| 摘要: | 研究目的
過去齒顎矯正醫師習慣以?維的影像作為臨床醫師診斷治療之依據，但正、側?資訊無法整合成真正的立體關係且?維資訊在成像過程中存在誤差。透過三微軟組織照相機，我們現在能夠觀察到在?維影像中無法看?的變化，更深入地了解臉部結構的三維變化。本研究的主要?標是討論台灣?三維微笑的顏??腔軟組織變化，並探討顱顏牙齒型態對三維微笑顏??腔軟組織變化的影響。
材料與方法
本研究招募了131位年齡介於18?30歲之間、具有吸引??部特徵的受試者。我們使?台灣數位影像科技有限公司的 Accu 3D相機，拍攝了受試者在休息和姿勢性微笑狀態下的 3D ?部照片。此外，我們還進?了 CBCT（Cone BeamComputerized Tomography）掃描，測量各種數據。在研究中記錄並分析了受試者在休息和微笑狀態下的各種數據，包括界標點、線性/?度測量、比例值以及頻率分佈。我們通過分析微笑變化的界標點位移，建立了微笑變化的標準值。同時，我們採?統計?法分析了頭顱?部牙齒組織與 3D 微笑變化之間的相關性。這些步驟旨在深入了解 3D 微笑變化，並為臨床診斷和治療計畫提供科學依據。
研究結果
本研究收集131名受試者，其中男性65?(平均年齡23.5±3.2歲），女性66?(平均年齡 22.5±1.5 歲），年齡範圍為18?30歲，性別間無顯著年齡差異(p>0.05）。研究結果顯?，男性下顎平均?度為 127.8 毫米，女性為 121.38mm；男性上顎骨?度平均為 6.27mm，女性為 4.79mm；男性上顎橫寬平均為36.98mm，女性為 33.95mm。牙齒間距、顱寬、?齒?度和GoR-GoL點距離、右側和左側中?部?度(R Co-A 和 L Co-A及下顎?度（R Co-Gn 和 LCo-Gn）、下切牙前突（L1 Protrusion）和上顎橫寬等，有顯著性別差(p>0.05）。然?，Ns-Pr、Ss-Pr 和上顎骨?度（A-Na Perp）等測量沒有顯著性別差異（p 值>0.05），顯?不同?部特徵間的變異性。在微笑狀態下，僅左側?唇溝顯?出顯著的性別差異。在 X 軸平?上，?些標誌向右側移動，?另?些標誌向左側移動。女性組中，標誌移動數量較男性多，顯?女性在微笑時比男性表現出更多?部表情。在 Y 軸平?上，多變量顯?性別差異。在 Z 軸平?上，微笑時所有?部標誌均向前移動。
上唇?度（sn-uli）、下唇?度（lls-SB）和下唇紅唇?度（lls-li）在靜?和微笑狀態下均顯?出性別差異。然?，女性組的?唇??於男性組。此外，嘴寬與?寬之間、上唇?度與下前顏??度、上唇紅唇?度與下唇紅唇?度、下唇?度（lls-SB）與下唇紅唇?度的相關係數分別為 0.61、0.52、0.60、0.61，顯?這些測量之間存在正相關。這些結果強調了?部測量中的性別差異。
結論
在多項?部測量中存在顯著的性別差異，包括下顎?度、上顎骨?度和上顎橫寬。右側和左側中?部?度及下顎?度。在微笑狀態下，在 X、Y、Z 軸平?上的座標移動也顯?出性別差異，如：女性在微笑時比男性表現出更多的?部表情，上唇?度、在靜?和微笑狀態下唇?度和下唇紅唇?度、女性的?唇?值?於男性、嘴寬與?寬之間的強正相關、上唇?度與下前??度之間的潛在比例關係、唇部垂直尺?之間的強正相關等，皆存在男女差異性，表?在臨床和?類學研究中應考慮性別因素，以便更精確地理解和應?這些?部三度空間特徵測量。
Purpose:
In the past, orthodontists commonly relied on two-dimensional images for
clinical diagnosis and treatment planning. However, frontal and lateral views do not provide an integrated understanding of the true three-dimensional relationships, and there are inherent errors in the imaging process. With the advent of three-dimensional photogrammetry, we can now observe changes that are not visible in two-dimensional images, allowing for a more comprehensive understanding of the three-dimensional changes in facial structures. The primary objective of this study is to investigate the three-dimensional changes in orofacial soft tissues during smiling in a Taiwanese population and to examine the influence of craniofacial and dental morphology on these three-dimensional changes.
Materials and Methods:
131 individuals, aged 18-30 with attractive facial features, were recruited. 3D facial photos were captured with 3D camera (Accu 3D camera Digident Image Technology Co., Ltd, Taiwan. Rest and posed smiles 3D photos and CBCT scans were
taken. Various data were recorded and analyzed in rest and smile images, including landmarks, linear/angular measurements, proportion values, and frequency distributions. Landmark displacements for smile changes and standard values for 3D smiles were established. Statistical methods were performed to analyze relationship between craniofaciodental tissue and 3D smile changes.
Results:
Based on this study involving 131 participants, 65 males (mean age 23.5±3.2years) and 66 females (mean age 22.5±1.5 years), aged between 18 and 30 years, there was no significant age difference between genders (p > 0.05). The results revealed that the average mandibular length was 127.8 mm in males and 121.38 mm in females. The average maxillary bone length was 6.27 mm in males and 4.79 mm in females. The average maxillary width was 36.98 mm in males and 33.95 mm in females. Significant gender differences were observed in tooth spacing, cranial width, molar length, the distance between GoR-GoL points, the right and left midface lengths (R Co-A and L Co-A), mandibular length (R Co-Gn and L Co-Gn), lower incisor protrusion (L1 Protrusion), and maxillary width (p < 0.05). However, no significant gender differences were found in the measurements of Ns-Pr, Ss-Pr, and maxillary bone length (A-Na Perp) (p > 0.05), indicating variability among different facial features. In the smiling condition, only the left nasolabial groove showed a significant gender difference. On the X-axis plane, some landmarks shifted to the right, while others shifted to the left. The number of landmark movements was higher in the female group than in the male group, indicating that females exhibited more facial expressions while smiling. Multivariate analysis showed gender differences on the Y-axis plane. On the Z-axis plane, all facial landmarks moved forward during smiling. Upper lip length (sn-uli), lower lip length (lls-SB), and lower red lip length (lls-li) showed gender differences in both resting and smiling states. Additionally, the nasolabial angle was higher in females than in males. The correlation coefficients between mouth width and nasal width, upper lip length and lower anterior facial height, upper red lip length and lower red lip length, lower lip length (lls-SB), and lower red lip length were 0.61, 0.52, 0.60, and 0.61, respectively, indicating positive correlations among these measurements. These findings highlight the gender differences in facial measurements.
Conclusion:
Significant gender differences were found in various facial measurements, including mandibular length, maxillary bone length, and maxillary width. Differences were also observed in the right and left midface lengths and mandibular lengths. During smiling, the coordinate movements in the X, Y, and Z axes planes displayed gender differences, with females showing more facial expressions compared to males. Upper lip length, lower lip length, and lower red lip length exhibited gender differences in both resting and smiling states. Additionally, the nasolabial angle was greater in females than in males. Strong positive correlations were observed between mouth width and nasal width, a potential proportional relationship between upper lip length and lower anterior facial height, and strong positive correlations between vertical lip dimensions, all indicating gender differences. These findings suggest that gender should be considered in clinical and anthropological research to better understand and apply these three-dimensional facial measurements accurately. |
