环梨状孔缘植骨对软组织改变的形态学研究<br />-《中国美容医学》

文章信息/Info

Title:: Morphological Study on the Changes of Soft Tissue Via Simultaneous Bone Graft of
Around Piriform Aperture with Alveolar Bone Graft

Author(s):: LI Jing1; 2; 3; LI Jin-feng1; 2; BI Si-si1; 2; REN Zhan-ping1; 2; TAO Yong-wei1; 2; GUO Yan1; 2

Keywords:: ; Key words: unilateral complete cleft alveolar; alveolar bone graft (abg); alar base; piriform aperture; CBCT

摘要:: [摘要]目的：探讨牙槽突裂环梨状孔缘植骨对鼻翼基底位置及鼻旁软组织形态的改变。方法：对35例单侧完全性牙槽突裂患
者植骨术前及术后至少6个月的口腔颌面锥形束CT(Cone beam computed tomography,CBCT)资料进行重建分析，用SPSS 22.0
软件进行统计分析，比较手术前后软、硬组织三维方向的改变。结果：手术前后梨状孔缘对称性明显改善，但鼻翼基底软组
织改变较为复杂：术前患侧鼻翼基底各测量标志点在X及Y方向上均表现为较健侧向外、下方移位，Z方向并未表现出健、患
侧的显著性差异，术后X及Y方向对称性有所改善，但Z方向患侧较健侧均表现为偏前，差异均有统计学意义（P ＜0.05）；量
化鼻翼基底区软组织对称性的改变，发现其与术前梨状孔的塌陷程度呈现阈值效应。结论：术前患侧梨状孔较健侧偏后小于
4.6mm时，鼻翼基底对称性改善不明显，为保护面部立体结构及视觉美观，环梨状孔缘植骨应更为谨慎；术前患侧梨状孔较
健侧偏后大于4.6mm时，植骨同期环梨状孔缘植骨效果良好。

Abstract:: Abstract: Objective To analyze the symmetry of the hard tissues and soft tissues of the alar base in unilateral complete alveolar
cleft patients by three-dimensional computed tomography (CBCT). Methods CBCT images were investigated for 35 patients
with unilateral complete alveolar cleft. Each patient served as his or her own control. Results Analysis of the symmetries shows
that the simultaneous bone graft of around piriform aperture with alveolar bone graft makes more satisfactory changes in the
symmetries of piriform than alar base. The four landmark points of the alar base on the cleft side was demonstrated lateral and
caudal translocation pre-operation, the difference was statistically significant (P ＜0.05), while no statistic significant difference
was found in ventral and dorsal direction. The postoperative measurement showed that the asymmetry was present in the middle
and basal structure of the piriform aperture or X and Y direction showed satisfactory changes while Z direction showed ventral
translocation. The difference was statistically significant (P ＜0.05). The dorsal distance of the pirifrom and the RMSD have a
relationship of threshold. Conclusion When the bone depression was less than 4.6mm,we can get satisfied appearance of nose
only through the repair of soft tissues;When the bone depression was more than 4.6mm,it must be combined with graft and the
restitution of cleft of alveolus.