运用CBCT评估MRC矫治器对替牙期口呼吸儿童上气道口咽段和舌骨位置的影响  

The changes of the upper airway and hyoid position following the treatment of MRC appliance in the mixed dentition with mouth breathing via cone beam computed tomography

作　　者：蒋昕怡 高轶昳 陈建军 唐卫忠 JIANG Xinyi;GAO Yiyi;CHEN Jianjun;TANG Weizhong(Department of Stomatology,Changhai Hospital,the Secondary Military Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学附属长海医院口腔科,上海200433 [2]上海市宝山区仁和医院口腔科,上海200431 [3]上海市中医药大学附属第七人民医院耳鼻喉科,上海200137 [4]海军特色医学中心口腔科,上海200000

出　　处：《口腔医学》2021年第6期532-536,共5页Stomatology

基　　金：上海市卫生和计划生育委员会科研课题青年项目(20184Y0117);上海市宝山区科学技术委员会科技创新专项资金项目(18-E-16);上海市宝山区青年医学人才基金(bswsyq-2016-A07)。

摘　　要：目的运用锥形束计算机断层扫描(cone beam computed tomography, CBCT)和Dolphin软件评估Myofunctional Research Center(MRC)肌功能矫治器治疗替牙期错(牙合)畸形伴口呼吸儿童后,上气道和舌骨位置的变化,为临床应用MRC肌功能矫治器提供参考依据。方法纳入20例替牙期错(牙合)畸形且伴有口呼吸的儿童,男11例,女9例,平均年龄(8.70±0.92)岁。所有患儿均接受MRC肌功能矫治器治疗12个月,治疗前后运用CBCT和Dolphin软件分析和评估MRC矫治器对上气道口咽段和舌骨位置的影响。结果处于生长发育期的儿童经过MRC肌功能矫治器矫治12个月后,上气道口咽段气道表面积显著增大(增加(63.28±16.99)mm2,P<0.001),最小横截面积显著增加(增加(69.67±26.70)mm2,P<0.001),容积显著增大(增大(2 896.44±688.86)mm3,P<0.001);舌骨位置显著向前向下移动(相对于第三颈椎前上缘移动(5.62±0.88)mm,P<0.001;相对于第三颈椎前下缘移动(3.43±0.92)mm,P<0.001)。结论 MRC肌功能矫治器引导替牙期口呼吸儿童下颌向前,辅助肌功能训练,治疗12个月后上气道口咽段和舌骨位置的解剖结构改善,有助于破除口呼吸习惯,有利于解除影响颅颌面与上气道的正常生长的不利因素。Objective To evaluate the changes of the upper airway and hyoid position before and after the MRC muscle functional appliance in the treatment of children with malocclusion in the mixed dentition with mouth breathing by cone beam computed tomography(CBCT) and Dolphin software, in order to provide reference for clinical application of MRC muscle functional appliances. Methods Twenty children with malocclusion and accompanied by mouth breathing in the mixed dentition were included. There were 11 males and 9 females with an average age of(8.70±0.92) years. All the children were treated with MRC muscle appliance for 12 months. CBCT and Dolphin software were used to analyze and evaluate the effect of MRC appliance on the upper oropharyngeal airway and hyoid position. Results After 12 months of orthodontic treatment with MRC muscle appliance, the surface area of upper oropharyngeal airway was significantly increased(increased by(63.28±16.99) mm2, P<0.001), and the minimum axial area of oropharyngeal airway increased significantly(increased by(69.67±26.70) mm2, P<0.001). The total volume of oropharyngeal airway increased significantly(increased by(2 896.44±688.86) mm3, P<0.001). The hyoid position moved significantly forward and downward((5.62±0.88) mm to the third anterior superior cervical margin, P<0.001;(3.43±0.92) mm to the third anterior lower cervical margin). Conclusion MRC muscle functional appliance has a good effect on the anatomical structure of oropharyngeal airway and hyoid position of children in mixed dentition with malocclusion and accompanied by mouth breathing, which is conducive to giving up the habit of mouth breathing and relieve adverse factors affecting the normal growth of cranial-maxillofacial and upper airway.

关 键 词：替牙期儿童 口呼吸 MRC肌功能矫治器 锥形束电子计算机断层扫描 

分 类 号：R783.5[医药卫生—口腔医学]