Email Alert | RSS

北京大学学报（医学版） ›› 2025, Vol. 57 ›› Issue (1): 128-135. doi: 10.19723/j.issn.1671-167X.2025.01.019

• 论著 • 上一篇    下一篇

基于牙颌面畸形患者三维颅面特征相似性度量模型的建立及评估

吴灵, 方嘉琨, 刘筱菁, 李自力*(), 李阳, 王晓霞   

  1. 北京大学口腔医学院·口腔医院口腔颌面外科，国家口腔医学中心，国家口腔疾病临床医学研究中心，口腔生物材料和数字诊疗装备国家工程研究中心，北京 100081
  • 收稿日期:2024-10-08 出版日期:2025-02-18 发布日期:2025-01-25
  • 通讯作者: 李自力 E-mail:kqlzl@sina.com
  • 基金资助:
    国家自然科学基金(82171012);首都卫生发展科研专项(CFH 2022-2-4104);北京市自然科学基金(7232222)

Establishment and evaluation of a similarity measurement model for orthognathic patients based on the 3D craniofacial features

Ling WU, Jiakun FANG, Xiaojing LIU, Zili LI*(), Yang LI, Xiaoxia WANG   

  1. Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
  • Received:2024-10-08 Online:2025-02-18 Published:2025-01-25
  • Contact: Zili LI E-mail:kqlzl@sina.com
  • Supported by:
    the National Natural Science Foundation of China(82171012);Capital's Funds for Health Improvement and Research(CFH 2022-2-4104);Beijing Natural Science Foundation(7232222)

RICH HTML

   

PDF (PC)

摘要：

目的: 建立一种基于牙颌面畸形患者三维颅面特征的相似性度量模型，并通过专家相似度评分对度量模型的有效性进行检测。方法: 选取2020年1月至2022年12月在北京大学口腔医院行双颌手术及术前正畸治疗的骨性Ⅲ类牙颌面畸形患者52例，其中男性26例，女性26例，根据性别分为两组。每组各随机设置1例患者作为参考样本，该组内其余患者均为测试样本。由3位专家对测试样本与参考样本的相似度进行主观评分，评分范围为1~10分，其中1分为完全不同，10分为完全相同，设定7.5分为临床可接受的相似性结果。提取患者术前锥形束计算机断层扫描(cone beam computed tomography, CBCT) 和三维面部图像的三维硬、软组织颅面特征，包括距离、角度和三维点云特征等，采用特征选择算法和线性回归模型，并与专家相似度评分结果进行拟合，建立相似性度量模型。为验证模型的可靠性，选取14例新患者进行相似度匹配，并由专家评价匹配结果的相似度，以评价相似性度量模型的可靠性。结果: 相似性度量模型显示，面中、下颅面特征是影响颅面相似度的主要特征，包括前鼻棘点-颏下点(anterior nasal spine-menton，ANS-Me)距离、右上尖牙点至眶耳平面(right canine-Frankfurt horizontal plane，U3RH)距离、左髁顶点-左下颌角点(left superior point of condyle-left gonion, CoL-GoL)距离、左髁顶点-颏下点(left condyle-menton, CoL-Me)距离、颏前点至正中矢状面垂直(pogonion-midsagittal plane, Pog-MSP)距离、右鼻翼点-左鼻翼点(right alar base-left alar base, AlR-AlL)距离、鼻尖点-软组织颏前点-下唇点(pronasale-soft tissue pogonion-labrale inferius, Pn-Pog’-Li)交角、发际点-右侧耳屏点(trichion-right tragus, Tri-TraR)距离、左外眦点-左鼻翼点(left exocanthion-left alar base, ExL-AlL)距离、骨性面下1/3、骨性面中下2/3及软组织上唇区域等。在模型可靠性测试中，14例相似性匹配案例的平均相似度评分为(7.627±0.711)分，与7.5分差异无统计学意义。结论: 本研究使用的相似性度量模型寻找的相似案例与专家主观评价匹配度高，可用于骨性Ⅲ类患者的相似案例检索。

关键词: 牙颌面畸形, 头颅相似性, 三维形态特征

Abstract:

