组织更明显.     

Ⅱ类1分类错[牙合]正畸治疗前后牙齿移动与软组织侧貌变化的线性相关分析

目的通过对Ⅱ类1分类错[牙合]患者正畸治疗前后的头影测量指标进行相关性分析,探讨影响面部软组织侧貌变化的相关因素。方法选取2012年6月至2017年11月于上海交通大学医学院附属第九人民医院口腔颅颌面科就诊的42例已完成正畸治疗的Ⅱ类1分类错[牙合]患者[男性10例,女性32例,年龄(23.8±6.3)岁,平均矫治时间1.9年],拔除4颗第一前磨牙或2颗上颌第一前磨牙后进行正畸治疗纠正磨牙关系,测量矫治前后硬组织及软组织相关头影测量指标30个,包括上下唇突点、颏唇沟点、软硬组织颏前点及颏顶点的矢状向及垂直向距离、鼻唇角及颏唇角等。对矫治前后各指标变化量进行线性回归分析,根据标准化回归系数(Beta)分析影响上下唇、鼻唇角、颏唇角等面部软组织的主要相关因素。结果30个头影测量指标中18个矫治前后差异均有统计学意义(P<0.05),与矫治前相比,矫治后上中切牙点矢状向距离[(63.87±7.14)mm]、上唇突点矢状向距离[(77.73±7.60)mm]显著减小(P<0.05)。14对头影测量指标变化量间存在线性关系,其中上唇突点矢状向变化量与上中切牙点矢状向变化量强正相关(r=0.649,P<0.01),上唇突点垂直向变化量与上中切牙点垂直向变化量中度正相关(r=0.544,P<0.01),软组织颏顶点矢状向变化量与Y轴角变化量中度负相关(r=0.537,P<0.01)。多元逐步后退回归分析显示,上唇突点内收量与上中切牙点内收量、平面角增大量以及上中切牙角增大量均相关,且与上中切牙点内收量相关性最大(Beta=0.79);上唇突点下移量与上中切牙点下移量、上中切牙角减小量、上颌第一磨牙面中点到腭平面距离减小量以及平面角增大量相关,且与上中切牙点下移量及平面角增大量的相关性最大(Beta均为0.59);下唇突点下移量与上、下中切牙点下移量相关,且与上中切牙点下移量相关性更大(Beta=0.36)。结论Ⅱ类1分类错[牙合]矫治后鼻唇颏关系得到一定改善,切牙的矢状向变化对唇突度的影响最大,且下唇矢状向与垂直向移动与上中切牙的位置关系更密切,牙齿移动对颏部的影响有限。     

Twin-block与Headgear-activator矫治骨性Ⅱ类错牙合临床疗效对比研究

目的:对比Twin-block与Headgear-activator两种功能矫治器的临床疗效.方法:选择自然生长和使用Twin-block、Headgear-activator功能矫治器矫治成功的60例骨性Ⅱ类错牙合患者为研究对象,将其分为对照组、Twin-block组和Headgear-activator组,每组均为20例患者.在正畸治疗前后拍摄X线头颅定位侧位片,对治疗前后X线头影测量值进行比较.结果:软组织指标:上唇审美平面距、下唇审美平面距、上唇突角、上唇倾角、下唇倾角、上下唇突角、颏沟倾角、上唇颏突角、软组织面角、鼻唇角、颏唇沟角、Z角、面突角、软组织面高、软组织下面高、上唇长的变化与对照组比较有统计学意义(P<0.05);硬组织指标:SNB、ANB、U1-SN、U1-NA的变化与对照组比较有统计学意义(P <0.05);两治疗组间,上唇倾角、上唇长、软组织面高、软组织下面高、IMPA、FMIA、FMA的变化有统计学意义(P<0.05).结论:Twin-block与Headgear-activator可明显改善上下颌骨矢状不调,一定程度上恢复了鼻、唇、颏之间的协调性,两者在下前牙唇倾度、下面高、唇部形态等方面的效果存在差异.     

