目的:应用结构光扫描对骨性Ⅲ类错正畸正颌联合治疗的患者手术前后软组织三维方向的变化进行初步评价。方法:8例成人骨性Ⅲ类错正畸正颌联合治疗患者,男性3例、女性5例,平均年龄(27.08±4.42)岁,正颌外科手术术式均为上颌Le FortⅠ型截骨术+双侧下颌升支矢状劈开切骨术+颏部成型术,分别在术前2周、术后6个月对面部进行结构光扫描,获得患者面部三维图像,测量术前和术后软组织三维标志点的变化以及线距、角度变化,并且对软组织体积变化做出初步评价。结果:标志点水平向变化不大,变化主要集中在垂直向和前后向,线距和角度的变化也主要在唇部;颏部的体积变化显著,其次为上颌,最后是额面部。结论:骨性Ⅲ类患者接受双颌手术后,面部软组织三维方向的变化主要表现在垂直方向和矢状方向;结构光三维扫描技术作为面部软组织扫描的一种技术,相对于二维来说,能从整体上较直观、准确地观察和监测颌面部软组织在正颌正畸联合治疗过程的三维变化。
Objective: To evaluate facial soft tissue 3-deminsion changes of skeletal Class Ⅲ malocclusion patients after orthognathic surgery using structure light scanning technique. Methods: Eight patients[3 males and 5 females,aged( 27. 08 ± 4. 42) years] with Class Ⅲ dentoskeletal relationship who underwent a bimaxillary orthognathic surgical procedure involving advancement of the maxilla by Le FortⅠ osteotomy and mandibular setback by bilateral sagittal split ramus osteotomy( BSSO) and genioplasty to correct deformity were included. 3D facial images were obtained by structure light scanner for all the patients 2 weeks preoperatively and 6 months postoperatively. The facial soft tissue changes were evaluated in 3-dimension. The linear distances and angulation changes for facial soft tissue landmarks were analyzed. The soft tissue volumetric changes were assessed too. Results: There were significant differences in the sagittal and vertical changes of soft tissue landmarks. The greatest amount of soft tissue change was close to lips. There were more volumetric changes in the chin than in the maxilla,and fewer in the forehead. Conclusion: After biomaxillary surgery,there were significant facial soft tissue differences mainly in the sagittal and vertical dimension for skeletal Class Ⅲ patients. The structure light 3D scanning technique can be accurately used to estimate the soft tissue changes in patients who undergo orthognathic surgery.