随着患者美学要求的提高,软组织评估对颌面部治疗尤其是建立量化畸形数据库、制定治疗方案和开展术前评估愈发重要.临床工作中,三维摄影技术如锥形束计算机断层扫描、三维立体摄影、激光扫描等,相比二维摄影技术如头部正、侧面照片和头影X线测量,具有精准、快捷、自动、无害的优点.然而,尚无国际统一的三维颌面部测量标准限制了三维摄影技术的临床应用.由于自然头位是目前公认的评价面部容貌的最佳参照基准,故建立三维颌面部测量标准的首要任务是建立摆正头位的标准方法.本文着重叙述基于三维立体摄影技术的头位摆正方法,并将系列方法与基于锥形束计算机断层扫描的头位摆正方法进行比较分析,进而讨论理想的以三维立体摄影技术为基础的头位摆正方法.%With the growing importance of esthetic considerations, soft-tissue evaluation plays a crucial role in maxillofacial treatment, including the establishment of normative anthropometric database, treatment planning, and postoperative evaluation. In therapy, three-dimensional (3D) photography techniques with high reproducibility, such as cone beam computed tomography (CBCT), 3D stereo-photography, and laser scanning technology, can facilitate the comprehensive oral and maxillofacial assessment different from direct and 2D measurements. 3D photography is faster, more precise, more automatic and less harmful than the traditional methods. A universal standard for 3D-maxillofacial morphology has not been established, thus limiting the clinical applications of 3D stereo-photography. Natural head position is the most direct reference to maxillofacial assessment. However, the lack of a standardized method of correcting natural head position is the main factor that limits the use of 3D stereo-photography. Therefore, a versatile method for correcting accurate and reliable head position is needed. In this paper, several methods for recording and correcting the natural head position based on 3D stereo-photography were discussed. The difference between the correction procedure based on 3D stereo-photography and CBCT were compared, and the optimal approach for correcting natural head position in 3D scale was determined.
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