双[牙合]垫矫治器双期矫治对骨性Ⅱ类患者上气道及周围组织的影响  

Changes in upper airway and neighbor tissues during Twin-Block two-phase treatment in ClassⅡpatients

作　　者：毛丰 薛晴 徐静 胡敏[1] Mao Feng;Xue Qing;Xu Jing;Hu Min(Hospital of Stomatology,Jilin University,Jilin 130021,China)

机构地区：[1]吉林大学口腔医院,吉林130021

出　　处：《中华口腔正畸学杂志》2023年第3期126-131,共6页Chinese Journal of Orthodontics

基　　金：吉林省科技发展计划基金(20200603007SF)。

摘　　要：目的评估附加上颌快速扩弓(rapid maxillary expansion,RME)的双[牙合]垫矫治器(Twin-Block,TB)双期矫治对骨性Ⅱ类患者上气道、舌骨及下颌骨的影响。方法回顾性研究通过附加上颌快速扩弓的双颌垫矫治器双期矫治的骨性Ⅱ类患者42例。拔牙组18例[男6例,女12例,年龄(11.67±1.14)岁],TB治疗时长为(11.38±1.10)个月,总治疗时间为(40.45±9.17)个月。非拔牙组24例[男14例,女10例,年龄(11.38±1.10)岁],TB治疗时长为(11.67±1.14)个月,总治疗时间为(39.02±13.42)个月。比较矫治前,TB矫治后,固定矫治后,双期矫治后上气道、舌骨及下颌骨的变化。结果①拔牙组与治疗前比较,咽顶点对应的气道水平于TB治疗后扩宽(1.97±2.15)mm(P=0.038),双期矫治后扩宽(4.02±3.32)mm(P<0.001)。软腭中心水平上气道于双期矫治后扩宽(3.08±3.14)mm(P=0.015)。舌骨于固定及双期矫治后至下颌骨距离增加且向下移动。双期矫治后下颌骨总长度增加(8.53±6.04)mm(P=0.011),有效长度增加(7.77±5.43)mm(P=0.018),升支长度增加(7.28±3.75)mm(P=0.001)。②非拔牙组与治疗前比较,腺样体对应的气道于TB治疗后扩宽(2.57±3.49)mm(P=0.008),双期矫治后扩宽(3.43±3.95)mm(P<0.001)。软腭中心水平上气道于双期矫治后扩宽(3.96±3.51)mm(P<0.001)。舌骨于固定及双期矫治后至C3颈椎距离增加且向下移动。双期矫治后面平面与眶耳平面的夹角增大了2.09°±2.76°(P=0.04)。下颌骨总长度TB矫治后增加(5.12±5.59)mm(P=0.015),固定矫治后增加(5.26±4.32)mm(P=0.012),双期矫治后增加(10.37±6.50)mm(P<0.001)。下颌骨有效长度TB矫治后增加(5.43±5.62)mm(P=0.008),固定矫治后增加(4.74±5.31)mm(P=0.024),双期矫治后增加(10.17±6.76)mm(P<0.001)。结论附加上颌快速扩弓的双[牙合]垫矫治器双期治疗对鼻、腭咽气道及下颌骨发育有利且保持稳定,舌骨未抵抗生长发育影响下移;拔牙矫治不利于舌骨位置。Objective To explore the effect of Twin-Block(TB)with Rapid Maxillary Expansion(RME)two-phase treatment on upper airway(UA),hyoid and mandible in ClassⅡpatients.Methods Forty-two ClassⅡpatients using TB with RME in Jilin University Stomatological Hospital were retrospectively included.Patients were divided into extraction and non-extraction group.Tooth extraction group has 18 patients[male 6,woman 12,average age(11.67±1.14)with TB treatment time of(11.38±1.10)months and total treatment time of(40.45±9.17)months].Non-tooth extraction group has 24 patients[male 14,woman10,average age(11.38±1.10)with TB treatment time of(11.67±1.14)months and total treatment time of(39.02±13.42)months].The UA,hyoid and mandible measurements were compared at time points of before-treatment,after-TB treatment,and at the end of the two-phase treatment.Results①Extraction group:PNS-Ad2 increased by(1.97±2.15)mm(P=0.038)after TB treatment and by(4.02±3.32)mm(P<0.001)after two-phase treatment.SPP-SPPW increased by(3.08±3.14)mm(P=0.015)after two-phase treatment.The distance between hyoid and mandible increased and moved downward after fixed and two-phase treatment.Total length of mandible increased by(8.53±6.04)mm(P=0.011),while effective length increased by(7.77±5.43)mm(P=0.018)during two-stage treatment,and the ramus length increased by(7.28±3.75)mm(P=0.001).②Non extraction group:PNS-Ad2 increased by(2.57±3.49)mm(P=0.008)after TB treatment and by(3.43±3.95)mm(P<0.001)after two-phase treatment.SPP-SPPW increased by(3.96±3.51)mm(P<0.001)after two-phase treatment.Distance between hyoid and C3 cervical increased and moved downward in non-extraction group after fixed and two-phase treatment.The angle of NP-FH increased by 2.09°±2.76°(P=0.04)after two-phase treatment.Total length of mandible increased by(5.12±5.59)mm(P=0.015)after TB treatment,increased by(5.26±4.32)mm(P=0.012)after fixed treatment and increased by(10.37±6.50)mm(P<0.001)after two-phase treatment.The effective length of mandible increased by(5.43±5.

关 键 词：双[牙合]垫矫治器 双期矫治 上气道 疗效评价 

分 类 号：R783.5[医药卫生—口腔医学]