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目的 通过口内扫描技术初步探索并建立一种评价软组织改变的方法,评估牙周组织再生结合骨皮质切开术对骨性Ⅲ类错(牙合)骨嵴顶冠方牙龈厚度的影响.方法 纳入2018年1月至2019年3月于北京大学口腔医学院·口腔医院正畸科和口腔颌面外科转诊至牙周科、全身和牙周健康、需行正畸-正颌联合治疗的骨性Ⅲ类错(牙合)畸形患者22例,其中男性4例,女性18例,年龄(24.0±4.5)岁(19～35岁);观测前牙共1 12颗,其中上颌前牙46颗,下颌前牙66颗.在前牙去代偿正畸移动前行牙周组织再生结合骨皮质切开术,观察探诊深度、出血指数、角化龈宽度,比较术前及术后6个月的差异.术前与术后6个月通过口内扫描技术直接获取患者上下颌前牙区数字化模型,在分析软件中构建软组织形态测量模型,并定量分析牙冠正中测量矢状面上龈缘根方1和2 mm处牙龈厚度的变化.结果 22例患者手术前后探诊深度、出血指数差异均无统计学意义(P＞0.05);术后6个月角化龈宽度从术前的(4.22±1.43) mm显著增加至(5.18±2.32) mm(P＜0.05).术后6个月上颌、下颌前牙龈缘根方1和2 mm处牙龈厚度与术前相比均显著增加(P＜0.05);其中上颌前牙龈缘根方1和2 mm处牙龈厚度增加量分别为(0.68±0.56)和(1.00±0.69) mm;下颌前牙龈缘根方1和2mm处牙龈厚度增加量分别为(0.38±0.42)和(0.58±0.45) mm;且上颌牙龈厚度增加量均显著大于下颌(P＜0.01).结论 基于口内扫描技术进行软组织形态变化的定量评价方法切实可行.在骨性Ⅲ类错(牙合)正畸-正颌联合治疗中牙周组织再生结合骨皮质切开术不但能增加角化龈宽度,而且可增加骨嵴顶冠方牙龈组织厚度.“,”Objective To establish a quantitative three-dimensional method based on intraoral scan to evaluate the changes of soft tissue,and to evaluate the changes of supracrestal gingival thickness (SGT) in skeletal class Ⅲ patients induced by periodontal regenerative and corticotomy surgery (PRCS).Methods Twenty-two systematically and periodontally healthy skeletal class Ⅲ patients (4 males and 18 females,aged between 19 and 35 years),who were in need of combined orthodontic-orthognathic treatment and referred to the Department of Periodontology from the Department of Orthodontics and the Department of Oral and Maxillofacial Surgery,Peking University School and Hospital of Stomatology from January,2018 to March,2019,were collected in the study.The teeth involved were 112 anterior teeth (46 maxillary anterior teeth and 66 mandibular anterior teeth).PRCS in anterior tooth area was conducted before orthodontic decompensation.Probing depth (PD),bleeding index (BI) and keratinized gingiva width (KGW) were recorded before surgery and 6 months post-surgery.The intraoral digital impressions of maxillary and mandibular anterior teeth were obtained by 3-shape intraoral scanner before surgery and 6 months after surgery.The Standard Tessellation Language (STL) files were processed using Geomagic qualify 12.2 software to establish the soft tissue morphological measurement model,and to quantitatively analyze the changes of gingival thickness situated 1 to 2 mm apical to the free gingival margin on the median sagittal measurement plane.Results Probing depth and bleeding index had no significant difference before and 6 months after operation (P＞0.05).KGW in 6-month post-operation group [(5.18 ± 2.32) mm] was significantly higher than that in pre-operation group [(4.22± 1.43) mm] (P＜0.05).Supracrestal gingival thickness situated 1 to 2 mm apical to the free gingival margin also significantly increased 6 months after surgery (P＜0.05).The changes of gingival thickness situated 1 to 2 mm apical to the free gingival margin in the upper anterior area were (0.68 ± 0.56) and (1.00 ± 0.69) mm,respectively.The changes in the lower anterior area were (0.38±0.42) and (0.58±0.45) mm,respectively.The gingival changes of the upper anterior teeth were also significantly higher than those of the lower anterior teeth (P＜0.01).Conclusions The described quantitative measurement based on intraoral scan could be an effective method for quantitative evaluation of the changes of soft tissue.PRCS could safely increase the supracrestal gingival thickness as well as KGW in skeletal class Ⅲ patients who were in need of combined orthodontic-orthognathic treatment.