替牙列期儿童错颌畸形颅-颌骨及牙弓的测量分析  

Measurement of the craniofacial bone and dental arch between different malocclusions in the mixed dentition

作　　者：贺泽群 曾欢 唐欢 林居红[1] 罗俊[1] He Zequn;Zeng Huan;Tang Huan;Lin Juhong;Luo Jun(Stomatological Hospital of Chongqing Medical University,Chongqing Key Laboratory of Oral Diseases and Biomedical Science;Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Educatio)

机构地区：[1]重庆医科大学附属口腔医院口腔疾病与生物医学重庆市重点实验室重庆市高校市级口腔生物医学工程重点实验室,重庆400015

出　　处：《重庆医科大学学报》2018年第10期1354-1359,共6页Journal of Chongqing Medical University

基　　金：重庆市卫计委科研资助项目(编号:2016MSXM045)

摘　　要：目的:探索替牙列期儿童不同矢状向骨性错颌畸形患儿颅-颌骨及牙弓在三维方向的特征性差异。方法:选取我院儿童口腔科180名8～12岁替牙列期初诊儿童,分为骨性Ⅰ类组(60例),骨性Ⅱ类组(60例),骨性Ⅲ类组(60例)3组。对组间头颅侧位X线片及3D扫描模型测量数据进行比较分析。结果:骨性Ⅱ类错颌较骨性Ⅰ类的SNB角(74.60±3.13 vs. 77.33±3.74,P=0.00)、下颌长(Cond-Pog)(90.20±4.72 vs. 92.90±5.44,P=0.00)明显减小,SNA角(81.42±3.13 vs. 79.77±5.39,P=0.03)、Y轴角(67.45±3.99 vs. 64.72±6.82,P=0.00)及下前牙唇倾度(IMand-ML)(96.93±5.48 vs. 93.13±6.53,P=0.00)明显增大,骨性Ⅱ类较骨性Ⅲ类上牙弓后段宽度(upper posterior maxillary width,UPMW)减小(31.17±2.33 vs. 32.36±5.19,P=0.07)。骨性Ⅲ类较骨性Ⅰ类的SNA角(76.00±4.21 vs. 79.77±5.39,P=0.00)、上颌长(ANS-PNS)(38.53±3.63 vs. 42.60±2.90,P=0.00)、上牙弓长(upper total arch length,UTAL)(24.37±2.68 vs. 25.68±2.24,P=0.00)、前颅底长度(N-S)(57.12±3.05 vs. 58.67±3.10,P=0.01)、前面高(N-Me)(99.70±4.91 vs. 101.77±5.78,P=0.03)、Y轴角(62.50±4.22 vs. 64.72±6.82,P=0.02)及IMand-ML(85.17±6.81vs. 93.13±6.53,P=0.00)明显减小,骨性Ⅲ类错颌下颌骨位置(S-Co)前移(13.92±2.57 vs. 15.15±2.79,P=0.01)。结论:替牙列期不同矢状向错颌畸形颅-颌骨及牙弓形态存在特征性差异。骨性Ⅱ类错颌畸形主要表现为较短的下颌长,下前牙较唇倾,上颌牙弓后段有缩窄趋势;骨性Ⅲ类错颌畸形主要表现为较短的上颌长、前颅底长和面高,下颌位置前移,下前牙舌倾,上牙弓长度减小。研究结果为早期识别并矫正儿童错颌畸形骨性及牙性发育异常提供参考依据。Objective：To explore the three-dimensional differences in the morphological features of the craniofacial bone and dental arch between children with different sagittal skeletal malocclusions in the mixed dentition. Methods：This study included 180 children（aged 8-12 years） in the mixed dentition who consulted with the doctor for the first time in the Department of Pediatric Dentistry,Stomatological Hospital of Chongqing Medical University,and they were assigned to three groups：skeletal class Ⅰ malocclusion group （60 cases）,skeletal class Ⅱ malocclusion group（60 cases）,and skeletal class Ⅲ malocclusion group（60 cases）. Lateral cephalometric radiograph and the measurement data of 3D scanning model were compared between these groups. Results：Compared with the skele-tal class Ⅰ malocclusion group,the skeletal class Ⅱ malocclusion group showed significant reductions in SNB angle（74.60±3.13 vs. 77.33±3.74,P=0.00） and mandibular length（Cond-Pog）（90.20±4.72 vs. 92.90±5.44,P=0.00） and significant increases in SNA angle（81.42±3.13 vs. 79.77±5.39,P=0.03）,Y-axis angle （67.45±3.99 vs. 64.72±6.82,P=0.00）,and inclination of the lower anterior teeth（IMand-ML）（96.93±5.48 vs. 93.13±6.53,P=0.00）. The skeletal class Ⅱ malocclusion group had a smaller upper posterior maxillary width（UPMW） than the skeletal class Ⅲ malocclu-sion group（31.17±2.33 vs. 32.36±5.19,P=0.07）. Compared with the skeletal class Ⅰ malocclusion group,the skeletal class Ⅲ malocclusion group showed significant reductions in SNA angle（76.00±4.21 vs. 79.77±5.39,P=0.00）,maxillary length（ANS-PNS）（38.53±3.63 vs. 42.60±2.90,P=0.00）,upper total arch length（UTAL）（24.37±2.68 vs. 25.68±2.24,P=0.00）,anterior cranial base length（N-S）（57.12±3.05 vs. 58.67±3.10,P=0.01）,facial height（N-Me）（99.70±4.91 vs. 101.77±5.78,P=0.03）,Y-axis angle（62.50±4.22 vs. 64.72±6.82,P=0.02）,and IMand-ML（85.17±6.81 vs. 93.13±6.53,P=0.00）,and had a forward ma

关 键 词：骨性错颌畸形 替牙列期 早期矫治 三维方向 

分 类 号：R783.5[医药卫生—口腔医学]