Objective: To establish a similarity measurement model for patients with dentofacial deformity based on 3D craniofacial features and to validate the similarity results with quantifying subjective expert scoring. Methods: In the study, 52 cases of patients with skeletal Class Ⅲ malocclusions who underwent bimaxillary surgery and preoperative orthodontic treatment at Peking University School and Hospital of Stomatology from January 2020 to December 2022, including 26 males and 26 females, were selected and divided into 2 groups by sex. One patient in each group was randomly selected as a reference sample, and the others were set as test samples. Three senior surgeons rated the similarity scores between the test samples and the reference sample. Similarity scores ranged from 1 to 10, where 1 was completely different, and 10 was exactly the same. Scores larger than 7.5 was considered as clinically similar. Preoperative cone beam computed tomography (CBCT) and 3D facial images of the patients were collected. The three-dimensional hard and soft tissue features, including distances, angles and 3D point cloud features were extracted. The similarity measurement model was then established to fit with the experts' similarity scoring by feature selection algorithm and linear regression model. To verify the reliability of the model, 14 new patients were selected and input to similarity measurement model for finding similar cases. The similarity scoring of these similar cases were rated by experts, and used to evaluate the reliability of the model. Results: The similarity metric models indicated that the features of the middle and lower craniofacial features were the main features to influence the craniofacial similarity. The main features that were related to the expert' s similarity scoring included distance of anterior nasal spine-menton (ANS-Me), distance of right upper canion point-Frankfurt horizontal plane (U3RH), distance of left superior point of the condyle-left gonion (CoL-GoL), distance of left gonion-menton (CoL-Me), distance of pogonion-midsagittal plane (Pog-MSP), distance of right alar base-left alar base (AlR-AlL), angle of pronasale-soft tissue pogonion-labrale inferius (Pn-Pog' -Li), distance of trichion-right tragus (Tri-TraR), distance of left exocanthion-left alar base (ExL-AlL), lower 1/3 of skeletal face, middle and lower 2/3 of skeletal face and upper lip region of soft tissue. Fourteen new patients were chosen to evaluate the model. The similar cases selected by the model had an average experts' similarity scoring of 7.627± 0.711, which was not significantly different with 7.5. Conclusion: The similarity measurement model established by this model could find the similar cases which highly matched experts' subjective similarity scoring. The study could be further used for similar cases retrieval in skeletal Ⅲ malocclusion patients.

Key words: Dentofacial deformities, Craniofacial similarity, 3D morphological features

中图分类号: 

  • R782.2

表1

颅颌面硬组织标志点相关特征"

Feature Definition
SNA Angle sella-nasion-A point
SNB Angle sella-nasion-B point
N-A-Pog Angle nasion-A point-pogonion
N-Pog_FHP Angle formed by FHP and nasion-pogonion line
S-Gn_FHP Angle formed by FHP and sella-gnathion line
UI-UIapex_FHP Angle formed by FHP and UI-UIapex line
LI-LIapex_MP Angle formed by mandible plane and LI-LIapex line
MP_FHP Angle formed by FHP and mandible plane
OP_FHP Angle formed by FHP and occlusion plane
CoR-GoR-Me Angle right superior point of the condyle -right inferior gonion-menton
CoL-GoL-Me Angle left superior point of the condyle -left inferior gonion-menton
GoR-Me-GoL Angle right inferior gonion-menton-left inferior gonion
CoR-Me-CoL Angle right superior point of condyle-menton-left superior point of the condyle
Ba-S-N Angle basion-sella-nasion
Ba-N Distance between basion and nasion
Ba-S Distance between basion and sella
S-N Distance between sella and nasion
PoR-PoL Distance between right porion and left porion
ZyR-ZyL Distance between right zygoma point and left zygoma point
JR-JL Distance between right jugale and left jugale
N-Me Distance between nasion and menton
N-ANS Distance between nasion and anterior nasal spine
ANS-Me Distance between anterior nasal spine and menton
S-GoRL Distance from sella to the line right inferior gonion-left inferior gonion
MxR-MxL Distance between right maxillary basal point and left maxillary basal point
UI-APNS Distance from UI point to the line anterior nasal spine-posterior nasal spine
ANS-PNS Distance between anterior nasal spine and posterior nasal spine
UMcuspR-UMcuspL Distance between right upper first molar point and left upper first molar point
UIH Distance from upper incisor point to FHP
U3RH Distance from right upper canion point to FHP
U3LH Distance from left upper canion point to FHP
U6RH Distance from right upper first molar point to FHP
U6LH Distance from left upper first molar point to FHP
LMcuspR-LMcuspL Distance between right lower first molar point and left lower first molar point
CoR-CoL Distance between right superior point of the condyle and left superior point of the condyle
CpR-CpL Distance between right coracoid process and left coracoid process
GoR-GoL Distance between right gonion and left gonion
AgR-AgL Distance between right antegonion and left antegonion
CoR-GoR Distance between right superior point of the condyle and right gonion
CoL-GoL Distance between left superior point of the condyle and left gonion
GoR-Me Distance between right gonion and menton
GoL-Me Distance between left gonion and menton
CoR-Me Distance between right superior point of the condyle and menton
CoL-Me Distance between left superior point of the condyle and menton
UI-MSP Distance from UI point to MSP
LI-MSP Distance from LI point to MSP
Pog-MSP Distance from pogonion to MSP
Overbite Vertical distance from UI to LI
Overjet Sagittal distance from UI to LI

