正畸大幅度内收切牙对年轻成年错畸形患者上气道大小的影响  

Effects of large retraction of incisors due to orthodontic treatment on the upper airway dimensions in young adult patients with malocclusion

作　　者：徐科峰[1] 陈威[1] 刘月华[1] 

机构地区：[1]上海同济大学口腔医学院,上海200072

出　　处：《临床口腔医学杂志》2010年第10期600-603,共4页Journal of Clinical Stomatology

摘　　要：目的:研究强支抗结合拔牙矫治而产生的大幅度切牙后移对年轻成年错畸形患者上气道大小的影响,探讨牙齿位置及颌面形态变化与上气道大小之间的相关性。方法:随机选择31例拔除4个第一前磨牙并使用强支抗(种植支抗或口外弓加TPA)和21例非拔牙的错畸形矫治完成病例,测量矫治前后的X线头颅定位侧位片,将测量数据进行配对t检验,单因素相关分析及多因素回归分析。结果:非拔牙组患者矫治前后牙颌面及上气道测量参数均无显著性变化(P>0.05)。强支抗拔牙组患者矫治前后,上下切牙明显后移(U1-Y、L1-Y,P<0.01),而上下磨牙无明显前移(U6-Y、L6-Y,P>0.05);软腭后气道间隙(SPAS,P<0.01)、软腭尖后气道间隙(MAS,P<0.05)及舌根后气道间隙(IAS,P<0.01)均显著减小。单因素相关分析结果显示,SPAS及IAS改变量与L1-Y距改变量呈正相关(P<0.05),MAS改变量与U1-Y距改变量呈正相关(P<0.05)。多因素回归分析结果显示,SPAS改变量与L1-Y及SNA改变量呈正相关(P<0.05);MAS改变量与U1-Y及SNB改变量呈正相关(P<0.05);IAS改变量与U1-Y及L1-Y改变量呈正相关(P<0.05)。结论:因拔牙矫治结合强支抗而产生的大幅度切牙后移会引起上气道各水平前后径减小,切牙前后向位置的明显改变与上气道大小改变相关。Objective：To investigate the effects of large retraction of incisors due to extraction orthodontic treatment with strong anchorage on the upper airway dimensions in young adult patients with malocclusion,and to evaluate the relationship between changes in the craniofacial morphology,position of incisor and upper airway dimensions.Method：31 patients with upper and lower first premolar extractions in extraction group with strong anchorage（Implant Anchorage or extraoral bow with TPA） and 21 patients without extraction were recruited.Cephalometry analysis was performed at pretreatment and posttreatment.Result：No statistical difference was found in the dentofacial and upper airway measurement parameters in non-extraction group at pretreatment and posttreatment（P 0.05）.In extraction group with strong anchorage at pretreatment and posttreatment,the upper and lower incisors significantly retruded（U1-Y distance and L1-Y distance P 0.01）;while the upper and lower anchorage molar had no significant antedisplacement（P 0.05）;and upper airway size parameters diminished significantly（SPAS and IAS P 0.01,MAS P 0.05）.In linear correlation analysis,the change of SPAS and IAS was positively correlated with the change of L1-Y distance（P 0.05）;and the change of MAS and was positively correlated with the change of U1-Y distance.The multiple regression analysis revealed that the change of SPAS was positively correlated with the change of L1-Y distance and SNA angle（P 0.05）;and the change of MAS and was positively correlated with the change of U1-Y distance and SNB angle（P 0.05）;and the change of IAS was positively correlated with the change of U1-Y and L1-Y distance（P 0.05）.Conclusion：Large retraction of incisors due to extraction orthodontic treatment with strong anchorage will diminish the anteroposterior dimension of the upper airway,and the obviously change of the anteroposterior position of incisors were correlated with the change of the upper airway dimensions.

关 键 词：切牙内收 拔牙矫治 上气道 头影测量 强支抗 

分 类 号：R783.5[医药卫生—口腔医学]