上颌扩弓结合TB治疗牙颌畸形对患儿语言、咀嚼、吞咽功能及头影测量数据的影响  

Effects of Maxillary Expansion Combined with TB on Language,Chewing,Swallowing Function and Cephalometric Data in Children with Dentofacial Deformity

作　　者：宋冠娅 宋冠杰 邬礼政 SONG Guanya;SONG Guanjie;WU Lizheng(Department of Stomatology,Special Medical Center of the Chinese People's Armed Police Force,Dongli District,Tianjin 300300,China;Department of Stomatology,People's Hospital of Baodi District,Tianjin 301800,China)

机构地区：[1]中国人民武装警察部队特色医学中心口腔科,天津300300 [2]天津市宝坻区人民医院口腔科,天津301800

出　　处：《中国美容医学》2025年第2期146-150,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:研究骨性Ⅱ类错牙合畸形患儿行上颌扩弓联合双牙合垫矫治器(Twin-block,TB)矫治的美学疗效及对患儿语言功能、咀嚼功能和吞咽功能的影响。方法:选择2020年6月-2022年12月来笔者医院就诊的63例骨性Ⅱ类错牙合畸形患儿作为研究对象,对其临床资料展开回顾性分析,其中31例接受上颌扩弓加斜导治疗(对照组),32例在接受上颌扩弓的基础上联合TB治疗(研究组)。治疗结束后,分析比较两组患儿的临床疗效、语言、咀嚼和吞咽功能、口腔恢复情况及头影测量数据变化。结果:治疗后,两组患儿的语言功能评分均上升,而咀嚼功能评分值和吞咽功能评分值下降(P<0.05);且研究组改变幅度高于对照组(P<0.05)。与治疗前比较,两组患儿的H-NP、H-CVP、H-Or、H-PP、H-MP、H-FH、H-PNS、PNS-Ba、SPP-SPPW、Mc1-Mc2、U-MPW、V-LPW均显著增大(P<0.05),其中研究组的H-MP、PNS-Ba显著高于对照组(P<0.05)。治疗后,两组患儿的ANB、U1-SN和Wits值均较治疗前显著减小;而SNB、U1-L1、L1-NB和L1-MP均较治疗前显著增大(P<0.05)。治疗后,研究组的ANB、U1-SN、L1-NB和Wits值低于对照组(P<0.05)。结论:上颌扩弓联合TB治疗可提高骨性Ⅱ类错牙合畸形患儿的口腔治疗效果,改善语言、咀嚼和吞咽功能,改善舌骨位置并扩大上气道,有效改善患儿侧貌。Objective To investigate the aesthetic efficacy of maxillary arch expansion with Twin-block orthodontic appliance(TB)in children with bony Class II malocclusion and its effect on speech,mastication,and swallowing.Methods Sixty-three children with osseous Class II malocclusion were selected for treatment in the author's hospital from June 2020 to December 2022,and their clinical data were retrospectively analyzed,of which 31 cases were treated with maxillary expansion with oblique guidance(control group)and 32 cases received TB treatment on the basis of maxillary expansion(study group).At the end of the treatment course,the clinical efficacy,speech,mastication and swallowing functions,oral recovery,and changes in cephalometric data were analyzed and compared between the two groups.Results After treatment,the scores of language function increased in both groups,but the scores of chewing function and swallowing function decreased(P<0.05).The change of the study group was higher than that of the control group(P<0.05).Compared with before treatment,H-NP,H-CVP,H-Or,H-PP,H-MP,H-FH,H-PNS,PNS-Ba,SPP-SPPW,Mc1-Mc2,U-MPW,V-LPW were significantly increased in 2 groups(P<0.05).The H-MP and NCS-BA of the study group were significantly higher than those of the control group(P<0.05).After treatment,the ANB,U1-SN and Wits values of the two groups were significantly reduced compared with those before treatment.SNB,U1-L1,L1-NB and L1-MP were significantly increased compared with those before treatment(P<0.05).After treatment,the ANB,U1-SN,L1-NB and Wits values in the study group were lower than those in the control group(P<0.05).Conclusion Maxillary arch expansion combined with TB treatment can improve the oral treatment effect of children with bony Class II malocclusion,improve speech,mastication and swallowing functions,improve the position of the hyoid bone and expand the upper airway,and effectively improve the lateral appearance of the children.

关 键 词：骨性Ⅱ类错牙合畸形 上颌扩弓 双牙合垫矫治器 语言功能 咀嚼功能 吞咽功能 

分 类 号：R783.5[医药卫生—口腔医学]