表2

颅颌面软组织标志点相关特征"

Feature Definition
Tri-Me’ Distance between trichion point and soft tissue menton
N’-Me’ Distance between soft tissue nasion and soft tissue menton
N’-Me’-v Vertical distance between soft tissue nasion and soft tissue menton
Tri’-N’ Distance between trichion point and soft tissue nasion
Tri-N’-v Vertical distance between trichion point and soft tissue nasion
N’-Sn Distance between soft tissue nasion and subnasale
N’-Sn-v Vertical distance between soft tissue nasion and subnasale
Sn-Me’ Distance between subnasale and soft tissue menton
Sn-Me’-v Vertical distance between subnasale and soft tissue menton
Sn-Stm Distance between subnasale and stomion
Stm-Me’ Distance between stomion and soft tissue menton
TraR-GoR’ Distance between right tragus and right soft tissue gonion
TraL-GoL’ Distance between left tragus and left soft tissue gonion
Tra-Go’(mean) Average value of distance between tragus and soft tissue gonion
GoR’-Me’ Distance between right soft tissue gonion and soft tissue menton
GoL’-Me’ Distance between left soft tissue gonion and soft tissue menton
Go’-Me’ (mean) Average value of distance between soft tissue gonion and soft tissue menton
ExR-ExL Distance between right exocanthion and left exocanthion
TraR-TraL Distance between right tragus and left tragus
GoR’-GoL’ Distance between right soft tissue gonion and left soft tissue gonion
AlR-AlL Distance between right alar base and left alar base
ChR-ChL Distance between right cheilion and left cheilion
ULPR-ULPL Distance between right upper lip point and left upper lip point
ZyR’-ZyL’ Distance between right soft tissue zygoma point and left soft tissue zygoma point
Li-B’-Pog’ Angle labrale inferius-soft tissue B point-soft tissue pogonion
Pn-Pog’-Ls Angle pronasale-soft tissue pogonion-labrale superius
Pn-Pog’-Li Angle pronasale-soft tissue pogonion-labrale inferius
Tri-G Distance between trichion and glabella
G-N’ Distance between glabella and soft tissue nasion
N’-Pn Distance between soft tissue nasion and pronasale
Pn-Sn Distance between pronasale and subnasale
Li-B’ Distance between labrale inferius and soft tissue B point
B’-Pog’ Distance between soft tissue B point and soft tissue pogonion
Pog’-Me’ Distance between soft tissue pogonion and soft tissue menton
Tri-ExR Distance between trichion and right exocanthion
Tri-ExL Distance between trichion and left exocanthion
Tri-TraR Distance between trichion and right tragus
Tri-TraL Distance between trichion and left tragus
N’-AlR Distance between soft tissue nasion and right alar base
N’-AlL Distance between soft tissue nasion and left alar base
N’-GoR’ Distance between soft tissue nasion and right soft tissue gonion
N’-GoL’ Distance between soft tissue nasion and left soft tissue gonion
N’-Go’(mean) Average value of distance between soft tissue nasion and soft tissue gonion
ExR-AlR Distance between right exocanthion and right alar base
ExL-AlL Distance between left exocanthion and left alar base
ExR-ChR Distance between right exocanthion and right cheilion
ExL-ChL Distance between left exocanthion and left cheilion
TraR-AlR Distance between right tragus and right alar base
TraL-AlL Distance between left tragus and left alar base

