骨性Ⅲ类错[牙合]畸形患者双颌手术后舌形态变化的初步研究  

Preliminary Research on Tongue Morphology Changes in Skeletal ClassⅢPatients after Bimaxillary Orthognathic Surgery

作　　者：胡小蓓 张昆 张建云 王育新[2] HU Xiaobei;ZHANG Kun;ZHANG Jianyun;WANG Yuxin(Department of Orthodontics,Nanjing Stomatological Hospital,Affiliated Hospital of Medical School,Institute of Stomatology,Nanjing University,Nanjing 210008,China;Department of Oral and Maxillofacial Trauma Orthognathic Plastic Surgery,Nanjing Stomatological Hospital,Affiliated Hospital of Medical School,Institute of Stomatology,Nanjing University,Nanjing 210008,China.)

机构地区：[1]南京大学医学院附属口腔医院·南京市口腔医院口腔正畸科,南京大学口腔医学研究所,江苏南京210008 [2]南京大学医学院附属口腔医院·南京市口腔医院口腔颌面创伤正颌整形外科,南京大学口腔医学研究所,江苏南京210008

出　　处：《口腔医学研究》2024年第12期1054-1058,共5页Journal of Oral Science Research

基　　金：江苏省重点研发计划项目(社会发展)(编号:BE2021609)。

摘　　要：目的:研究骨性Ⅲ类错[牙合]畸形患者双颌手术后舌形态的变化,探究舌形态变化与上下颌骨矢状向移动量之间的关系。方法:本研究为回顾性研究,选取行Le fortⅠ型截骨术+双侧下颌矢状劈开后退术的骨性Ⅲ类错[牙合]畸形患者35例。收集患者术前1周(T0)、术后1个月(T1)、术后6~12个月(T2)的螺旋CT影像资料,测量T0、T1、T2期舌在口内的相对位置、舌相对于颅底的矢状向位置、垂直向位置、舌长度、舌高度、舌正中矢状截面面积及口内舌体积,并分析其与上下颌骨矢状向移动量的相关性。结果:正颌术后,舌在口内的位置更靠后上,较T0期,T2期L2、L3、L4分别增大(2.08±2.76)mm、(1.88±2.48)mm、(1.64±2.31)mm。与T0期相比,T1期舌高度显著增加,而舌矢状向位置、舌长度、口内舌体积显著减小;T2期舌高度恢复至T0期水平,而舌矢状向位置、舌长度、口内舌体积仍显著减小,分别减小(4.41±5.53)mm、(4.81±6.96)mm、(6.04±13.62)cm 3。舌矢状向位置、口内舌体积的变化量与下牙槽座点的矢状向移动距离呈正相关(r=0.394,r=0.452)。结论:骨性Ⅲ类错[牙合]畸形患者双颌手术后,舌在固有口腔内更靠后上,口内舌体积减小,提示舌发生自适应性改变。Objective:To evaluate the changes of tongue morphology in skeletal ClassⅢpatients after bimaxillary orthognathic surgery,and to explore the relationships between the changes of tongue morphology and the sagittal movement distance of maxilla and mandible.Methods:Thirty-five patients with skeletal ClassⅢmalocclusion who underwent LeFort I osteotomy and bilateral sagittal split mandibular osteotomy were included in this retrospective study.Spiral CT was collected 1 week before operation(T0),1 month after operation(T1),and 6-12 months after operation(T2).The tongue position,length,height,area,and volume in oral cavity proper were measured.The data in T0,T1,and T2 were compared.The relationships between the changes of tongue morphology and the sagittal movement distance of maxilla and mandible were analyzed.Results:After orthognathic surgery,the tongue position in oral cavity proper was more backward and upward.The L2,L3,and L4 distance increased significantly at T1 and T2,and the amount of increase were(2.08±2.76)mm,(1.88±2.48)mm,and(1.64±2.31)mm at T2 compared with T0,respectively.At T1,the tongue height increased significantly,and the tongue sagittal position measurement,tongue length,and tongue volume in oral cavity proper decreased significantly compared with T0.At T2,the tongue height returned to T0 level,but the tongue sagittal position measurement,tongue length,and tongue volume in oral cavity proper still decreased significantly,and the amount of decrease were(4.41±5.53)mm,(4.81±6.96)mm,and(6.04±13.62)cm 3 compared with T0,respectively.The change degree of the tongue sagittal position measurement and the tongue volume in oral cavity proper between T2 and T0 was positively correlated with the sagittal movement distance of supramentale(r=0.394,r=0.452).Conclusion:After bimaxillary orthognathic surgery,the relative position of the tongue in oral cavity proper was more backward and upward,while the tongue volume in oral cavity proper decreased.It suggests that the tongue underwent adaptive changes.

关 键 词：骨性Ⅲ类错[牙合]畸形 双颌手术 舌形态 舌体积 螺旋CT 

分 类 号：R783.5[医药卫生—口腔医学]