【作者】 李红；

【导师】 王春玲；

【作者基本信息】 山东大学 ， 口腔临床医学， 2009， 硕士

【摘要】 目的:建立山东地区不同矢状骨面型成人鼻部形态影像学特征数据库;分析不同性别及不同矢状骨面型成人的鼻部形态差异,评价性别及矢状骨面型因素对鼻部形态特征的影响,并进一步分析探讨鼻部形态与颅颌面骨骼形态间的相关性及鼻部形态各测量指标之间的相关性,从而为正畸临床制定合理、可行的矫治计划提供重要参考依据。材料与方法:选取150例山东地区成人错(牙合)畸形患者作为研究对象,患者均为中等面角,其中Ⅰ类骨面型样本54人(男26,女28)、Ⅱ类骨面型样本48人(男25,女23)、Ⅲ类骨面型样本48人(男24,女24),治疗前拍摄数字化X线头颅侧位片进行测量分析。鼻部形态测量指标12项,颅颌面骨骼形态测量指标15项。采用SPSS 12.0统计学软件对测量结果进行分析。其中,采用t检验(α为0.05),比较分析每一类矢状骨面型样本中不同性别间鼻部形态特征的差异;采用多组间单因素方差分析比较分析各类矢状骨面型样本间鼻部形态特征的差异;采用Person相关分析进一步探讨鼻部形态与颅颌面骨骼形态间的相关性及鼻部形态各测量指标之间的相关性。结果1.Ⅰ类、Ⅱ类、Ⅲ类骨面型样本中,男性-女性相比较,在鼻背长、鼻深度1、鼻深度2、鼻峰高度、鼻骨长5项鼻部形态测量指标上均具有显著性差异,并且其男性测量值均大于女性测量值;此外,Ⅰ类骨面型样本中,男性-女性相比较,在鼻颏角、鼻骨角2项鼻部形态测量指标上也具有显著性差异。2.Ⅰ类、Ⅱ类、Ⅲ类骨面型样本间,在鼻唇角、鼻颏角、面型角、鼻骨长4项鼻部形态测量指标上均具有显著性差异。3.部分鼻部形态与颅颌面骨骼形态测量指标之间存在大多为低度到中度的相关性。4.鼻部形态各测量指标之间均存在低度到中度的相关性。结论:1.男性的鼻部较女性的更大、在面部位置更加突出,因此在制定正畸矫治方案时应考虑到这种性别差异。尤其是一些临界病例,考虑到男性鼻部发育良好,为获得或维持良好的软组织侧貌,不拔牙矫治的可能性会更大。2.Ⅰ、Ⅱ、Ⅲ类骨面型样本间鼻部形态存在差异。其中,三种骨面型样本间在反映鼻部大小的测量指标上无显著性差异,但因受上唇以及颏部位置的影响,在鼻唇角、鼻颏角、面型角3项测量指标上存在显著性差异。3.鼻部的形态、大小及在面部的位置与上下颌骨的长度、高度、位置相关。4.鼻部的内部结构是互相关联的,通过正畸治疗、正颌外科手术等方法改变其中任一部分可能导致整个鼻部外形的变化,进而导致整个软组织侧貌形态的改变。5.鼻部位于面部的中心,与其他结构关系密切,忽略了这一点有可能导致不理想的正畸和正颌外科效果。更多还原

【Abstract】 Objective:In this study, the lateral cephalograms of the adults with skeletal ClassⅠ、ClassⅡand ClassⅢmalocclusion were observed, The purpose of this study is to compare the nose of the adults with different skeletal patterns so as to explore the influence that skeletal patterns and sex, to evaluate the relationship between the facial skeletal and the nasal profile and the relationship among nasal parameters, to provide experimental results to help orthodontic clinic diagnosis and treatment.Materials and Methods:A cephalometric study was carried out on a sample of 150 subjects (75 males and 75 females, aged 18-28 years) before any treatment. The sample divided into 3 groups: 54 skeletal classⅠ(26 males and 28 females), 48 skeletal classⅡ(25 males and 23 females) and 48 skeletal classⅢ(24 males and 24 females). Each group were homogenous as to age and sex distribution. Fifteen facial skeletal parameters and twelve nasal parameters were measured on lateral cephalograms. All datas were analyzed by SPSS12.0 software.Results:1. Sex was found to be significant for nasal length (P<0.001), nasal depth (P<0.001) and hump(P<0.01).the value of these parameters in men were larger than that in women. In skeletal Class I, there were gender difference in the SFC (P<0.001) and NBoneL (P<0.05).2. The anteroposterior classifications were found to be significant with analysis of variance in certain parameters such as nasolabial angle (P<0.05), nasal mental angle (P<0.01) and soft-tissue facial convexity (P<0.001).3. Correlation analysis showed correlations between the skeletal and nasal parameters, and most correlation coefficient(r)values were moderate to low. Facial heights, lengths and the anteroposterior position of the maxilla and mandible were found to be correlated to nasal length and form.4. There were correlations among the nasal parameters, and most correlation coefficient (r) values were moderate to low.Conclusion:1. Several gender differences in nasal size, form and position were found, so when planning treatment, these foundings should keep in mind, especially in the borderline case. considering that the man had a prominent nose, a decision for nonextraction may be necessary in order to obtain or maintain the good soft profile.2. Skeletal classification had influence on certain nasal features. There were no significant difference in the nasal size among the three skeletal pattern; NLA were increased by the order of ClassⅡ、ClassⅠ、ClassⅢ. The soft tissue facial convexity of the ClassⅡsubjects was the largest, that of the ClassⅢwas the smallest, which was in consistent with the skeletal patterns. It was revealed that the outline of soft tissue profile might reflect the relationship of the skeletons.3. Nasal length、prominence and form are associated with height and length of the maxilla and the mandible. Posterior-inferior development results in a convex nasal profile, whereas anterior development produces a straight or concave nasal profile.4. There were correlations among nasal parameters. If one parameter was changed, the nasal form might be changed, which would influence the profile of the soft tissue, furthermore.5. The nose was sized in relation to each other part of the face. Ignoring this relationship can undermine the effectiveness of orthodontics and orthognathic-profilo-plastic procedures.更多还原