图1

测试样本(蓝色)与参考样本(黄色)的迭代最近点算法配准"

图2

三维颅骨的上、中、下三个区域"

图3

面部软组织19个分区示意图"

图4

相似性度量模型的构建流程"

表3

三个模型相似度评分相关自变量的线性回归分析"

Variable β(95%CI) P value Variance inflation factor
Landmark-based features
ANS-Me 0.171 (-0.545 to 0.887) 0.631 2.745
U3RH -0.350 (-0.942 to 0.241) 0.238 2.000
CoL-GoL 0.608 (-0.253 to 1.469) 0.161 1.075
CoL-Me -1.085(-1.984 to -0.187) 0.019* 1.962
Pog-MSP -1.082 (-1.693 to -0.471) 0.001* 1.153
Stm-Me’ -0.766 (-1.421 to -0.111) 0.023* 1.793
AlR-AlL -0.344 (-0.987 to 0.298) 0.285 1.498
Pn-Pog’-Li -0.656 (-1.260 to -0.052) 0.034* 1.232
Tri-TraR -0.277 (-0.764 to 0.211) 0.258 1.597
ExL-AlL -0.404 (-1.060 to 0.251) 0.220 1.578
Surface-based features
Lower 1/3 cranium 0.129 (-0.769 to 1.027) 0.773 2.065
Lower 2/3 cranium -1.975 (-3.497 to -0.453) 0.012* 4.173
Entire cranium 0.516 (-0.668 to 1.700) 0.384 2.855
Right cheek region 0.506 (-0.163 to 1.175) 0.134 1.081
Left paranasal region 0.543 (-0.166 to 1.251) 0.130 1.109
Upper vermilion region 1.308 (0.358 to 2.258) 0.008* 1.406
Lower facial region -1.140 (-1.838 to -0.443) 0.002* 1.271
All features
ANS-Me 0.031 (-0.634 to 0.696) 0.925 2.592
U3RH -0.226 (-0.807 to 0.355) 0.435 2.112
CoL-GoL 0.673 (-0.191 to 1.537) 0.123 1.188
CoL-Me -1.329 (-2.227 to -0.432) 0.005* 2.146
Pog-MSP -0.659 (-1.272 to -0.046) 0.036* 1.272
AlR-AlL -0.456 (-1.089 to 0.177) 0.153 1.592
Pn-Pog’-Li -0.678 (-1.259 to -0.096) 0.024* 1.253
Tri-TraR -0.082 (-0.545 to 0.381) 0.722 1.579
ExL-AlL -0.641 (-1.270 to -0.012) 0.046* 1.594
Lower 1/3 cranium -0.188 (-0.847 to 0.471) 0.568 1.929
Lower 2/3 cranium -0.626 (-1.492 to 0.239) 0.151 2.341
Upper vermilion region 0.814 (0.122 to 1.505) 0.022* 1.293
1 Jansma J , Schepers RH . Adjunctive aesthetic procedures in orthognathic surgery[J]. Oral Maxillofac Surg Clin North Am, 2023, 35 (1): 139- 152.
doi: 10.1016/j.coms.2022.06.007
2 Jie B , Han B , Yao B , et al. Automatic virtual reconstruction of maxillofacial bone defects assisted by ICP (iterative closest point) algorithm and normal people database[J]. Clin Oral Investig, 2022, 26 (2): 2005- 2014.
doi: 10.1007/s00784-021-04181-3
3 Zheng X , Zhao JL , Lv ZH , et al. Skull similarity comparison based on SPCA[J]. Multimed Tools Appl, 2020, 79 (31/32): 22423- 22446.
4 Zhang D , Wu Z , Wang X , et al. 3D skull and face similarity measurements based on a harmonic wave kernel signature[J]. Vis Comput, 2021, 37 (4): 749- 764.
doi: 10.1007/s00371-020-01946-x
5 Xiao D , Wang L , Deng H , et al. Estimating reference bony shape model for personalized surgical reconstruction of posttraumatic facial defects[J]. Med Image Comput Comput Assist Interv, 2019, 11768, 327- 335.
