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首页> 外文期刊>Journal of Clinical Medicine >Effect of Le Fort I Maxillary Advancement and Clockwise Rotation on the Anteromedial Cheek Soft Tissue Change in Patients with Skeletal Class III Pattern and Midface Deficiency: A 3D Imaging-Based Prediction Study
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Effect of Le Fort I Maxillary Advancement and Clockwise Rotation on the Anteromedial Cheek Soft Tissue Change in Patients with Skeletal Class III Pattern and Midface Deficiency: A 3D Imaging-Based Prediction Study

机译：Le Fort I上颌骨促进和顺时针旋转对骨骼级别和中型缺陷患者的前脸颊软组织变化的影响：基于3D成像的预测研究

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Patients with a skeletal Class III deformity may present with a concave contour of the anteromedial cheek region. Le Fort I maxillary advancement and rotational movements correct the problem but information on the impact on the anteromedial cheek soft tissue change has been insufficient to date. This three-dimensional (3D) imaging-assisted study assessed the effect of surgical maxillary advancement and clockwise rotational movements on the anteromedial cheek soft tissue change. Two-week preoperative and 6-month postoperative cone-beam computed tomography scans were obtained from 48 consecutive patients who received 3D-guided two-jaw orthognathic surgery for the correction of Class III malocclusion associated with a midface deficiency and concave facial profile. Postoperative 3D facial bone and soft tissue models were superimposed on the corresponding preoperative models. The region of interest at the anteromedial cheek area was defined. The 3D cheek volumetric change (mm 3 ; postoperative minus preoperative models) and the preoperative surface area (mm 2 ) were computed to estimate the average sagittal movement (mm). The 3D cheek mass position from orthognathic surgery-treated patients was compared with published 3D normative data. Surgical maxillary advancement (all p 0.001) and maxillary rotation (all p 0.006) had a significant effect on the 3D anteromedial cheek soft tissue change. In total, 78.9%, 78.8%, and 78.8% of the variation in the cheek soft tissue sagittal movement was explained by the variation in the maxillary advancement and rotation movements for the right, left, and total cheek regions, respectively. The multiple linear regression models defined ratio values (relationship) between the 3D cheek soft tissue sagittal movement and maxillary bone advancement and rotational movements of 0.627 and 0.070, respectively. Maxillary advancements of 3–4 mm and 4 mm resulted in a 3D cheek mass position (1.91 ± 0.53 mm and 2.36 ± 0.72 mm, respectively) similar (all p 0.05) to the 3D norm value (2.15 ± 1.2 mm). This study showed that both Le Fort I maxillary advancement and rotational movements affect the anteromedial cheek soft tissue change, with the maxillary advancement movement presenting a larger effect on the cheek soft tissue movement than the maxillary rotational movement. These findings can be applied in future multidisciplinary-based decision-making processes for planning and executing orthognathic surgery.
机译：骨骼等级畸形的患者可能存在主颊区域的凹入轮廓。 Le Fort I上颌骨进步和旋转运动纠正问题，但有关对前便脸颊软组织变化的影响的信息已迄今为止。这种三维（3D）成像辅助研究评估了外科上颌推进和顺时针旋转运​​动对前置颊氏软组织变化的影响。为期两周的术前和6个月的术后锥形束计算机断层扫描扫描是从48名接受3D引导的双颌骨正直手术的连续患者获得，用于校正与中型缺陷和凹形面部型材相关的III类捕手。术后3D面部骨骼和软组织模型叠加在相应的术前模型上。定义了主颊面区域的兴趣区域。计算3D脸颊体积变化（mm 3;术后术前模型）和术前表面积（mm 2）以估计平均矢状运动（mm）。与公开的3D规范数据进行比较了从正畸外科治疗患者的3D脸颊质量位置。外科上颌前进（所有P <0.001）和上颌旋转（所有P <0.006）对3D前置脸颊软组织变化有显着影响。总共78.9％，78.8％和78.8％的脸颊软组织矢状运动的变化分别解释了右侧，左侧和总颊区域的上颌前进和旋转运动的变化。多元线性回归模型分别定义了3D颊软组织矢状运动和颌骨前进和0.627和0.070的上颌骨前进和旋转运动之间的比率值（关系）。 3-4毫米和> 4毫米的上颌骨进步导致3D面颊质量位置（分别为1.91±0.53mm，分别为2.36±0.72 mm）与3D规范值相似（所有P> 0.05）（2.15±1.2 mm）。这项研究表明，Le Fort I上颌推进和旋转运动都影响了前腔颊软组织变化，上颌推进运动呈现对脸颊软组织运动的较大效果比上颌旋转运动更大。这些发现可以应用于未来的基于多学科的决策过程，用于规划和执行正畸手术。

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