Twin-Block和Activator矫治器对骨性Ⅱ类青少年上气道结构影响的研究  

Research on effect of Twin-Block and Activator on upper airway structure in adolescents with skeletal classⅡ

作　　者：王越 俞万钧[2] WANG Yue;YU Wanjun(Department of Stomatology,the Affiliated People′s Hospital of Ningbo University,Ningbo 315100,China;Department of Respiratory Medicine,the Affiliated People′s Hospital of Ningbo University,Ningbo 315100,China)

机构地区：[1]宁波大学附属人民医院口腔科,浙江宁波315100 [2]宁波大学附属人民医院呼吸内科,浙江宁波315100

出　　处：《中国现代医生》2021年第36期75-79,83,共6页China Modern Doctor

基　　金：浙江省医药卫生科技平台项目(2017KY615)。

摘　　要：目的通过双垫矫治装置(Twin-Block)和肌激动器(Activator)的矫正,观察治疗前后及两种矫治装置的差异探讨其对患者上气道结构的作用。方法选取2016年1月1日至2018年12月30日在宁波大学附属人民医院口腔科门诊经过纳排标准筛选的骨性Ⅱ类青少年患者30例,其中15例戴用Twin-Block矫治器,15例戴用Activator矫治器,分析比较两组矫治前后上气道矢状径及舌骨位置的变化量及比较两组上气道矢状径和舌骨位置矫治改变量的组间比较。结果Twin-Block和Activator矫治器在矫治后腭咽段指标(Ve1-Ve2、P1-P2)、舌咽段指标(Pas1-Pas2)、舌骨矢状向指标(AH-CVP、AH-NP、AH-RGn)、垂直向指标(AH-MP、AH-Or)均较矫治前差异均有统计学意义(P<0.05),而两组鼻咽段指标(PNS-S、PNS-Aa、PNS-Ad1、PNS-Ad2)、喉咽段指标(Va1-Va2)、软腭长度及厚度(PNS-P1、Sp1-Sp2)、舌骨指标(AH-FH、AH-SN、AH-PNS)组内比较,差异无统计学意义(P>0.05)。两组矫治装置治疗效果的对比结果显示,Ve1-Ve2、Pas1-Pas2、AH-MP比较,差异有统计学意义(P<0.05),其余指标差异均无统计学意义(P>0.05)。结论Twin-Block和Activator矫治器均能使上气道矢状径及舌骨位置得到改变,提升了呼吸通气效率。双垫矫治装置相较肌激动器能更好地改善骨性Ⅱ类的腭咽段及舌咽段矢状径,为骨性Ⅱ类早期矫治的临床诊疗给予一定的帮助及指导。Objective To observe the differences between Twin-Block and Activator before and after treatment so as to investigate their effects on the upper airway structure of patients through the correction of the two devices.Methods A total of 30 adolescent patients with skeletal typeⅡbased on the inclusion criteria from the outpatient Department of Stomatology of the Affiliated People′s Hospital of Ningbo University from January 1,2016 to December 30,2018 were selected.Among them,15 cases wore Twin-Block and 15 cases wore Activator.The changes of sagittal diameter of upper airway and hyoid position before and after correction were analyzed and compared respectively between the two groups.Results After treatment with Twin-Block and Activator,the indexes of velopharyngeal segment(Ve1-Ve2,P1-P2),glossopharyngeal segment(Pas1-Pas2),hyoid sagittal direction(AH-CVP,AH-NP,AH-RGn),vertical direction(AH-MP,AH-Or)were more significantly increased than those before the rectification,with statistically significant differences(P<0.05),while there were no significant differences in the indexes of nasopharyngeal segment(PNS-S,PNS-Aa,PNSAd1,PNS-Ad2),hypopharyngeal segment(Va1-Va2),soft palate length and thickness(PNS-P1,Sp1-Sp2),hyoid index(AH-FH,AH-SN and AH-PNS)(P<0.05).The results showed that there were significant differences in Ve1-Ve2,Pas1-Pas2,AH-MP between the two groups(P<0.05),but no significant differences were showed in other indexes(P<0.05).Conclusion Both Twin-Block and Activator can change the sagittal diameter of upper airway and hyoid bone position,thus improving the respiratory and ventilation efficiency.Compared with muscle activator,the double occlusal pad removable orthodontic appliances can better improve the sagittal diameter of velopharyngeal segment and glossopharyngeal segment of adolescents with skeletal classⅡ,providing certain help and guidance for clinical diagnosis and treatment of early orthodontic classⅡ.

关 键 词：TWIN-BLOCK矫治器 Activator矫治器 骨性Ⅱ类 上气道 青少年 

分 类 号：R783.5[医药卫生—口腔医学]