成人骨性Ⅲ类错牙合患者软组织侧貌形态Holdaway分析

［摘要］ 目的 研究成人骨性Ⅲ类错牙合畸形患者的软组织侧貌形态。方法 选取53例（女32例，男21例）成人骨性Ⅲ类患者及53例成人骨性Ⅰ类患者治疗前的CBCT数据，利用Dolphin imaging 11.0软件重建头颅侧位片，采用Holdaway软组织测量方法进行头影测量分析，测量结果按不同性别及不同矢状向骨面型进行比较，用SPSS 20.0软件进行单因素方差分析。结果 成人骨性Ⅲ类患者与骨性Ⅰ类患者相比，骨性Ⅲ类患者的面中1/3凹陷明显（A点突度、Sn-H线）、上唇前突（上唇沟深度、上唇紧张度）、下唇前突（LL-H线）、颏部前突、颏唇沟变浅（软组织面角、H角、颏唇沟深度、颏部厚度）。成人骨性Ⅲ类患者不同性别间的软组织侧貌形态差异主要集中在软组织面角、上唇沟深度及上唇紧张度，其余指标无明显差异，显示出女性患者具有较好的软组织代偿。结论 由于成人骨性Ⅲ类患者上下颌骨间存在明显的矢状向不协调，因此与骨性I类患者相比，其软组织侧貌有着显著不同的特点。

The Holdaway Soft Tissue Analyze of Adult Skeletal Class III Malocclusion

Objective: This study is aimed to analyze the morphology of soft tissue profile in adult skeletal Class III malocclusion. Methods: 53 adult patients (female 32, male 21) with skeletal Class III malocclusion and 53 adult patients with skeletal Class I malocclusion were taken cone beam CT (CBCT) before treatment, the lateral cephalometric radiographs were rebuilt by Dolphin imaging 11.0 and measured using soft tissue analysis of Holdaway. The results were divided into different groups based on gender and sagittal skeletal pattern. Statistical analysis was carried out with SPSS 20.0. Results: The skeletal Class III patients had sunken mid facial soft tissue (skeletal profile convexity, Sn - H line), protrusive upper lip (upper lip sulcus depth, upper lip strain measurement), protrusive lower lip (Li – H line), protrusive chin and shallow mentolabial sulcus (soft tissue facial angle, H angle, mentolabial sulcus depth, soft tissue chin thickness) compared to adult skeletal Class I malocclusion. The differences of soft tissue profile in adult skeletal Class III malocclusion between different genders were among soft tissue facial angle, upper lip sulcus depth and upper lip strain measurement. These differences revealed that females had better soft tissue compensation. Conclusion: Because of the inharmonious relationship between jaws, the soft tissue profile in adult skeletal Class III patients has remarkable different features compared with skeletal Class I patients. Orthodontists should know these features well in order to make more suitable and comprehensive treatment plan and improve the dissatisfactory soft tissue profile in skeletal Class III patients.