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目的:探讨曲面断层片和头颅后前位片在分析下颌不对称畸形中的作用。方法:人头颅骨标本5具,常规方法分别拍摄有钢珠标志和无钢珠标志的头颅标本的X线后前位定位片(PAC)和曲面断层片(Pa)。选取25例下颌不对称畸形患者的PAC和Pa。分别测量颅骨标本实体、颅骨标本的PAC和Pa、以及患者的PAC和Pa中的髁突长、下颌升支长和下颌体长。对颅骨标本测量项目的实际值和相应的影像测量值进行相关性检验,比较25例患者PAC和Pa的相应测量值的差异指数,用图表观察不同测量者测量同一样本所得测量结果的离散度。结果:当颅骨标本有钢珠标志时,其大部分影像测量值与实际值显示很强的相关性(0.96～0.99,P<0.01)。当颅骨标本无钢珠标志时,Pa测量的髁突长和下颌升支长与实际值有很强的相关性,PAC所测下颌升支长和下颌体长与实际值的相关性降低,髁突长无法测量。不同测量者测量下颌升支长时,在Pa所测的可重复性要比在PAC所测者高,测量下颌体长时,在PAC所测的可重复性则比在Pa高。结论:PAC对评价下颌骨水平向不对称较有价值,对评价下颌骨垂直向不对称的作用有限;Pa对评价下颌骨水平向不对称的价值不高,但对评价下颌骨垂直向不对称有确切的意义。
Objective: To investigate the role of curved surface anterior segment and posterior segment in the analysis of asymmetric mandibular deformity. Methods: There were 5 human skull specimens. Conventional methods were taken to take the radiographs of the anterior posterior radiographs (PAC) and curved surface slices (Pa) of the skull specimens and the skull specimens without the steel ball marks respectively. 25 cases of mandibular asymmetric deformity in patients with PAC and Pa. The skull specimen entities, the PAC and Pa of the skull specimens, and the condylar length, mandibular ascending length, and mandibular body length in the PAC and Pa patients, respectively, were measured. The correlation between the actual value of the skull specimen measurement and the corresponding image measurement was tested. The difference index of the corresponding measured value of PAC and Pa in 25 patients was compared. The scatter of measurement results obtained by different measurers on the same sample was observed. Results: When the skull specimens were marked with steel balls, most of the measured images showed strong correlation with the actual values (0.96 ~ 0.99, P <0.01). The condylar length and the mandibular ascending length measured by Pa had a strong correlation with the actual value when the skull specimens were not marked with steel balls. The correlation between the mandibular ascending length and the mandible length measured by the PAC and the actual value decreased, Long can not measure. Repeatability measured at Pa was higher for different measurers than mandibular ascending measures, and repeatability measured on PACs was higher for mandibular body measurements when measuring mandibular body length. CONCLUSIONS: PAC is valuable for evaluating the horizontal asymmetry of the mandible and is of limited value in assessing the vertical asymmetry of the mandible. Pa is of little value in assessing the horizontal asymmetry of the mandible, but for assessing the vertical asymmetry of the mandible Have exact meaning