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研究生:宋亭萱
研究生(外文):Ting-Shiuan Sung
論文名稱:成人安格式第三級異常咬合者中臉部形態之研究—幾何形態學分析
論文名稱(外文):Geometric Morphometry of the Midfacial Complex in Adult with Angle Class III Malocclusion
指導教授:張宏博
指導教授(外文):Hong-Po Chang
學位類別:碩士
校院名稱:高雄醫學大學
系所名稱:牙醫學研究所
學門:醫藥衛生學門
學類:牙醫學類
論文種類:學術論文
論文出版年:2000
畢業學年度:88
語文別:中文
論文頁數:62
中文關鍵詞:第三級異常咬合中臉部複合體幾何形態分析有限元素分析薄板仿樣分析中臉部後縮
外文關鍵詞:Class III malocclusionMidfacial complexGeometric morphometryFinite-element methodThin-plate spline analysisRetrognathic midface
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本研究之目的,評估成年人第一級咬合者與第三級異常咬合者,中臉部形態是否有所差異;並以形態分析法:有限元素分析和薄板仿樣分析法評定變異處。採用台灣成年人側方測顱片共200張,其中安格式第一級咬合者(Angle Class I molar occlusion)女性和男性各50張,而安格式第三級咬合者(Angle Class III malocclusion)女性與男性各50張。使用9個中臉部標記點,12項線段與角度測量,以Student t-test作統計分析。以普式分析法(Procustes analysis)求得各組的中臉部平均形態,作為形態分析的比較。統計分析的結果,第三級咬合者後中臉部的水平線段(PNS-MPP和PtmS-Or)都變小,前齒槽骨角度和中臉部角度(PtmS-Rh-A和PtmS-Rh-Pr)都變小,前中臉部高度(Rh-Pr)變小。在有限元素分析發現,第一與第三級咬合者的臉部形態,有尺寸和形態上的差異,第三級咬合者的後中臉部較小,而前臉部沒有尺寸變小的情形,在下鼻棘區(subspinal region)和前上中臉部有較大的變形;由薄板仿樣分析法,發現上上顎複合體是後縮的,鼻骨尖端向下位移﹔由於這些變異,使第三級咬合者呈現後縮的中臉部輪廓;鼻骨尖端向下位移,呈現較短的前中臉部高度;並且有前傾的上顎門齒齒槽骨突起(proclined maxillary dentoalveolar process)。

The purpose of this study was to evaluate whether the morphology of the midface differed in Angle Class I occlusion and Class III malocclusion adults, and to localize differences with finite-element method and thin-plate spline analysis. This study comprised lateral cephalographs of 100 adult Taiwanese with Angle Class I occlusion (50 female and 50 male), and 100 adult Taiwanese with Angle Class III malocclusion(50 female and 50 male). The cephalographs were traced, and 9 homologous landmarks were identified and digitized. The student t-test was used to analyze 12 linear and angular measurements for the evaluation of the differences between Class I and Class III subjects. The average configuration of each group was generated by the Procrustes analysis. The average configurations were employed with geometric morphometry: finite-element method and thin-plate spline analysis. The results of student t-test showed the posterior horizontal length of the midface (PNS-MPP and PtmS-Or) of Class III malocclusion subjects were reduced, and the anterior alveolar angle (ANS-A-Pr) and midfacial angles (PtmS-Rh-A and PtmS-Rh-Pr)were reduced also. The results of finite-element method were evident that there were size- and shape- changes between the midfacial configuration of the Class I and Class III subjects. Size changes demonstrate that negative allometry presented in the posterior region of the Class III midfacial complex. Shape changes demonstrate that the anisotropy localized in the subspinal region (ANS-A) and anterior-superior area of the midface. Thin-plate spline presented the retrusion of the palatomaxillary complex and downward deformation of the Rhinion. Due to these differences, the Class III malocclusion adults presented retrognathic profile of the midfacial complex, inferior displacement of the nasal tip, and proclined maxillary dentoalveolar process.

第一章 前言……………………….…………….…….. 1
第二章 文獻回顧…………………….………………... 3
2.1 形態變異的分析…………………………..…..…. 6
2.2 有限元素分析法…………………………………. 6
2.3薄板仿樣分析法………………………………..… 9
2.3.1 薄板仿樣分析法的發展…………………….. 9
2.3.2 使用薄板仿樣法分析……..………….……... 10
2.3.3 薄板模型……………………………….……. 10
第三章 材料和方法……………………………….…... 13
3.1.1 研究對象………………………………….…. 13
3.1.2 測顱分析法………………………………… 14
3.2 統計方法………………………………………….. 15
3.3 圖示分析法………………………………………. 16
3.3.1有限元素分析法……………………………... 16
3.3.2 薄板仿樣分析法…………………………….. 17
第四章 結果……………………………………………. 18
4.1比較第一級咬合女性與第三級咬合女性………... 18
4.1.1 傳統測顱術分析……………………………... 18
4.1.2 有限元素分析………………………………... 19
4.1.3 薄板仿樣分析………………………………... 20
4.2比較第一級咬合男性與第三級咬合男性………... 21
4.2.1傳統測顱分析……………………………….... 21
4.2.2有限元素分析………………………………… 22
4.2.3 薄板仿樣分析…………………….………….. 23
4.3比較第一級咬合男女性與第三級咬合男女性…… 24
4.3.1 傳統測顱分析………………………………... 24
4.3.2有限元素分析…………………………………. 25
4.3.3薄板仿樣分析……………………………….… 26
第五章 討論…………………………………………….. 27
第六章 結論…………………………………………….. 39
參考文獻………………………………………………..… 41
表圖目錄
圖1. 有限元素分析的幾何圖形………..………..……... 46
圖2. Thompson的方格圖………………….…………… 47
圖3. 中臉部標記點………….……………….…………. 48
圖4. 下中臉部線段測量………………………..………. 49
圖5. 上中臉部線段測量…………………..……………. 50
圖6. 中臉部高度測量………………..…………………. 51
圖7. 角度測量…………………..………………………. 52
圖8. 女性有限元素分析圖………………..……………. 53
圖9. 男性有限元素分析圖…………..…………………. 54
圖10. 男女性有限元素分析圖..…………………………. 55
圖11. 女性薄板仿樣分析圖……………………………... 56
圖12. 男性薄板仿樣分析圖…………………………..… 57
圖13. 男女性薄板仿樣分析圖………………………..… 58
表1. 9個中臉部標記點的定義….…………………..… 59
表2. 中臉部線段測量的平均值與標準差…………..… 60
表3. 中臉部線段和角度測量的平均值與標準差…….. 61
表4. 中臉部標記點的有限元素尺寸和形狀變化…….. 62

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