前方牵引矫治不同年龄骨性Ⅲ类错[牙合]颞下颌关节的效果评价  

Changes in the temporomandibular joint following maxillary protraction for skeletal class Ⅲ malocclusion at different ages

作　　者：刘亚非[1] 王雅淋 左艳萍[1] 赵利霞[1] 尉静[1] 张超[1] 宋蕾 Liu Yafei;Wang Yalin;Zuo Yanping;Zhao Lixia;Wei Jing;Zhang Chao;Song Lei(Department of Orthodontics,The First Hospital of Hebei Medical University,Shijiazhuang 050031,Hebei Province,China;Department of Stomatology,Baoding No.2 Hospital,Baoding 071000,Hebei Province,China)

机构地区：[1]河北医科大学第一医院口腔正畸科,河北省石家庄市050031 [2]保定市第二医院口腔科,河北省保定市071000

出　　处：《中国组织工程研究》2023年第32期5203-5208,共6页Chinese Journal of Tissue Engineering Research

基　　金：河北省卫生厅课题编号(20211450):骨性Ⅲ类患者前方牵引矫治后颞下颌关节结构的比较分析,项目负责人:刘亚非。

摘　　要：背景:已有研究证实,不同年龄骨性Ⅲ类错[牙合]患者在前方牵引矫治后牙颌面的改变有显著不同;但是前方牵引矫治不同年龄患者颞下颌关节的改变是否存在差异尚未明确。目的:探讨年龄对于前方牵引矫治骨性Ⅲ类错[牙合]对颞下颌关节改变的影响。方法:将58例8-14岁的骨性Ⅲ类错[牙合]患儿分成2组,8-11岁组29例,[牙合]类型为替牙晚期;12-14岁组29例,[牙合]类型为恒牙早期。在矫治前、矫治后分别摄X射线头颅侧位片,进行[牙合]颌面的头影测量分析以及颞下颌关节在坐标系统位置的定量分析。采用配对t检验分别比较两组治疗前后的变化,独立t检验进行两组间治疗前后改变量的比较,Pearson相关分析对两组分别进行[牙合]颌面改变与颞下颌关节改变的相关性分析。结果与结论:①2个年龄组矫治后均发生了显著的[牙合]颌面及颞下颌关节变化;[牙合]颌面矢状方向上,8-11岁组上齿槽座点-鼻根点-下齿槽座点角(ANB)增加了4.76°,颌突角(NA-PA)增加了9.02°,显著大于12-14岁组的改变3.97°及6.88°(P<0.05);[牙合]颌面垂直方向上,8-11岁组下颌平面与前颅底平面的交角(MP-SN)、下颌平面与眼耳平面的交角(FH-MP)分别增加了1.92°及3.02°,明显大于12-14岁组的1.02°及0.78°(P<0.05)。②颞下颌关节改变在2个年龄组差异有显著性意义,8-11岁组较12-14岁组关节窝上缘位置(S-Fsx)的后移更显著;8-11岁组的关节窝后缘位置(S-Fpx)改变表现为后移,而12-14岁组则为前移;两组的髁状突前缘位置(S-Cix)、后缘位置(S-T4x)均发生后移,但8-11岁组较12-14岁组更明显。③颞下颌关节改变与[牙合]颌面的改变存在相关关系:8-11岁组的S-Fpx与蝶鞍点-鼻根点-下齿槽座点角(SNB)、NP连线与眼耳平面FH相交的交角(NP-FH)有负相关关系(P<0.05,r=-0.489;P<0.05,r=-0.424);12-14岁组的S-Fpx与上中切牙切缘到鼻根点-上牙槽座点连线的距离(U1-NAmm)为正BACKGROUND:Previous studies have shown that there are significant differences in occlusal and maxillofa cial changes in patients with skeletal class Ⅲ malocclusion of different ages after maxillary protraction treatment.However,the difference of temporomandibular joint changes in patients with different ages remains unknown.OBJECTIVE:To study the influence of age on the changes of the tempo romandibular joint after maxillary protraction treatment of skeletal class Ⅲ malocclusion.METHODS:Fifty-eight children with skeletal class Ⅲ malocclusion aged 8-14 years were divided into two groups.Twenty-nine children aged 8-11 years were diagnosed with late mixed dentitions.Twenty-nine children aged 12-14 years were diagnosed with early permanent dentitions.X-ray lateral cephalograms were taken pre-and post-treatment,and cephalometric analysis of occlusal and maxillofa cial regions and qua ntitative analysis of temporomandibular joint position in the coordinate system were carried out.Paired t-test was used for intragroup comparison.Independent t-test was used for intergroup comparison.Pearson correlation analysis was used to analyze the correlation between occlusal and maxillofa cial changes and temporomandibular joint changes.RESULTS AND CONCLUSION:The occlusal and maxillofacial structure and the temporomandibular joint changed significantly in the two groups after treatment.In the sagittal direction of the occlusal and maxillofa cial structure,subs pinale-nasion-supramental angle(ANB) in the 8-11-year-old group increased by 4.76°,and nasion-subs pinale line and pogonion-subspinale line angle(NA-PA) increased by 9.02°,which was significantly larger than those in the 12-14-year-old group(3.97° and 6.88°)(P <0.05).In the vertical direction,the mandible plane and sella-nasion line angle(MP-SN) and Frankie plane and sella-nasion line angle(FH-MP) in the 8-11-year-old group increased by 1.92° and 3.02° respectively,which was significantly higher than those in the 12-14-year-old group(1.02°and 0.78°)(P<0.05).There

关 键 词：前方牵引 骨性安氏Ⅲ类错[牙合] 颞下颌关节 年龄 [牙合]颌面 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R783.5