咬合垂直距离升高后咬合重建修复患者的头影测量分析

目的 采用X线头影测量方法研究咬合垂直距离(occlusal vertical dimension,OVD)升高后咬合重建修复患者的软硬组织变化情况.方法 咬合升高重建修复患者15例,分别于修复前后拍摄X线头颅侧位片进行头影测量分析,对结果进行配对t检验.结果 修复后,反映颅部骨性结构及上颌骨相对颅部的各测量项目与升高前相比,差异均无统计学意义(P＞0.05);描述颌骨矢状向关系的测量项目中,SNB角、SND角、SNPog角、颌凸角及SN-Y轴角修复前后的差异均具有统计学意义(P＜0.05);描述颌骨垂直向关系的各测量项目除ANS-FH外,修复前后的差异均具有统计学意义(P＜0.05).描述下颌骨形态的SL、SE,描述(牙合)的覆验、IMPA及FMIA,描述软组织侧貌的Z角及Sn、TUL、TLL、SB分别到McNamara线距,修复前后的差异均具有统计学意义(P＜0.05).其中SNB角减小1.13°(P＜0.05),SND角减小2.27°(P ＜0.05);SE减少1.02 mm(P ＜0.05),SL减少3.07 mm(P＜0.05).结论 OVD升高后的咬合重建修复使患者下颌骨向下向后旋转,双唇突点内收,面部比例及软组织侧貌得到改善.

X-ray cephalometric analysis of the occlusal rehabilitation treatment for the patients with occlusal vertical dimension increasement

Objective To discuss and analyze the cephalometric changes of the hard and soft tissues before and after increasing occlusal vertical dimension(IOVD).Methods Fifteen adult patients accepted the occlusal rehabilitation treatment with reasonablely IOVD.The pre-and post-IOVD X-rays cephalometric are examined.Using Winceph 8.0,craniomaxillofacial parameters were chosen from Jarabak,Tweed and McNamara system to fulfill the analysis.The changes of the hard tissue and soft tissue were calculated by self-control paired t-test.Results The parameters of craniobase and maxilla bone showed no statistical significant difference before and after IOVD(P>0.05);the SNB angle,SND angle,SNPOg angle,NA-PA angle,and SN-Y axis angle which describe the sagittal direction relationship of jaw bones;The anterior lower facial height,the anterior facial height,the posterior facial height,the lower facial height,the total facial height,the distance of Me-FH,the FMA angle,the mandibular plane angle,GoGn-SN angle and the Y axis angle which describe the vertical direction relationship of jaw bones;SL and SE which describe the position of the mandibular condyle;Overbite,IMPA and FMIA which describe the occlusion;and the Z angle,the distance of Sn-McNamara,the distance of TUL-McNamara,the distance of TLL-McNamara and the distance of SB-McNamara which describe the soft tissue profile,showed statistical significant difference before and after IOVD(P<0.05).Conclusion The mandibular would twist backward and downward;the occlusal rehabilitation treatment with IOVD can improve the facial profile by converging the upper and lower lips,and increasing the lower facial height.