成人正畸术后美观人群的颅颌面特征和前牙目标位设计OA北大核心CSTPCDMEDLINE
Craniofacial features and incisor position design of esthetics population after orthodontic treatment
目的 以正畸患者为基础,探究成人正畸术后美观人群的颅颌面特征,并为前牙目标位设计提供参考.方法 从1 055例成人正畸患者中,经过纳入标准、排除标准和术后美学评价,最终纳入338例术后美观人群进行头影测量分析.统计描述术后美观人群的头影测量均值,广义估计方程比较性别、骨性矢状向分类(ANB)的差异,单因素分析评价不同性别中年龄、骨性指标和软组织指标的相关性,多因素分析评价骨组织指标、软组织指标对正畸切牙指标拟合的影响.结果 术后美观人群中,男女性在颅骨和下颌骨长度、下颌骨顺旋程度、骨性颏部突度、上颌切牙唇倾度、上唇厚度、面下1/3高度、鼻部突度差异存在统计学意义.术后美观骨性Ⅰ类人群中,男性和女性的骨性颏部突度差异无统计学意义,男性下唇突度比女性更小,其余性别差异与不区分骨性矢状向分类的美观人群结果一致.男性在不同骨性分类中,上下唇突度、软组织颏部突度差异存在统计学意义,但骨性Ⅱ类比骨性Ⅰ类人群的上唇基底部更薄,骨性Ⅲ类比骨性Ⅰ类人群的下唇面高更大.女性在不同骨性分类中,上唇突度、上唇面高、软组织颏部突度差异存在统计学意义,但骨性Ⅲ类比骨性Ⅰ类人群的上唇基底部更厚.术后美观人群中,男女性的上唇厚度、女性上唇基底部厚度及下唇面高与年龄存在相关性.男性患者上唇突度与后颅底长度、下颌体长度、ANB、上颌骨矢状向长度存在相关性,下唇突度与下颌升支高度、下颌骨顺旋情况、骨性颏部突度存在相关性.女性患者上唇突度与SNA、ANB、上颌骨矢状向长度、下颌骨顺旋情况、骨性颏部突度存在相关性,下唇突度与ANB、下颌骨顺旋情况、骨性颏部突度存在相关性.使用多个骨性指标拟合牙性指标时,男性的牙性指标IMPA和女性的牙性指标G Vert-U1的adjusted R2(分别为0.712、0.795)最大.同时使用多个骨性和软组织指标拟合牙性指标时,男女性的G Vert-U1的adjusted R2(分别为0.836、0.842)最大,其中男性G Vert-U1主要受软组织颏部突度和鼻基底部突度影响,女性G Vert-U1主要受鼻基底部突度和ANB影响.结论 本研究以正畸患者为基础,展示了成人正畸术后美观人群的颅颌面特征,发现了性别、年龄、骨组织与软组织指标的相关性,基于多个骨组织和软组织对牙性指标进行拟合,为正畸前牙目标位美学设计提供参考.
Objective This study aims to provide craniofacial features and incisor position prediction models among esthetics population after orthodontic treatment.Methods A total of 338 patients with esthetic profiles were se-lected from 1 055 post-orthodontic adults based on inclusion and exclusion criteria and scored by five dental students.Mean values of cephalometric measurement were demonstrated with gender and sagittal skeletal pattern(ANB)differ-ences assessed by generalized estimating equation.Correlations among age,skeletal,and soft tissue variables in differ-ent genders were determined.Multivariate analysis was used to assess the influence of skeletal and soft tissue variables on orthodontic incisor position.Results Within the esthetic cohort after orthodontic treatment,gender differences ex-isted in cranial and mandibular length,mandibular rotation,protrusion of pogonion,inclination of maxillary incisors,upper lip thickness,lower 1/3 face height,and nose protrusion.However,in class Ⅰ malocclusion,the development of the chin showed no significance,whereas the protrusion of the lower lip significantly differed between genders,with less protrusion in males.In males,the protrusion of lip and chin varied among groups,with thinner basic upper lip thick-ness of class Ⅱ than class Ⅰ and greater lower lip height of class Ⅲ than class Ⅰ.In females,the protrusion and height of the upper lip and chin varied in groups,with thicker basic upper lip thickness of class Ⅲ than class Ⅰ.Upper lip thickness,female basic upper lip thickness,and female lower lip height were correlated with age.The protrusion of the upper lip was mainly correlated with posterior cranial base,mandibular body length,ANB in male and SNA,ANB,sag-ittal maxillary length,mandibular rotation,and protrusion of pogonion in female.The protrusion of the lower lip in males was mainly correlated with ramus height,mandibular rotation,protrusion of pogonion in male and ANB,mandib-ular rotation,and protrusion of pogonion in females.After employing skeletal variables to fit dental parameters,optimal results were achieved in male IMPA(adjusted R2=0.712)and female G Vert-U1(adjusted R2=0.795).After employing skeletal and soft tissue variables simultaneously,optimal results were achieved in male and female G Vert-U1,which was mainly influenced by the protrusion of the chin and nasal base in males(adjusted R2=0.836)and the protrusion of the nasal base as well as ANB in females(adjusted R2=0.842).Conclusion This study demonstrated the craniofacial features of esthetics population after orthodontic treatment and revealed the correlation of gender,age,skeleton,and soft tissues to provide reliable prediction models for aesthetic orthodontic incisor position.
程俊鑫;朱钰洁;李玥霖;郑英成;王军
口腔疾病防治全国重点实验室 国家口腔医学中心 国家口腔疾病临床医学研究中心四川大学华西口腔医院,成都 610041
口腔医学
美观正畸颅颌面特征前牙目标位设计头影测量参考标准
aestheticsorthodonticscraniofacial featureincisor position designcephalometric standard
《华西口腔医学杂志》 2024 (005)
609-623 / 15
Sichuan Health Commission Medical Sci-ence and Technology Program(21ZD003);Research and Develop Program of West China Hospital of Stoma-tology,Sichuan University(RD-03-202101) 四川省卫生健康委员会医学科技项目(21ZD003);四川大学华西口腔医院探索与研发项目(RD-03-202101)
评论