安氏Ⅰ类双颌前突成年患者前牙内收后上气道三维形态及流体力学的变化  

Effect of incisor retraction on three-dimensional morphology of upper airway and fluid dynamics in adult class Ⅰ patients with bimaxillary protrusion

作　　者：孙福财[1] 杨婉祯 麻益可[1] Sun Fucai;Yang Wanzhen;Ma Yike(Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou Zhejiang 325000, Chin)

机构地区：[1]温州医科大学附属第一医院口腔科,浙江325000

出　　处：《中华口腔医学杂志》2018年第6期398-403,共6页Chinese Journal of Stomatology

摘　　要：目的研究安氏Ⅰ类双颌前突成年患者前牙内收后上气道三维形态及流体力学变化，探讨强支抗内收前牙对双颌前突患者上气道形态及通气功能的影响。方法根据随机数字表法随机选取2011年1月至2014年9月就诊于温州医科大学附属第一医院口腔科并行全口固定矫治的安氏Ⅰ类双颌前突成年患者30例。所有患者均减数4颗第一前磨牙后利用种植体支抗内收上下颌前牙，前牙内收前后行锥形束CT扫描，使用Mimics16.0软件对患者上气道锥形束CT数据进行三维重建，并使用Ansys14.0软件对上气道的气流流场特征进行数值模拟。采用配对t检验比较前牙内收前后上气道鼻咽段、口咽段及喉咽段的体积、平均横截面积、横截面最大左右径与最大前后径比值（LP/AP）以及气流最高压（Pmax）、最低压（Pmin）及气流压降（△P）的变化，并对前牙内收前后气道内△P变化最显著部分的压降变化量[△（△P）]与上气道形态指标的变化量进行Pearson相关性检验。结果患者鼻咽段三维形态及气流流场特征指标的前牙内收前后差异均无统计学意义（P〉0.05）。前牙内收后患者上气道口咽段及喉咽段体积[分别为（6885±601）及（2535±156）mm3]和平均横截面积[分别为（197±37）及（236±42）mm2]均较前牙内收前[口咽段及喉咽段体积分别为（7580±622）及（2564±162）mm3，平均横截面积分别为（217±40）及（239±43）mm2]显著减小（P〈0.05），其中口咽段体积及平均横截面积的变化最明显，且前牙内收后口咽段LP/AP由前牙内收前的1.9±0.6显著增大为2.1±0.7（P〈0.05）。前牙内收后患者上气道口咽段Pmin、喉咽段Pmax及Pmin[分别为（-16.4±6.5）、（-11.9±3.6）及（-46.0±11.0）Pa]均较前牙内收前[分别为（-13.7±4.3）、（-8.3±3.8）及（-42.8±9.5）Pa]显著减小（P〈0.05），口咽段△P由前牙内收前的（42.7±10.1）Pa显ObjectiveTo investigate the effect of incisor retraction on three-dimensional morphology of upper airway and fluid dynamics in class Ⅰ adult patients with bimaxillary protrusion.MethodsThirty class Ⅰ patients with bimaxillary protrusion that received fixed orthodontic treatment in Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University from January 2011 to September 2014 were selected using random number table. All the patients were treated with extraction of four first premolars and retraction of anterior teeth using implant anchorage. Cone-beam CT （CBCT） scans were performed before and after incisor retraction for all patients. The CBCT data of the upper airway were constructed using Mimics 16.0, and the flow field characteristics inside the upper airway were simulated using Ansys 14.0. The changes of volume （V）, mean cross-sectional area （mCSA）, maximum lateral diameters/maximum anteroposterior diameters （LP/AP） of cross section, the maximum pressure of airflow （Pmax）, the minimum pressure of airflow （Pmin） and pressure drop （△P） of nasopharynx, oropharynx and hypopharynx before and after incisor retraction were measured and compared using paired t test. The correlation between the variation of △P in the most significant pharyngeal part and the morphological variables after incisor retraction was analyzed using Pearson correlation test.Results No statistical differences were observed in the morphology and flow field in nasopharynx before and after incisor retraction （P〉0.05）. Before incisor retraction, the oropharyngeal volume and mCSA were （7 580±622） mm3 and （217±40） mm2, respectively, and the hypopharyngeal volume and mCSA were （2 564±162） mm3, and （239±43） mm2, respectively. After incisor retraction, the volumes of oropharynx and hypopharynx were （6 885±601） mm3 and （2 535±156） mm3, respectively, and mCSA of oropharynx and hypopharynx were （197±37） mm2 and （236±42） mm2, respectively. The volume

关 键 词：错(he) 安氏Ⅰ类 牙正畸牵引 流体力学 口咽 

分 类 号：R783.5[医药卫生—口腔医学]