骨性安氏Ⅱ类错经外科—正畸联合治疗后颜面软组织侧貌的变化

目的 :探讨骨性安氏Ⅱ类错患者采用外科—正畸联合治疗后颜面软组织侧貌在矢状和垂直方向上的变化。方法 :选用华西医科大学口腔医院正畸科连续收治的骨性安氏Ⅱ类错患者 2 2例 ,男 7例 ,女 15例 ,年龄 2 0～30岁。在术前及术后 6～ 12个月摄取X线头侧位片 ,对 16个软硬组织标志点的变化进行矢状、垂直向的分析。结果 :在矢状向上 ,上唇沟点、上唇缘点、上唇下点后退均大于 2mm(P <0 0 1) ;与上切牙点后移量之比为 0 5 9∶1～0 6 4∶1;颏唇沟软、硬组织点前移量之比为 0 83∶1,软组织颏前点与硬组织颏前点前移量之比为 0 95∶1。在垂直向上 ,鼻尖点、鼻底点、上唇缘点平均向上移动量均小于 1mm(P >0 0 5 ) ;但软组织颏前点、颏唇沟、下唇缘点、下唇上点向上移动量均大于 2mm(P <0 0 5 ) ,与相应的硬组织移动量之比为 1 0 7∶1～ 1 34∶1。结论 :骨性安氏Ⅱ类错患者经外科—正畸联合治疗后颜面软组织侧貌改善明显。在矢状方向 ,上下颌软组织改变量均小于硬组织 ;但在垂直方向 ,下颌软组织的改变却比硬组织更明显     

Nance弓支抗下双颌前突患者拔牙矫治后软组织变化及与硬组织关系的研究

目的 探讨传统支抗下双颌前突拔牙患者正畸治疗后软组织的变化及与硬组织变化的关系.方法 应用回顾性研究方法,对满足纳入标准的29例拔除四个第一双尖牙并应用Nance弓增加支抗的女性成人双颌前突患者进行治疗前后的手工X线头影测量分析.测量软硬组织项目35项,应用SPSS 15.0软件进行统计分析.治疗前后的变化用配对t检验,软组织变化的相关分析用Pearson相关分析.结果 软组织测量项目显示,经过正畸治疗患者的上、下唇突度、软组织A点及B点的突度减小,颏唇沟深度增加,差异有统计学意义（P＜0.01）;上、下唇基底厚度减小,上唇突厚度增大,下唇突厚度减小,差异有统计学意义（P＜0.01）.而上唇长度、软组织颏前点突度在正畸治疗前后差异无统计学意义.与上唇突度变化（ ΔUL-SL）相关的硬组织测量项目为ΔU1-SL（r=0.469,P＜0.01）;与下唇突度变化（△LL-SL）相关的硬组织测量为ΔSNA（r=0.436,P＜0.05）、ΔU1 -SL（r=0.374,P＜.05）、△L1-SL（r=0.478,P＜0.01）;上、下唇突度变化正相关.鼻唇角的变化与ΔU1-SL（r=-0.534,P＜0.01）、△UL-E（r=-0.394,P＜0.05）负相关,与△A’-SL（r=0.478,P＜0.05）、ΔULL（r=0.474,P＜0.05）及ΔA’-A（r=0.423,P＜0.05）正相关.颏唇沟深度（B’-E）与下切牙的内收（ΔL1-SL）及下唇突度变化（ΔLL-SL）正相关.上唇突度减小与上前牙内收的关系为1∶0.6（以审美平面评价）或1∶0.62（以蝶鞍点垂线评价）.下唇突度减小与下切牙内收关系是1∶1.13;而下唇变化与上前牙内收的关系则是1∶（0.83±0.21）（LL-SL/U1-SL）.结论 传统支抗控制下拔除四个双尖牙后双颌前突成人侧貌改善显著.面下部软硬组织间存在中度相关关系.     

活动翼矫治技术治疗高角型双颌前突的临床研究

目的研究活动翼矫治技术治疗高角型双颌前突的临床疗效方法选择54例拔除4颗第一前磨牙的双颌前突患者,根据治疗前的SN/MP角将患者分为2组,高角组27例,SN/MP≥40°。均角组27例,29°﹤SN/MP﹤40°。使用活动翼矫治技术进行矫治。对2组治疗前后的X线头影测量数据进行统计学分析。结果①活动翼矫治技术治疗的高角型双颌前突上下颌骨在矢状方向上无明显变化。②高角型双颌前突治疗后上下颌磨牙伸长量分别为1.04和0.99 mm。上下颌磨牙前移量分别为2.74和2.37 mm。下颌平面未发生顺时针旋转。活动翼矫治技术治疗的高角型双颌前突平面能够保持稳定③高角组的U1-PP、U1-V、L1-V、U1/NA、U1-NAmm、L1/NB和L1-NBmm治疗前后变化均有统计学意义。④高角型双颌前突治疗后的上下唇突度明显减小,上下唇长度变小,软组织突度减小。⑤高角组的上颌中切牙与上唇内收的比例为1∶0.357,下颌中切牙与下唇内收的比例为1∶0.879 9。结论活动翼矫治技术治疗的高角型双颌前突垂直向和矢状向支抗可以达到很好的控制,上下颌骨在矢状关系上更加协调,上下颌前牙突度和倾斜度明显减小,软组织侧貌有明显改善,临床疗效较好。     

