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首页> 外文学位 >Three-dimensional evaluation of soft-tissue changes in extraction and non-extraction treatment of Class II high and low mandibular plane angle orthodontic patients .
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Three-dimensional evaluation of soft-tissue changes in extraction and non-extraction treatment of Class II high and low mandibular plane angle orthodontic patients .

机译：高低位II型下颌正畸患者拔牙和非拔牙治疗软组织变化的三维评估。

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摘要

Facial esthetics affect an individual's quality of life, self-image, social behavior, and public perception. The oro-facial region, in particular, plays a pivotal role in facial esthetics as dento-facial deformities can cause an individual to be perceived as less attractive, less successful, and less socially acceptable. The ability of orthodontic treatment to alter the soft-tissue facial form makes it a powerful tool to improve facial esthetics. Orthodontic treatment exhibits the most control over the soft-tissue in the lower third of the face, specifically the profile, position of the lips, and lower-third convexity. The position of the soft-tissue in this region plays an important role in the perception of facial attractiveness.;Due to the importance of the oro-facial region in facial esthetics, it is of the utmost importance that orthodontists better understand the effects of their treatment on the soft-tissue. The majority of literature evaluates soft tissue changes using 2-D imaging, such as a profile photo or lateral cephalogram; however, the evaluation of soft-tissue changes requires more than just what is seen in a 2-D sagittal image. It is essential that this knowledge is obtained in the most accurate and realistic way possible; to understand changes in three-dimensions instead of two. Using 3dMD technology, pre- and post- three-dimensional soft tissue images of dental Class II patients with high or low mandibular plane angle, treated with or without extraction therapy, were compared. The objective was to determine the effect of extraction treatment on the soft-tissue of different facial types.;Subjects were sampled from a database of patients treated by orthodontic residents under the supervision of faculty at the graduate orthodontic clinic of the Maurice H. Kornberg School of Dentistry at Temple University in Philadelphia, PA. Pre- and post-treatment 3dMD images were obtained of 42 dental Class II, high-angle (FMA ≥ 28) and low-angle (FMA < 28) subjects treated with extraction or non-extraction therapy. The 3dMDface system (3dMD, Atlanta, GA) is a stereophotogrammetric system used to capture 3D soft tissue images. Pre- and post-treatment images were superimposed to evaluate soft-tissue changes both quantitatively and qualitatively. Quantitative Analysis: The average linear (mm) changes between the pre- and post-images for each group were recorded for the following areas: right/left commissures and cheeks, upper/lower lips at the midline, chin (pogonion), and tip of the nose. In addition, sectional volumetric (cc) changes of the peri-oral area were recorded. The mean volumetric and linear changes were compared between groups. Qualitative Analysis: Color histograms were created from the superimpositions, representing a color-coded map of the direction and magnitude of soft-tissue changes. The magnitude and direction correspond to color, with warmer colors, such as pink and purple, representing