6 Fang X , Deng HH , Kuang T , et al. Patient-specific reference model estimation for orthognathic surgical planning[J]. Int J Comput Assist Radiol Surg, 2024, 19 (7): 1439- 1447.
doi: 10.1007/s11548-024-03123-0
7 Wang L , Ren Y , Gao YZ . Estimating patient-specific and anato-mically correct reference model for craniomaxillofacial deformity via sparse representation[J]. Med Phys, 2015, 42 (10): 5809- 5816.
doi: 10.1118/1.4929974
8 Li Z , Teng S , Cheng Y , et al. Craniomaxillofacial deformity correction via sparse representation in coherent space[J]. IEEE Access, 2015, 8, 69- 76.
9 Cheung LK , Chan YM , Jayaratne YSN , et al. Three-dimensional cephalometric norms of Chinese adults in Hong Kong with balanced facial profile[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2011, 112 (2): e56- e73.
doi: 10.1016/j.tripleo.2011.02.045
10 Fagertun J , Harder S , Rosengren A , et al. 3D facial landmarks: Inter-operator variability of manual annotation[J]. BMC Med Imaging, 2014, 14 (1): 1- 9.
doi: 10.1186/1471-2342-14-1
11 Paulsen RR, Juhl KA, Haspang TM, et al. Multi-view consensus CNN for 3D facial landmark placement[C]. Cham: Springer, 2019.
12 Rusinkiewicz S, Levoy M. Efficient variants of the ICP algorithm[C]. Quebec City: IEEE, 2001.
13 Lo LJ , Weng JL , Ho CT , et al. Three-dimensional region-based study on the relationship between soft and hard tissue changes after orthognathic surgery in patients with prognathism[J]. PLoS One, 2018, 13 (8): e0200589.
doi: 10.1371/journal.pone.0200589
14 Gopika N, MKME A. Correlation based feature selection algorithm for machine learning[C]. Cairo: IEEE, 2018.
15 Rupperti S , Winterhalder P , Krennmair S , et al. Changes in the facial soft tissue profile after maxillary orthognathic surgery[J]. J Orofac Orthop, 2022, 83 (3): 215- 220.
doi: 10.1007/s00056-021-00294-2
16 Hou L , He Y , Yi B , et al. Evaluation of soft tissue prediction accuracy for orthognathic surgery with skeletal class Ⅲ malocclusion using maxillofacial regional aesthetic units[J]. Clin Oral Investig, 2023, 27 (1): 173- 182.
17 Olivetti EC , Nicotera S , Marcolin F , et al. 3D soft-tissue prediction methodologies for orthognathic surgery: A literature review[J]. Appl Sci, 2019, 9 (21): 4550.
doi: 10.3390/app9214550
[1] 王兴, 林野, 伊彪, 周彦恒, 梁成, 王晓霞, 李自力, 张震康. 内置式颌骨牵引成骨在疑难牙颌面畸形矫治中的应用--附88例报告[J]. 北京大学学报（医学版）, 2001, 33(3): 258-262.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
ISSN 1671-167X
CN 11-4691/R
主管单位：中华人民共和国教育部
主办单位：北京大学
地址： 北京市海淀区学院路38号 北京大学医学部 《北京大学学报（医学版）》
邮编：100191
电话：010-82801551
Email： xbbjb2@bjmu.edu.cn

《北京大学学报（医学版）》
微信公众号
版权所有 © 2018 《北京大学学报（医学版）》编辑部