The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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Prediction of frontal soft tissue changes after mandibular surgery in facial asymmetry individuals

안면비대칭자의 하악골 악교정수술 후 정면 연조직 변화 예측을 위한 연구

  • Hwang, Hyeon-Shik (Department of Orthodontics, 2nd Stage of Brain Korea 21, School of Dentistry, Dental Science Research Institute, Chonnam National University) ;
  • Lee, Jessica J. (Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Washington) ;
  • Hwang, Chung-Hyon (Korea Adult Occlusion Study Center) ;
  • Choi, Hak-Hee (Department of Orthodontics, School of Dentistry, Chonnam National University) ;
  • Lim, Hoi-Jeong (Department of Orthodontics, School of Dentistry, Chonnam National University)
  • 황현식 (전남대학교 치의학연구소, 2단계 BK21 연구사업단, 치과학대학 교정학교실) ;
  • ;
  • 황정현 (한국성인교합연구소) ;
  • 최학희 (전남대학교 치과대학 교정학교실) ;
  • 임회정 (전남대학교 치과대학 교정학교실)
  • Published : 2008.08.30
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Abstract

Objective: To aid the development of a frontal image simulating program, we evaluated the soft tissue frontal changes in relationship to movement of hard tissue with orthognathic surgery of facial asymmetry patients. Methods: Preoperative and postoperative frontal cephalograms and frontal view photographs of 45 mandibular surgery patients with facial asymmetry were obtained in a standardized manner. Vertical and horizontal changes of hard tissue and soft tissue were measured from cephalograms and photographs, respectively. Soft tissue change in result to hard tissue change was then analyzed. Results: Both vertical and horizontal correlation analysis showed a weak relationship between the changes. Hard tissue points that were picked for 1 : 1 mean ratio with soft tissue points did not show any significant relevance. For each soft tissue change, regressive equation was formulated by stepwise multiple regression analysis, and the equation for soft tissue Menton was most reliable in predicting changes. Both vertical and horizontal hard tissue changes were used together in prediction of vertical or horizontal soft tissue change. Conclusions: The results suggest that computerized image simulation using regression analysis may be of help for prediction of soft tissue change, while 1:1 mean ratio method is not useful.

본 연구는 안면비대칭 환자의 악교정수술 시 경조직 이동에 따른 연조직 변화를 정면에서 평가함으로써 정면 얼굴 이미지 시뮬레이션 프로그램 개발에 도움이 되고자 시행되었다. 안면비대칭이 동반된 하악골 수술 예정 환자 45명을 대상으로 정모 두부방사선규격사진과 얼굴사진(photo)을 술전 및 술후에 각각 같은 각도로 촬영한 후, 술전 및 술후의 방사선사진을 이용하여 경조직 계측점의 변화를, 얼굴사진을 이용하여 연조직 계측점의 변화를 수평 및 수직으로 구분하여 각각 측정한 후 경조직 변화에 따른 연조직 변화를 비교 분석하였다. 연조직 변화와 경조직 변화의 상관성을 살펴본 결과 수평 방향, 수직 방향 모두에서 전반적으로 낮은 상관성을 보였으며, 1 : 1 mean ratio 산출을 위하여 서로 상관성이 가장 높은 경조직 계측점을 연조직 계측점별로 선택한 결과 직하방에 있는 경조직보다는 다소 멀리 떨어져 있는 경조직 계측점이 선택되는 경우가 많이 나타났다. 경조직 변화를 이용하여 연조직 변화를 예측할 수 있는 회귀방정식을 연조직 계측점별로 산출한 결과 연조직 수평변화 예측에 경조직 수직변화도 사용되고 연조직 수직변화 예측에 경조직 수평변화도 사용되었으며, 수평과 수직변화 모두에서 가장 설명력이 높은 방정식은 연조직 menton에서 나타났다. 이상의 연구결과 하부 경조직 계측점과 상부 연조직 계측점의 비율을 이용하는 1 : 1 mean ratio 방법은 불가능한 것으로 나타난 반면 회귀분석을 이용한 연조직 변화 예측은 임상에 도움이 될 수 있는 것으로 나타나 정면 이미지의 경우 컴퓨터를 이용한 시뮬레이션 프로그램이 반드시 필요함을 시사하였다.

Keywords

References

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