Le Fort I 골 절단술에 의한 악교정 수술후 연조직 변화에 관한 연구

Abstract

[한글]

악교정 수술후 환자의 만족도는 연조직의 모습에 의하여 판단되므로 수술후 연조직 변화의 예측은 성공적인 치료계획을 수립하는데 매우 중요하다 하겠다.

이에 저자는 상악골 수술후의 상순 및 코의 모습을 예측하는데 도움을 주고자 Le Fort Ⅰ 골절단술에 의한 상악골 전방이동으로 악교정 수술을 시행받은 10명을 대상으로 수술전과, 수술후 최소한 6개월후의 두부방사선 규격사진에서 안면연조직 변화를 계측 분석하

여 다음과 같은 결론을 얻었다.

1. 상악골 전방이동으로 연조직의 각 계측정은 전방 및 상방이동을 보였다.

2. ANS의 전방이동에 대한 Pn의 전방이동비율은 20%이며 Pn의 상방이동비율은 15%였다.

3. A의 전방이동에 대한 Sn의 전방이동비율은 54%이며 Sn의 상방이동비율은 15%였다.

4. Pr의 전방이동에 대한 Ls의 전방이동비율은 64%이며 Ls의 상방이동비율은 20%였다.

5. Pn에서 Ls로 갈수록 경조직 변화량에 대한 연조직 변화량이 증가하였다.

6. 비순각의 변화와 상악전치의 수평변화 간에는 유의의 차가 없었다.

7. 상순두께의 변화와 A점의 수평변화 간에는 유의의 차가 없었다.

SOFT TISSUE CHANGES ASSOCIATED WITH Le Fort Ⅰ MAXILLARY ADVANCEMENT

Byung Ho Choi, D.D.S.

Dept. of Dental Science, The Graduate School, Yon Sei Univ.

(Directed by Prof. Jung Ho Yoon, D.D.S., Ph.D.)

From the patient's standpoint, the result of orthognathic surgery will mainly be

judged by the soft tissue configuration obtained. The prediction of soft-tissue

changes following orthognathic surgery is very important to plan a successful

treatment.

To aid in prediction of postoperative upper lip and nose position following

maxillary orthognathic surgery, retrospective investigation of soft-tissue changes

associate with maxillary advancement(Le Fort Ⅰ osteotomy) was performed. The

following conclusions were drawn.

1) Soft tissue landmarks(Pn, Sn, Ls) moved in a anterior and superior directions

following maxillary advancement.

2) The mean ratio for hPn/hANS is 0.2±0.15.

The mean ratio for vPn/hANS is 0.15±0.13

3) The mean ratio for hSn/hA is 0.54±0.14

The mean ratio for vSn/hA is 0.15±0.05

4) The mean ratio for hLs/hPr is 0.64±0.20

The mean ratio for vLs/hPr is 0.2±0.16

5) A progressive increase in the horizontal soft-tissue movement from the tip of

the nose(Pn) to the free end of the upper lip was observed.

6) A decreased in lip thickness was observed with a mean of-1.4mm at A point.

[영문]

From the patient's standpoint, the result of orthognathic surgery will mainly be judged by the soft tissue configuration obtained. The prediction of soft-tissue changes following orthognathic surgery is very important to plan a successful treatment.

To aid in prediction of postoperative upper lip and nose position following maxillary orthognathic surgery, retrospective investigation of soft-tissue changes associate with maxillary advancement(Le Fort Ⅰ osteotomy) was performed. The

following conclusions were drawn.

1) Soft tissue landmarks(Pn, Sn, Ls) moved in a anterior and superior directions following maxillary advancement

2) The mean ratio for hPn/hANS is 0.2±0.15.

The mean ratio for vPn/hANS is 0.15±0.13

3) The mean ratio for hSn/hA is 0.54±0.14

The mean ratio for vSn/hA is 0.15±0.05

4) The mean ratio for hLs/hPr is 0.64±0.20

The mean ratio for vLs/hPr is 0.2±0.16

5) A progressive increase in the horizontal soft-tissue movement from the tip of the nose(Pn) to the free end of the upper lip was observed.

6) A decreased in lip thickness was observed with a mean of-1.4mm at A point.