前方牵引联合快速扩弓对安氏Ⅲ类错牙合畸形患者上气道影响的CBCT研究

doi:10.6040/j.issn.1671-7554.0.2014.636

摘要/Abstract

摘要： 目的研究生长发育期骨性安氏Ⅲ类错牙合患者经前方牵引联合快速扩弓(PE)治疗后其上气道形态的改变.方法收集30例8~11岁经PE治疗后的骨性安氏Ⅲ类错牙合畸形患者治疗前(T1)和治疗后(T2)的锥体束计算机断层扫描(CBCT)数据,将T1、T2数据进行三维重建、配准,测量上气道形态的改变.采用t检验分析统计学差异.结果经PE治疗后上牙槽座点和上中切牙切缘最前点向前上方移动,而颏顶点向后下方移动.治疗前后舌骨的位移、上颌骨的牙弓宽度和长度、上气道鼻咽部和口咽部的体积和平均横截面积差异均有统计学意义,而喉咽部体积差异则无统计学意义.口咽部气道最大前后径与最大左右径的比值增大,而喉咽部比值减小.结论骨性安氏Ⅲ类错牙合伴上颌骨发育不足的患者经PE治疗后,其鼻咽和口咽部气道尺寸变大,而喉咽部无明显变化.口咽部气道形态变得较为圆缓,而喉咽部变得较为椭圆.

关键词: 气道, 前方牵引, 三维重建, 快速扩弓, 安氏Ⅲ类错牙合, 锥体束计算机断层扫描

Abstract: Objective To evaluate the effects of protraction headgear with rapid maxillary expansion (PE) on the upper airway morphological dimensions in growing patients with skeletal Class III malocclusion. Methods The pre-treatment (T1) and post-treatment (T2) cone beam computed tomography (CBCT) data of 30 patients aged 8 to 11 years who had completed PE therapy were collected. After the data were reconstructed and registered, the morphological changes of the upper airway were measured. The t-test was used to assess the statistical differences. Results After the PE treatment, the subspinale (A) of maxillary and upper incisor (UI) moved in the anterosuperior direction. The gnathion (Gn) of mandible moved in the posterior-inferior direction. The placement of the hyoid bone, length and width of dentalarch, volume and mean cross-sectional area of nasopharynx and oropharynx region had significant differences, while the hypopharynx showed no remarkable change. The ratio of the largest anteroposterior/lateral diameter of the oropharynx increased, while that of the hypopharynx decreased. Conclusion The PE treatment of Class Ⅲ malocclusion with maxillary skeletal deficiency produces a significant enlargement in the nasopharynx and oropharynx, but the hypopharynx shows no significant changes. The oropharynx is found to be more circular and the hypopharynx becomes more elliptic in transverse shape.

Key words: Rapid palatal expansion, 3-dimensional virtual model reconstruction, Airway, Protraction headgear, Angle Class III, Cone beam computed tomography

中图分类号:

R783.5

陈雪凌, 吴子忠, 刘东旭, 谢涌涛, 郭甜甜, 张士杰. 前方牵引联合快速扩弓对安氏Ⅲ类错牙合畸形患者上气道影响的CBCT研究[J]. 山东大学学报（医学版）, 2015, 53(8): 71-78.

CHEN Xueling, WU Zizhong, LIU Dongxu, XIE Yongtao, GUO Tiantian, ZHANG Shijie. CBCT evaluation of the upper airway morphological changes in skeletal Class Ⅲ malocclusion patients using protraction and rapid maxillary expansion appliance[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(8): 71-78.

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