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山东大学学报（医学版） ›› 2014, Vol. 52 ›› Issue (10): 61-65,71.doi: 10.6040/j.issn.1671-7554.0.2014.178

• 临床医学 • 上一篇    下一篇

三维配准方法评价下颌后退手术后上呼吸道的形态学变化

MICHAEL M. P. NG'WANAMASELE1, 韩延钊1, 张风河2, 佟冬冬2, 李亮1, 程慧娟1, 王春玲1, 刘东旭1   

  1. 1. 山东大学口腔医院口腔正畸科, 山东 济南 250012;
    2. 山东大学口腔医院口腔颌面外科, 山东 济南 250012
  • 收稿日期:2014-03-31 修回日期:2014-09-25 出版日期:2014-10-10 发布日期:2014-10-10
  • 通讯作者: 刘东旭。E-mail：liudongxu@sdu.edu.cn E-mail:liudongxu@sdu.edu.cn
  • 基金资助:
    山东省科技计划项目合作研究（2007GG30002027，2010G0020232，2010HM053，21350005071301）；山东大学交叉学科项目（2011JC009，2012JC031）

Three dimensional registration method to evaluate the upper airway morphologic changes after mandibular setback surgery

MICHAEL M. P. NG'WANAMASELE1, HAN Yanzhao1, ZHANG Fenghe2, TONG Dongdong2, LI Liang1, CHENG Huijuan1, WANG Chunling1, LIU Dongxu1   

  1. 1. Department of Orthodontics, Stomatology Hospital of Shandong University, Jinan 250012, Shandong, China;
    2. Department of Oral and Maxillofacial Surgery, Stomatology Hospital of Shandong University, Jinan 250012, Shandong, China
  • Received:2014-03-31 Revised:2014-09-25 Online:2014-10-10 Published:2014-10-10

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摘要： 目的 本研究拟在介绍基于颧弓的三维配准评价下颌后退手术后上呼吸道形态学变化的一种方法。方法 选择1例行下颌后退手术的24岁男性患者作为研究对象，分别在治疗前（T0）、治疗后1周（T1）和治疗后1年零5个月（T2）拍摄锥形束CT（CBCT）。应用MIMICS16.0软件将不同时期的CBCT扫描数据重构为颌面骨骼和上呼吸道的三维模型，然后以立体模型（STL）格式输出。在不同时期每个立体模型两侧的颧骨、颧弓和上颌骨额突上选择标志点进行点对点配准。配准完成后，在同一横截面上，测量不同时期4个不同平面上呼吸道的前后向长度（APL）、最大横向宽度（LTW）和横截面积（CSA），同时计算出口咽和喉咽的容积。最后以矢状面窗口三维模型轮廓线上不同时期下齿槽座点（B点）间距离为准测量下颌骨移动的距离。结果 T1期上呼吸道有明显地减少，T2期有轻微地复发。手术后T1期下颌B点与手术前T0期下颌B点间距离较大，手术后T2期下颌B点与手术前T0期下颌B点间距离比手术后T1期下颌B点与手术前T0期下颌B点间距离略有减少。结论 基于颧弓的三维配准方法可以评价手术后及手术后期上呼吸道形态学变化。

关键词: 上呼吸道形态, 下颌后退术, 三维配准, 锥形束CT

Abstract: Objective To introduce a method of three dimensional (3D) registration based on the zygomatic arch to evaluate upper airway morphologic changes after mandibular setback surgery. Methods One male patient aged 24 years who underwent mandibular setback surgery to correct Angle class Ⅲ malocclusion was involved in this study. CBCT scans were taken before start of treatment (T0), 1 week after treatment (T1) and 1 year and 5 months after treatment (T2). The 3D models of skull and upper airway were constructed from the CBCT scans and exported as stereolithography by mimics16.0 software. The stereolithoghraphy was registered by selecting landmark points on either side of each 3D models on the zygoma, zygomatic arch and frontal process of the maxilla. After that, anteroposterior length, the largest transverse width and cross-section area were measured in the axial window in four planes, and thevolume was automatically computed in two regions of oropharynx and the laryngopharynx. The distances of mandibular retrusion and relapse were measured between the B-points located along the contour lines of 3D models. Results A notable decrease in upper airway dimensions at T1 and a slight relapse at T2 was observed. The distance of mandibular B-point at T1 and T0 was large. The distance of mandibular B-point between T2 and T0 is slightly smaller than the distance between T1 and T0. Conclusion The three dimensional registration method based on the zygomatic arch can evaluate upper airway morphologic changes after mandibular setback surgery.

