骨性Ⅱ类高角成人患者强支抗内收前牙后上气道变化的研究  

Changes of upper airway dimensions in skeletal class Ⅱ hyperdivergent patients after orthodontic retraction

作　　者：邓金荣[1] 赵健慧[1] 王秀婧[1] 丁云[1] 

机构地区：[1]北京大学口腔医院第三门诊部,北京100191

出　　处：《中华口腔正畸学杂志》2015年第4期197-201,共5页Chinese Journal of Orthodontics

摘　　要：目的 评价骨性Ⅱ类高角成人患者强支抗内收上下前牙后上气道的改变.方法 本研究回顾性地选取了22例成人Ⅱ类高角无鼾患者进行研究,治疗方法为减数上颌第一前磨牙和下颌第二前磨牙,支抗类型为上颌强支抗下颌弱支抗.分别获取治疗前后的头颅侧位片进行颅颌面各项指标和气道相关指标的测量、分析.使用SPSS软件对治疗前后的各项指标进行配对t检验分析.结果 经过拔牙矫治,患者的上颌切牙得到大幅度内收,下颌前牙唇倾度减小.上下唇组织也内收明显,治疗前后变化具有统计学意义（P＜0.05）.上颌后牙未见明显前移,而下颌后牙前移明显（P＜0.05）.治疗前后下颌平面角未见明显增加.上气道鼻咽和喉咽部分的宽度和整个上气道的高度未见显著性变化（P＞0.05）,而腭咽和舌咽的气道宽度在牙齿大幅度内收后出现变窄的现象,且差异具有统计学意义（P＜0.05）.舌骨的矢状向和垂直向位置在治疗前后均未见明显变化（P＞0.05）.结论 Ⅱ类高角患者在上颌前牙大幅度内收后腭咽和舌咽部分的气道宽度有明显变窄,而鼻咽和喉咽部分以及舌骨的位置在治疗前后未出现明显改变.Objective To evaluate the changes of upper airway dimensions in skeletal class Ⅱ hyperdivergent patients after orthodontic retraction.Methods 22 skeletal class Ⅱ hyperdivergent patients were assembled.All the patients were treated by extraction, and the extraction pattern was upper first premolar and lower second premolar combined with upper maximum anchorage and lower minimum anchorage.The pre and post treatment cephalograms were analyzed and measured for craniofacial measurements and upper airway dimensions.Paired t-test was adopted using SPSS software.Results Upper incisors were retracted markedly after extraction, the proclination of lower incisors were also decreased.Lip protrusion was improved significantly （P〈0.05）.Upper molars were almost motionless due to maximum anchorage, with apparent advancement of lower molars.Mandibular plane angle was kept well after treatment.The differences of nasopharynx and laryngopharynx width, upper airway height were not found （P〉0.05）, but palatopharyngeal and glossopharyngeal width were narrowed after treatment （P〈 0.05）.Conclusions Patients with skeletal Class Ⅱ and hyperdivergent malocclusion will have a narrower palatopharyngeal and glossopharyngeal after treatment.The width of nasopharynx and laryngopharynx, height of upper airway and position of hyoid were found to have no significant difference after treatment.

关 键 词：成人 Ⅱ类高角 拔牙矫治 上气道变化 

分 类 号：R783.5[医药卫生—口腔医学]