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作 者:王宏伟[1] 齐素青[1] 王建国[2] 蔡智芳[2] 李创[3]
机构地区:[1]邢台市眼科医院正畸科,邢台054001 [2]天津市口腔医院正畸科,天津300041 [3]石家庄市第二医院口腔科,石家庄050051
出 处:《华西口腔医学杂志》2012年第6期650-654,共5页West China Journal of Stomatology
摘 要:目的研究正畸—正颌联合治疗骨性Ⅲ类错畸形对舌骨、舌体位置和咽腔间隙的影响,分析下颌后退与舌骨、舌体位置改变和咽腔间隙缩窄之间的相关性。方法选取经正畸—正颌联合治疗的患者20例为研究对象,于正颌手术前1周及术后6个月拍摄锥形束CT,三维重建颅颌面、气道及舌骨的立体模型,建立以蝶鞍中心(S)点为原点的三维坐标系。测量治疗前后咽腔各段最窄处的矢状径、冠状径、截面积,各段容积和咽腔总容积,同时测量颏前点、舌骨点、舌根点的三维位置,分析颏前点的变化与咽腔间隙及舌骨、舌体位置变化的相关性。结果治疗后,咽腔间隙呈现整体缩窄趋势。舌骨发生了后下移位,其中向后、向下平均移动距离分别为5.72、2.76 mm(P<0.05);舌根点向后平均移动了4.04 mm(P<0.01)。19项相关性比较中,有统计学意义的项目有14项,其中下颌后退量与咽腔总容积改变的相关性最强(r=0.834,P<0.01)。结论正畸—正颌联合治疗骨性Ⅲ类错畸形可造成咽腔缩窄,舌骨后下移位,舌体向后移位;下颌后退量与咽腔间隙缩窄、舌骨和舌体位置的改变具有较强的相关性。Objective To observe changes in tongue and hyoid position, and pharyngeal airway in patients with skeletal class Ⅲ malocclusion after the combined orthodontic and orthoguathic treatment. Methods Twenty patients were involved in this study. Cone beam CT (CBCT) was performed on patients one week before and six months after treatment. Raw data were reconstructed into three-dimensional model. To set up a three-dimensional reference frame, which was based by point "S', the sagittal and transversal measurements, cross sectional areas, partial and total vo- lumes were computed. The three-dimensional position changes of chin, hyoid bone and tongue were measured in order to analyze the amount of mandibular setback relationship with the changes of pharyngeal airway, hyoid bone and tongue positions. Results After treatment, the pharyngeal airway was constricted siguificantly. The hyoid significantly moved inferoposteriorly by 5.72 mm (backward) and 2.76 mm (downward) and the tongue moved posteriorly by 4.04 mm after surgery 6~〈0.05). Among the 19 correlated indexes between the amount of mandibular setback and other 14 of which were significantly correlated(P〈0.05). The strongest correlation was found between the amount of mandi- bular setback and total volumes of pharyngeal airway6=0.834, P〈0.01). Conclusion Following combination therapy, the pharyngeal airway space decreased, the hyoid moved inferoposteriorly and tongue moved posteriorly. There were great correlations between the amount of mandibular setback and the changes.
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