- 學位論文
正顎手術患者的臉部軟組織分析
Soft Tissue Facial Aesthetics Analysis of Orthognathic Surgery Patients.
摘要
在正顎手術與矯正治療的搭配下，可改善骨骼問題與齒顎顏面關係異常所導致的咬合不正與臉部不對稱。這兩種治療方式的結合不只實現了功能性咬合，還能提升患者的臉部美觀、心理健康以及其對治療結果的整體滿意度。過去對於骨骼和軟組織矯正的研究多以高加索人為主，提及亞洲人的篇幅並不多，更缺乏台灣人的數據。本篇論文針對台灣人的正顎手術結果進行進一步分析，以求能在將來的手術中獲得更加和諧的臉部輪廓與美觀。 本篇運用Burstone側位頭顱Ｘ光分析、Ricketts側位頭顱Ｘ光分析、 Holdaway側位頭顱Ｘ光分析、Steiner側位頭顱Ｘ光分析，對skeletal與profile進行解讀與統計處理，將六十位接受過正顎手術之患者的數據進行判讀，並且比較 (1) 六十位接受正顎手術（上顎、下顎或雙顎手術）的台灣成年患者術前與術後的軟、硬組織差異。(2) 將此六十位接受正顎手術患者之數據與先前他篇論文中未曾手術且經由矯正醫師評估後符合骨骼與外型美觀之標準的四十八名成年台灣人（reference norm）進行比對，觀察兩組數據中軟硬組織之差異。 研究結果顯示，在矯正治療與正顎手術的搭配下，不僅可調整頦突出的幅度與側面輪廓角的弧度，還能使軟組織的形狀改變，包含上唇溝的深度降低、鼻唇角度增加、下唇溝的深度增加、上下唇水平線至美觀線之直線距離減少等，另外，也進一步改善了上下顎骨間的相對位置。下顎軟組織的改善幅度較上顎軟組織更大，此結論與另一篇研究的結果相符，造成此現象的原因可能源自下顎軟組織的塑形與骨骼位置的改變有更強的相關性。
並列摘要
Orthognathic surgery and orthodontic treatment are collaborative approaches in addressing skeletal and dentoalveolar discrepancies that contribute to malocclusions and facial imbalances. Numerous research on the skeletal and soft tissue correction had been done in the past mostly based on the Caucasian population, fewer have studied the Asian population, and even less can be found on the Taiwanese. The purpose of this study was to statistically analyze the results of orthognathic surgery in Taiwanese adults, so as to help orthodontists and surgeons understand the ability and limitations of surgery; thereby aid in achieving patients’ harmonious facial contour in future treatment planning. Using Burstone, Ricketts, Holdaway, and Steiner lateral cephalometric analyses, skeletal and facial profile data were gathered to (1) compare between before and after orthognathic surgery (either maxillary, mandibular, or bimaxillary surgery) hard and soft tissue changes, and (2) to compare the sixty Taiwanese patients who underwent orthognathic surgery with the forty-eight Taiwanese reference norm selected by other orthodontists for their aesthetically pleasing profiles. The combination of orthodontic treatment and orthognathic surgery resulted in: correction of chin projection and profile angles, reduction of superior sulcus depth and increased nasolabial angle, increased inferior sulcus depth, decreased distance between horizontal upper and lower lip position to aesthetic lines, and enhancement of the relative position between maxilla and mandible. The ratio of mandibular soft tissue improvement was found to be higher than maxillary soft tissue improvement because of the significant positive correlation and strong soft tissue response.