Key words: Mandibular setback surgery, Upper airway morphology, Cone beam CT, Three dimensional registration

中图分类号: 

  • R783.5
[1] Graber L W, Vanarsdall Jr R L, Vig K W L. Orthodontics: current principles and techniques[M]. Philadelphia, Pennsylvania, USA, Elsevier Health Sciences, 2011: 157-178.
[2] Lenza M G, Lenza M M O, Dalstra M, et al. An analysis of different approaches to the assessment of upper airway morphology: a CBCT study[J]. Orthod Craniofac Res, 2010, 13(2): 96-105.
[3] Aboudara C, Nielsen I B, Huang J C, et al. Comparison of airway space with conventional lateral headfilms and 3-dimensional reconstruction from cone-beam computed tomography[J]. Am J Orthodontics Dentofacial Orthop, 2009, 135(4): 468-479.
[4] 胡海峰, 张丽, 陈志强, 等. 锥束 CT 技术在口腔临床中的应用[J]. CT 理论与应用研究, 2009, 18(3): 30-37.
[5] 王丽颖, 金作林. 锥形束 CT 及其在口腔正畸学中的应用[J]. 国际口腔医学杂志, 2013, 40(2): 181-184. WANG Liying, JIN Zuolin.The application of cone beam computer tomography in orthodontics[J]. International Journal of Stomatology, 2013, 40(2)181-184.
[6] Grauer D, Cevidanes L S H, Styner M A, et al. Pharyngeal airway volume and shape from cone-beam computed tomography: relationship to facial[J]. Am J Orthod Dentofacial Orthop, 2009, 136(6): 805-814.
[7] Achilleos S, Krogstad O, Lyberg T. Surgical mandibular setback and changes in uvuloglossopharyngeal morphology and head posture: a short-and long-term cephalometric study in males[J]. Eur J Orthod, 2000, 22(4): 383-394.
[8] Chen F, Terada K, Hua Y, et al. Effects of bimaxillary surgery and mandibular setback surgery on pharyngeal airway measurements in patients with Class Ⅲ skeletal deformities[J]. Am J Orthod Dentofacial Orthop, 2007, 131(3): 372-377.
[9] Nakagawa F, Ono T, Ishiwata Y, et al. Morphologic changes in the upper airway structure following surgical correction of mandibular prognathism[J]. Int J Adult Orthodon Orthognath Surg, 1997, 13(4): 299-306.
[10] Turnbull N R, Battagel J M. The effects of orthognathic surgery on pharyngeal airway dimensions and quality of sleep[J]. J Orthod, 2000, 27(3): 235-247.
[11] Holmberg H, Linder-Aronson S. Cephalometric radiographs as a means of evaluating the capacity of the nasal and nasopharyngeal airway[J]. Am J Orthod, 1979, 76(5): 479-490.
[12] Tselnik M, Pogrel M A. Assessment of the pharyngeal airway space after mandibular setback surgery[J]. J Oral Maxillofac Surg, 2000, 58(3): 282-285.
[13] Park S B, Kim Y I, Son W S, et al. Cone-beam computed tomography evaluation of short-and long-term airway change and stability after orthognathic surgery in patients with Class Ⅲ skeletal deformities: bimaxillary surgery and mandibular setback surgery[J]. Int J Oral Maxillofac Surg, 2012, 41(1): 87-93.
[14] Muto T, Yamazaki A, Takeda S, et al. Accuracy of predicting the pharyngeal airway space on the cephalogram after mandibular setback surgery[J]. J Oral Maxillofac Surg, 2008, 66(6): 1099-1103.
[15] Chen F, Terada K, Hanada K, et al. Predicting the pharyngeal airway space after mandibular setback surgery[J]. J Oral Maxillofac Surg, 2005, 63(10): 1509-1514.
[16] Nada R M, Maal T J J, Breuning K H, et al. Accuracy and reproducibility of voxel based superimposition of cone beam computed tomography models on the anterior cranial base and the zygomatic arches[J]. PloS one, 2011, 6(2): e16520. doi: 10.1371/journal.pone.0016520.
[17] De Vos W, Casselman J, Swennen G R J. Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: a systematic review of the literature[J]. Int J Oral Maxillofac Surg, 2009, 38(6): 609-625.
[18] Eggensperger N, Smolka W, Iizuka T. Long-term changes of hyoid bone position and pharyngeal airway size following mandibular setback by sagittal split ramus osteotomy[J]. J Craniomaxillofac Surg, 2005, 33(2): 111-117.
[19] Liukkonen M, Vhtalo K, Peltomki T, et al. Effect of mandibular setback surgery on the posterior airway size[J]. Int J Adult Orthodon Orthognath Surg, 2001, 17(1): 41-46.
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