青少年双颌前突患者拔牙矫治前后侧面部软组织改变的研究

目的 研究青少年双颌前突患者拔牙矫治前后侧面部软组织的改变。方法 对34名青少年双颌前突患者拔牙矫治前后的18项侧面部软组织指标进行对比,通过配对t检验来分析治疗后侧面部软组织的改变。结果 18项软组织指标中5项角度指标的改变在男性组与女性组的改变均有统计学意义,13项线距测量指标中的上唇厚度、下唇厚度、鼻凸度均增大,而鼻底厚度在男性组与女性组改变不同。结论 青少年双颌前突患者拔牙矫治前后面部凸度减小,男性与女性上唇、下唇的变化不同,患者的鼻、唇、颏关系得到改善,软组织侧貌发生明显改变。?     

Effects of retraction of anterior teeth and initial soft tissue variables on lip changes in Japanese adults

The aim of this study was to examine the effects of retraction of anterior teeth and the initial soft tissue profile variables on upper and lower lip changes in Japanese adults. Pre- and post-treatment cephalometric radiographs of 33 Japanese female adults (aged 23.0±5.0 years), with a Class II division 1 malocclusion, who had two or four first premolars extracted, were evaluated. Lateral cephalograms taken with the lips in a voluntary relaxed position were traced and compared. Nine linear and eight angular measurements were constructed for the hard tissue measurements and 16 linear and 2 angular for the soft tissue measurements. Stepwise multiple regression analysis revealed that the horizontal upper lip position could be explained by the position of the maxillary incisor cervical point and the occlusal plane to SN with a 54 percent contribution ratio, and horizontal lower lip position, maxillary incisor tip position, initial interlabial gap, and aesthetic line to the tip of lower lip with a 51 percent contribution ratio. All parameters employed explained the horizontal position of the upper and lower lip with higher than 96 percent confidence. While the horizontal positions could not be predicted by a limited number of parameters, the vertical positions of lips could be explained by three parameters with higher than 62 percent confidence. The predictability found in this study could be beneficial for orthodontists in treatment planning.     

Correlation between objective and subjective evaluation of profile in bimaxillary protrusion patients after orthodontic treatment

Objective:To correlate the objective cephalometric measurements with subjective facial esthetics in patients with bimaxillary protrusion.Materials and Methods:The sample consisted of 60 Asian-Chinese patients with bimaxillary protrusion who met the inclusion criteria. The facial esthetics of posttreatment profile and the change of profile on standardized lateral photographs were rated by a panel of 10 orthodontists and a panel of 10 lay persons with bimaxillary protrusion. All of the pretreatment and posttreatment cephalograms were digitized and traced. Twenty-five cephalometric measurements were constructed and analyzed. Correlations between the subjective facial esthetic scores and each cephalometric measurement were evaluated.Results:The cephalometric measurements correlated with the facial esthetic scores of posttreatment profile given by the orthodontist and the lay persons were basically the same. For the evaluation of posttreatment profile in bimaxillary protrusion patients, the upper and lower lip to E-line, upper and lower incisor tip to AP plane, Pg-NB distance, mentolabial angle, and sulcus depth correlated significantly with the esthetic score. For the evaluation of profile change during orthodontic treatment, retraction of upper incisor relative to AP plane or the perpendicular line through sella (line Y), change of upper incisor inclination, change of mentolabial sulcus depth, and retraction of lips relative to E-line were correlated positively with the esthetic value.Conclusions:Cephalometric measurements of lip position, incisor position, and chin morphology were key parameters correlated to facial esthetics.     

