摘要
目的:利用基于颅颌面神经网络(craniomaxillofacial neural network,CMF-Net)的三维自动定点系统对正畸正颌联合治疗患者进行疗效评估。方法:选取34例正畸正颌联合治疗患者,于治疗前、正颌术后、正畸术后采集CBCT影像,采用CMF-Net自动定点系统识别13个颅面三维标志点,对3个观测阶段颅面三维标志点及相应测量值的变化情况进行重复测量的方差分析,并通过Bland-Altman分析比较人工与自动定点在测量值上的差异性与一致性。结果:自动定点系统在13个标志点上的整体平均径向误差为2.104 mm。Ⅱ类正颌手术患者上齿槽座点(A点)与颅底点(Ba点)的距离在正颌术后与正畸前相比有所下降(P<0.05),下齿槽座点(B点)至双侧下颌角点(GoL点和GoR点)的平均距离在正颌术后与正畸前相比有所上升(P<0.05);B点与水平面距离在正颌术后与正畸前相比有所上升(P<0.05)。Ⅲ类正颌手术患者正颌术后以及正畸后,B点至下颌角的距离均较正畸前有显著下降(P<0.05);正畸后B点与水平面的距离较正畸前下降(P<0.05)。Ⅰ类正颌手术患者正颌术后A点与水平面的距离较正畸前显著增加,正畸后A点与水平面的距离较正畸前显著增加,而较正颌术后显著减小(P<0.05);正颌术后以及正畸后,B点与水平平面的距离较正畸前显著增加(P<0.05)。结论:CMF-Net三维自动定点系统具有较高的定位精度与临床一致性,可客观量化颌骨三维移动,为正畸正颌联合治疗的术前规划与术后评估提供可靠工具,是传统二维评估的有效补充。
Objective:To evaluate the efficacy of orthodontic-orthognathic combined treatment using a three-dimensional automatic landmark system based on the craniomaxillofacial neural network(CMF-Net).Methods:A total number of 34 patients undergoing orthodontic-orthognathic combined treatment were included.Cone-beam computed tomography(CBCT)images were acquired at three time points:before orthodontic treatment,after orthognathic surgery,and after orthodontic treatment.The CMF-Net automatic landmark system was employed to identify 13 craniofacial three-dimensional landmarks.A repeated-measures analysis of variance(ANOVA)was performed to compare changes in the three-dimensional landmarks and corresponding measurements across the three observational stages.Bland-Altman analysis was used to compare the differences and consistency in measurements between manual and automatic landmark identification.Results:The overall mean radial error of the automatic landmarking system for the 13 landmarks was 2.104 mm.For patients with Class II orthognathic surgery,the distance between subspinale(A point)and basion(Ba point)decreased after surgery compared to that before orthodontic treatment(P<0.05),while the average distance from supramental(B point)to the left and right gonial points(GoL and GoR)increased after surgery compared to that before orthodontic treatment(P<0.05).The distance from B point to the horizontal plane increased after surgery compared to that before orthodontic treatment(P<0.05).For patients with ClassⅢorthognathic surgery,the distance from B point to the gonial points significantly decreased both after surgery and after orthodontic treatment compared to that before orthodontic treatment(P<0.05).The distance from B point to the horizontal plane decreased after orthodontic treatment compared to that before orthodontic treatment(P<0.05).For patients with ClassⅠorthognathic surgery,the dis-tance from A point to the horizontal plane significantly increased after surgery compared to that before treatment,and it significantly increased after orthodontic treatment compared to that before treatment but significantly decreased compared to that after surgery(P<0.05).The distance from B point to the horizontal plane significantly increased both after surgery and after orthodontic treatment compared to that before orthodontic treatment(P<0.05).Conclusions:The CMF-Net three-dimensional automatic landmarking system demonstrates high localization accuracy and clinical consistency.It can objectively quantify the three-dimensional movement of the jaws,providing a reliable tool for preoperative planning and postoperative evaluation in combined orthodontic-orthognathic treatment,and serves as an effective supplement to traditional two-dimensional assessment methods.
作者
王嘉艺
张宇
张渊岫
WANG Jiayi;ZHANG Yu;ZHANG Yuanxiu(Department of Stomatology,Children s Hospital of Nanjing Medical University,Nanjing 210008,China;Department of Orthodontics,The Affiliated Stomatological Hospital of Nanjing Medical University,Nanjing 210029,China;State Key Laboratory Cultivation Base of Research,Prevention and Treatment for Oral Diseases(Nanjing Medical University),Nanjing 210029,China;Jiangsu Province Engineering Research Center of Stomatological Translational Medicine(Nanjing Medical University),Nanjing 210029,China)
出处
《口腔生物医学》
2026年第1期50-55,共6页
Oral Biomedicine
基金
江苏省卫生健康委指导性课题(Z2021033)。
关键词
三维自动定点
正畸正颌联合治疗
疗效评估
颅颌面神经网络
精准医疗
3D automatic cephelometric
orthodontic-orthognathic combined treatment
efficacy evaluation
CMF-Net
precision medicine
