Cone Beam Computed Tomography의 두부계측분석을 통한 골격성 제3급 부정교합 환자에서 악교정 수술 후 입술과 주위 연조직의 수직적 변화
The Vertical Changes of Lip and Perioral Soft Tissue Following Orthognathic Surgery in Skeletal Class III Patients by a Cephalometric Analysis of Cone Beam Computed Tomography
이종민, 강주완, 이종호, 김창현, 박재억,
소속 상세정보
이종민 ( Lee Jong-Min ) - 가톨릭대학교 의과대학 서울성모병원 구강악안면외과학교실
강주완 ( Kang Joo-Wan ) - 가톨릭대학교 의과대학 서울성모병원 구강악안면외과학교실
이종호 ( Lee Jong-Ho ) - 가톨릭대학교 의과대학 서울성모병원 구강악안면외과학교실
김창현 ( Kim Chang-Hyun ) - 가톨릭대학교 의과대학 서울성모병원 구강악안면외과학교실
박재억 ( Park Je-Uk ) - 가톨릭대학교 의과대학 서울성모병원 구강악안면외과학교실
KMID : 0360120120340050311
Abstract
Purpose: The aim of this study is to evaluate the vertical changes of the lip and perioral soft tissue, following orthognathic surgery in skeletal class III patients by a cephalometric analysis of a cone beam computed tomography (CBCT).
Methods: A total of 20 skeletal class III patients, who had bimaxillary surgery with Le Fort 1 osteotomy and bilateral sagittal split ramus osteotomy, were included in this study. The surgical plan for maxilla was posterosuperior impaction with the anterior nasal spine, as the rotation center. Further, the surgical plan for mandible was also posterosuperior movement. The soft tissue changes between lateral cephalogram and CBCT were compared. And the correlations between independent variables and dependent variables were evaluated.
Results: There were no significant differences of the soft tissues changes between lateral cephalogram and CBCT. Upper lip philtrum length (SnLs), nasolabial angle increased and upper lip vermilion length (LsStms), lower lip length (StmiB’), lower lip vermilion length (StmiLi), lower lip philtrum length (LiB’) and soft tissue lower facial height (SnMe’) decreased after surgery. Change of SnLs (${\Delta}$ 수식 이미지SnLs) was influenced by vertical change of menton (${\Delta}$ 수식 이미지MeV), and change of LsStms (${\Delta}$ 수식 이미지LsStms) was influenced by upper lip thickness (ULT). Change of StmiLi’ (${\Delta}$ 수식 이미지StmiLi’) were influenced by preoperative overjet. Change of StmiB’ (${\Delta}$ 수식 이미지StmiB’) were influenced by preoperative overjet, vertical change of lower incisor (${\Delta}$ 수식 이미지L1V) and horizontal change of posterior nasal spine (${\Delta}$ 수식 이미지PNSH). Change of LiB’ (${\Delta}$ 수식 이미지LiB’) was influenced by ${\Delta}$ 수식 이미지L1V and ${\Delta}$ 수식 이미지PNSH. Change of SnMe’ (${\Delta}$ 수식 이미지SnMe’) was influenced by ${\Delta}$ 수식 이미지MeV, horizontal change of upper incisor (${\Delta}$ 수식 이미지U1H) and horizontal change of lower incisor (${\Delta}$ 수식 이미지L1H). ${\Delta}$ 수식 이미지Nasolabial angle was influenced by change of ULT (${\Delta}$ 수식 이미지ULT).
Conclusion: Both soft tissues and hard tissues can be evaluated by CBCT. Posterosuperior rotation of maxillomandibular complex resulted in increase of upper lip philtrum length and nasolabial angle, while the upper lip vermilion length, lower lip philtrum length, lower lip vermilion length, and soft tissue lower facial height showed a decrease.
키워드
Orthognathic surgery;Cone-beam computed tomography;Skeletal class III;Soft tissue changes
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