Predicting soft tissue profile changes concurrent with orthodontic treatment

Two studies related to soft tissue profile change, are reported in this paper. In the first study, 50 adults with normal occlusion were compared to 50 adults with maxillary protrusion. Cephalometric radiographs were obtained for all subjects in two positions: with lips relaxed and lips closed. The amount of lower lip movement increased in relation to the degree of maxillary protrusion. In both groups, thickness of soft tissue pogonion decreased with upward movement of the lower lip. In the second study, 20 posttreatment patients were examined to determine how soft tissue profile is related to the morphologic alterations of treatment. Ten patients were treated for maxillary protrusion and 10 for bimaxillary protrusion. Upper lip retraction was about 40 percent of the maxillary incisor retraction. Cases with maxillary protrusion showed slightly less soft tissue change than cases with bimaxillary protrusion. Lower lip retraction was about 70 percent of the maxillary incisor retraction. With an understanding of pretreatment lip posture and data related to the soft tissue response to treatment, a framework is presented for predicting a patient's posttreatment facial profile.     

骨性Ⅲ类患者双颌手术后软硬组织变化及其相关性研究

目的:探讨临床双颌手术治疗骨性Ⅲ类错牙合后软组织的变化,以及软组织随硬组织变化的相关性.方法:选择进行双颌手术的骨性Ⅲ类错牙合患者29例,通过对手术前及手术后摄取的X线头颅侧位定位片头影测量分析,研究双颌手术后的软硬组织变化.结果:鼻下点无显著变化.上唇厚度和凸度变化均有统计学意义(P＜0.05).下唇及颏部所有软组织...     

Cephalometric soft tissue profile analysis between two different ethnic groups: a comparative study

The aim of this investigation was to study and compare the cephalometric soft tissue profile analysis between Saudis and Caucasian Americans. The study was carried out using standardized cephalometric radiographs of 56 Saudi subjects (30 males and 26 females) with pleasant and balanced facial profiles, competent lips, normal overjet and overbite, and showing no craniofacial deformities. Subject ages ranged from 22 to 23 years. One skeletal and thirteen soft tissue variables were investigated. F-test, two samples t-test, Mann-Whitney, and Wilcoxon tests were used for data analysis. The results showed no statistical significant differences between the Saudi males and females except for the angle of total facial convexity, soft tissue facial plane angle, lower lip length, sagittal nasal tip to the most protrusive lip distance, and also sagittal chin to the most protrusive lip distance. The Saudi females had a greater angle of total facial convexity and soft tissue facial plane angle than the males. In addition, the females had a shorter lower lip. They also had a short distance between the nasal tip and chin to the most protrusive lip. These results reveal significant differences in most of the soft tissue variables when comparing Saudis with Caucasian Americans as well as in other ethnic groups. Most of these variables are essential for the diagnosis and treatment planning of cases requiring orthodontics and orthognathic surgery.     

骨性Ⅱ类错 正畸正颌联合治疗前后软硬组织侧貌变化的线性相关分析

目的:通过对骨性Ⅱ类错 畸形患者正畸正颌联合治疗前后头颅定位侧位片指标的测量分析,探讨影响软组织侧貌的因素及贡献。 方法:选取40例骨性Ⅱ类错 畸形女性患者,对其正畸正颌联合治疗前后头颅定位侧位片进行测量分析,采用SPSS 24.0对治疗前后软硬组织的变化量进行线性回归分析。 结果:发现21组指标变化量间存在线性关系,其中软硬组织颏前点矢状向变化量呈极强相关性( r＝0.862, P<0.001),比率为0.935∶1;多元逐步后退回归分析显示上、下唇突点内收量分别与上、下中切牙内收量相关性更大等。 结论:骨性Ⅱ类错 畸形在正畸正颌联合治疗前后软组织移动量与硬组织移动量间存在着一定的线性比例关系,临床可根据患者诉求进行硬组织移动量的设计。     

骨性Ⅱ类错 正畸正颌联合治疗前后软硬组织侧貌变化的线性相关分析

目的:通过对骨性Ⅱ类错 畸形患者正畸正颌联合治疗前后头颅定位侧位片指标的测量分析,探讨影响软组织侧貌的因素及贡献。 方法:选取40例骨性Ⅱ类错 畸形女性患者,对其正畸正颌联合治疗前后头颅定位侧位片进行测量分析,采用SPSS 24.0对治疗前后软硬组织的变化量进行线性回归分析。 结果:发现21组指标变化量间存在线性关系,其中软硬组织颏前点矢状向变化量呈极强相关性( r＝0.862, P<0.001),比率为0.935∶1;多元逐步后退回归分析显示上、下唇突点内收量分别与上、下中切牙内收量相关性更大等。 结论:骨性Ⅱ类错 畸形在正畸正颌联合治疗前后软组织移动量与硬组织移动量间存在着一定的线性比例关系,临床可根据患者诉求进行硬组织移动量的设计。