上颌扩弓联合双[牙合]垫矫治器治疗对牙颌畸形口呼吸儿童上气道的影响  

Effect of maxillary expansion combined with Twin-block on upper airway of children with mouth breathing and dentomaxillofacial malformation

作　　者：郭靖晗 於丽明 李远远 刘月华[1] GUO Jing-han;YU Li-ming;LI Yuan-yuan;LIU Yue-hua(Department of Orthodontics,Shanghai Stomatological Hospital,Fudan University,Oral Biomedical Engineering Laboratory,Shanghai Stomatological Hospital,Fudan University.Shanghai 200001,China)

机构地区：[1]上海市口腔医院,复旦大学附属口腔医院口腔正畸科,口腔生物医学工程实验室,上海200001

出　　处：《上海口腔医学》2021年第6期634-638,共5页Shanghai Journal of Stomatology

基　　金：上海市卫健委先进适宜技术推广项目(2019SY041);上海市卫健委项目(GWV-10.2-YQ16);上海申康医院发展中心促进市级医院临床技能与临床创新三年行动计划(SHDC2020CR2043B)。

摘　　要：目的:研究牙颌畸形的口呼吸患儿行上颌扩弓联合双[牙合]垫矫治器(Twin-block,TB)矫治后上气道的变化。方法:选取12例口呼吸牙颌畸形患儿行上颌扩弓和TB矫治,拍摄治疗前、后的锥形束CT(CBCT),使用Dolphin 11.8软件对上气道进行测量。采用SPSS 21.0软件包对治疗前、后数据进行配对样本t检验。结果:患儿上气道各测量数据在联合治疗后总体呈增长趋势,上气道总体积增加3326.44 mm^(3)(P<0.05)。其中,舌咽部体积增加最多,平均增加1146.20 mm^(3)(P<0.05)。口咽部最窄横截面积及鼻咽部、腭咽部、舌咽部横截面积分别扩大33.55 mm^(2)(P>0.05)、71.68 mm^(2)(P<0.05)、46.23 mm^(2)(P<0.05)和54.60 mm^(2)(P<0.05)。鼻咽部、腭咽部、舌咽部横径(P>0.05)及矢状径(P<0.05)均增加,矢状径与横径之比亦显著增大(P<0.05)。治疗后仅口咽部最窄横截面积及鼻咽部、腭咽部、舌咽部横截面处横径的增加无统计学差异。结论:上颌扩弓联合TB治疗可增加牙颌畸形口呼吸儿童的上气道体积,使上气道形态整体趋向卵圆形,改善口呼吸症状,帮助建立正常鼻呼吸。PUROPOSE:This study aimed to investigate the changes of upper airway before and after combined treatment of maxillary expansion and Twin-block(TB)in children with mouth breathing(MB)and malocclusion.METHODS:Twelve children with orthodontic deformities were selected for maxillary expansion and TB.Cone-beam CT was taken before and after treatment,and the images were analyzed using Dolphin imaging software 11.8.The data were analyzed by paired sample t test with SPSS 21.0 software package.RESULTS:The patients'upper airway measurement data showed an overall increase trend after combined treatment,and the upper airway volume increased by 3326.44 mm^(3)(P<0.05).The glossopharyngeal volume increased the most,with an average increase of 1146.20 mm^(3)(P<0.05).The narrowest cross-sectional area of the oropharynx and the cross-sectional area of the nasopharynx,palatopharynx,and glossopharynx increased 33.55 mm^(2)(P>0.05),71.68 mm^(2)(P<0.05),46.23 mm^(2)(P<0.05),54.60 mm^(2)(P<0.05),respectively.The transverse(P>0.05)and sagittal(P<0.05)diameters of the nasopharynx,palatopharynx,and glossopharynx increased,and the ratio of the sagittal diameter to the transverse diameter(P<0.05)all increased.After treatment,only the narrowest cross-sectional area of the oropharynx and the increase in the transverse diameter of the nasopharynx,palatopharynx,and glossopharyngeal cross-sections were not statistically significant.CONCLUSIONS:Maxillary expansion combined with TB treatment can increase the upper airway volume of children with MB and malocclusion.The upper airway shape tends to be oval,respiratory symptoms are improved,which help the children and help establish normal nasal breathing.

关 键 词：上颌扩弓 双[牙合]垫矫治器 牙[牙合]畸形 儿童 上气道 

分 类 号：R783.5[医药卫生—口腔医学]