口腔医学研究 ›› 2017, Vol. 33 ›› Issue (10): 1118-1122.DOI: 10.13701/j.cnki.kqyxyj.2017.10.025

• 临床研究论著 • 上一篇    下一篇

青少年Ⅱ类骨面型非拔牙矫治后上气道结构变化的三维研究

杨彩霞1*,李骋2   

  1. 1 .青海省人民医院口腔正畸科 青海 西宁 810007;
    2. 四川大学华西口腔医院 四川 成都 610041
  • 收稿日期:2017-03-21 出版日期:2017-10-20 发布日期:2017-10-24
  • 通讯作者: 杨彩霞,电话:0971-8066222
  • 作者简介:杨彩霞(1977~ ),女,甘肃省人,主治医师,硕士,主要从事口腔正畸的临床治疗工作。
  • 基金资助:
    中华口腔医学会西部行口腔医学临床科研基金项目(编号:CSA-W2015-12)

Three-dimensional Alterations of Pharyngeal Airway in Skeletal Class Ⅱ Adolescents Undergoing Nonextraction Treatment

YANG Cai-xia1*, LI Cheng2   

  1. 1. Department of Orthodontics, Qinghai Province People's Hospital, Xining 810007, China;
    2. West China School of Stomatology, Sichuan University, Chengdu 610041, China.
  • Received:2017-03-21 Online:2017-10-20 Published:2017-10-24

摘要: 目的:探讨骨性安氏Ⅱ类错牙合青少年患者非拔牙固定矫治后上气道的三维变化。方法:对15例Ⅱ类骨面型采用非拔牙矫治的青少年患者,均在矫治前后拍摄头颅侧位片及锥形束CT, 应用Dolphin 11.5 软件进行三维测量分析,分析此类患者治疗前后的头影测量值及上气道的三维改变。结果:Ⅱ类骨面型非拔牙矫治后,除下切牙较唇倾外U1-L1(P<0.05 ),颅颌骨其他相关测量项目的变化均无统计学意义;上气道矢状径骨性鼻咽宽度增加PNS-UPW(P<0.05 ),上气道的总截面积,口咽段最小截面积,鼻咽、腭咽、舌咽截面积测量项目的变化均无统计学意义;上气道的总体积、腭咽、舌咽则均显著增大(P<0.05)、即上气道鼻咽部轴面变窄,而腭咽、舌咽部由扁平变为椭圆 。治疗前后的锥形束CT重叠显示:非拔牙矫治后患者的颏部发生了向前生长,而上气道整体发生了向后生长。结论:非拔牙矫治后患者仍按原有骨面型生长,颏部发生了明显向前生长,改善了患者的面型;能使上气道增大,一定程度改善呼吸功能;上气道的生长方向为整体向后生长。

关键词: 锥形束CT(CBCT), 上气道, Ⅱ类骨面型, 非拔牙矫治

Abstract: Objective: To analyze alterations of upper-airway morphology after nonextraction treatment of skeletal class Ⅱ malocclusion adolescent patients. Methods: Fifteen adolescent cases of skeletal class Ⅱ malocclusion receiving nonextraction treatment were selected, who were taken cephalometric radiograph and cone beam computed tomograph before and after orthodontic treatment. Then, Dolphin 11.5 was used to take 3D measurements. The alternations of upper-airway and cephalometric values were analyzed. Results: After the nonextraction treatments, the changes of other measure projects of cranio-maxillofacial were not significant different, except labial inclination of lower incisors (P<0.05). The width of upper-airway sagittal osseous nasopharynx increased (P<0.05), and the change values of total cross area of upper-airway, smallest cross area of oropharynx, and cross area of nasopharynx, palatopharynx and glossopharyngeal were not significant. The volumes of upper-airway, palatal pharyngeal and the glossopharyngeal significantly increased (P<0.05). Before and after treatment, the overlaps of Cone beam CT indicated that after the nonextraction treatments, the patients' chin had grown forward, while the whole upper-airway had grown backward. Conclusion: For the nonextraction treated adolescent skeletal class Ⅱ patients, craniofacial patterns keep the pre-treatment growth modality, significant forward growths of chins arise, and the patients' faces improve significantly. The therapy would enlarge the upper-airway, improve respiratory function to a certain extent, and the upper-airway grows entirely backward.

Key words: Cone beam computed tomography , Upper-airway, The skeletal class Ⅱ, Nonextraction therapy

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