positive changes in the soft-tissue (anterior movement) and cooler colors, like green, indicating a negative change (posterior movement). To allow comparison, the degree of change was coded using symbols, ranging from (+++) to (0) to (−−−), which correspond to the colors observed in each histogram. Coding was performed for the following areas: upper/lower lip, right/left commissures, right/left cheek, tip of the nose and chin (Horizontal (AP) and Vertical movement), the naso-labial fold, and the mento-labial fold. The coding for each facial area was placed in a table and color coded to aid visual analysis. The color-coded tables were analyzed for patterns within and between groups.;While the quantitative analysis found no statistically significant linear and volumetric differences between each group, the qualitative analysis of the 3-D histograms revealed noticeable changes in the soft-tissue. Similar changes resulting from treatment type (extraction vs. non-extraction) were seen in both the high and low angle groups. The changes exhibited by the upper lip were independent of treatment and facial type: retraction was seen in all groups, likely due to Class II mechanics. In contrast, the changes exhibited by the lower lip, nasolabial fold, and mentolabial fold were more dependent on treatment type, becoming fuller in the non-extraction groups, while exhibiting more negative changes in the extraction groups. The commissures and cheeks exhibited unpredictable changes regardless of treatment and facial type. The nose and chin exhibited similar changes in all groups. These data suggest that orthodontic treatment may in fact induce predictable qualitative responses from specific areas of the soft-tissue face. We also conclude that qualitative assessment of soft-tissue facial change is more appropriate than quantitative assessment.
机译：面部美学会影响个人的生活质量，自我形象，社会行为和公众认知。口腔面部区域尤其在面部美学中起着关键作用，因为牙齿面部畸形可以使个人被认为不那么有吸引力，不太成功并且在社会上不那么容易接受。正畸治疗改变面部软组织形态的能力使其成为改善面部美学的有力工具。正畸治疗对面部下三分之一的软组织具有最大的控制力，特别是嘴唇的轮廓，位置和下三分之一的凸度。软组织在该区域中的位置在面部吸引力的感知中起着重要作用。；由于口腔面部区域在面部美学中很重要，因此，牙齿矫正医生必须更好地理解其作用，这一点至关重要。软组织上的治疗。大多数文献使用二维成像（例如侧面照片或侧位头颅图）评估软组织的变化；然而，软组织变化的评估不仅需要二维矢状位图像中所见。必须以最准确，最现实的方式获得这些知识；了解三维尺寸而不是二维尺寸的变化。使用3dMD技术，比较了使用或不使用拔牙疗法治疗的具有高或低下颌平面角的II类牙科患者的三维三维软组织图像。目的是确定拔牙治疗对不同面部类型的软组织的影响。；在Maurice H. Kornberg学校研究生正畸诊所的指导下，从受正畸治疗的患者数据库中抽取受试者宾夕法尼亚费城坦普尔大学牙科学院。获得了治疗前和治疗后3dMD的3dMD图像，这些图像来自42位经拔牙或非拔牙疗法治疗的II级牙科，高角度（FMA≥28）和低角度（FMA <28）受试者。 3dMDface系统（3dMD，乔治亚州亚特兰大）是用于捕获3D软组织图像的立体摄影测量系统。叠加治疗前和治疗后的图像以定量和定性评估软组织变化。定量分析：记录以下区域各组图像在前后图像之间的平均线性（mm）变化：右/左连合和脸颊，中线的上/下嘴唇，下巴（po）和小费鼻子另外，记录了口周区域的截面体积（cc）变化。比较两组之间的平均体积和线性变化。定性分析：从叠加图中创建颜色直方图，代表软组织变化的方向和大小的彩色编码图。大小和方向与颜色相对应，较暖的颜色（如粉红色和紫色）​​表示软组织中的正变化（向前运动），较冷的颜色（如绿色）表示负变化（后运动）。为了进行比较，使用从（+++）到（0）到（---）的符号对变化程度进行编码，这些符号与每个直方图中观察到的颜色相对应。对以下区域进行了编码：上/下唇，右/左连合，右/左脸颊，鼻尖和下巴（水平（AP）和垂直运动），鼻唇褶和月经唇折。每个面部区域的编码都放在桌子上，并用颜色编码以帮助进行视觉分析。分析了颜色编码表中各组之间以及各组之间的模式。虽然定量分析发现各组之间没有统计学上显着的线性和体积差异，但对3D直方图的定性分析显示软组织中的显着变化。在高角度组和低角度组中都观察到类似的治疗类型变化（拔牙与非拔牙）。上唇表现出的变化与治疗和面部类型无关：在所有组中均观察到内陷，这可能归因于II类力学。相比之下，下唇，鼻唇沟和月经唇的折叠所表现出的变化更多地取决于治疗类型，在非萃取组中变得更饱满，而在萃取组中表现出更多的负变化。无论治疗方式和面部类型如何，连合和脸颊均呈现出不可预测的变化。在所有组中，鼻子和下巴都表现出相似的变化。这些数据表明，正畸治疗实际上可以从软组织面部的特定区域引起可预测的定性反应。我们还得出结论，软组织面部变化的定性评估比定量评估更合适。

著录项

  • 作者

    Papasikos, Jacy J.;

  • 作者单位

    Temple University.;

  • 授予单位 Temple University.;
  • 学科 Health Sciences Dentistry.
  • 学位 M.S.
  • 年度 2013
  • 页码 114 p.
  • 总页数 114
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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