均角型骨性Ⅲ类患者拔牙掩饰性或手术治疗后上气道容积和舌骨位置的比较  

Comparison of upper airway volume and hyoid position after camouflage orthodontic or orthodontic-orthognathic treatment in patients with skeletal class Ⅲ malocclusion with normal-angle vertical pattern

作　　者：徐景胙 刘浩洁 林成钊 刘振浩 翟烨 郭舒瑜 徐荣耀 Hsu ChingCho;Liu Haojie;Lin Chengzhao;Liu Zhenhao;Zhai Ye;Guo Shuyu;Xu Rongyao(Stomatological College of Nanjing Medical University,Nanjing 210029,China;State Key Laboratory Cultivation Base of Research,Prevention and Treatment for Oral Diseases,Nanjing 210029,China;Jiangsu Province Engineering Research Center of Stomatological Translational Medicine,Nanjing 210029,China;School of Stomatology,Xuzhou Medical University,Xuzhou 221004,China;Dept.of Oral and Maxillofacial Surgery,the Affiliated Stomatological Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学口腔医学院,南京210029 [2]口腔疾病研究与防治国家级重点实验室培育建设点,南京210029 [3]江苏省口腔转化医学工程研究中心,南京210029 [4]徐州医科大学口腔医学院,徐州221004 [5]南京医科大学附属口腔医院口腔颌面外科,南京210029

出　　处：《华西口腔医学杂志》2025年第1期53-62,共10页West China Journal of Stomatology

基　　金：国家自然科学基金(82270943)。

摘　　要：目的比较2种矫治方式对骨性Ⅲ类错[牙合]畸形治疗的气道影响差异,尤其关注气道容积、形态、腭角、下颌旋转及骨位移等方面的具体改变,并通过寻找可能具有临床意义的气道指标,以期为预防OSAHS提供新的监测依据。方法选取2018年9月—2023年12月在南京医科大学附属口腔医院口腔正畸科临床诊断为骨性Ⅲ类错[牙合]畸形患者36例,按照治疗方法不同,分为正畸正颌联合治疗组(n=18)和掩饰性治疗(n=18)组。通过比较术前、术后锥形束CT及三维头影测量分析气道容积、横径、腭角、下颌骨及舌骨等变化。结果掩饰性治疗后鼻咽容积、舌咽容积均有增大趋势,且差异有统计学意义(P<0.05)。正畸正颌联合治疗后鼻咽容积、气道鼻咽段和舌咽段横径、腭角、下颌旋转及舌骨位移的改变均有统计学意义(P<0.05)。2组患者治疗后比较,舌咽段横径、腭角及舌骨至蝶鞍点距离等变化具有统计学意义(P<0.05)。结论正畸正颌联合治疗组的患者在舌咽段截面积、腭角及舌骨的改变较掩饰性治疗组明显。OSAHS的易感人群多出现舌骨下移及气道最小截面积减小,因此在采取正畸正颌联合治疗方案时应格外注意其气道形态的改变,以避免造成不良后果。Objective This study aims to compare the effects of two orthodontic treatment modalities for skeletal classⅢmalocclusion on specific changes in airway volume,morphology,palatal angle,mandibular rotation,and bone displacement.Results provide scientific evidence for the selection of orthodontic treatment plans and reduce the risk of developing obstructive sleep apnea hypopnea syndrome(OSAHS).Methods Thirty-six patients diagnosed with skeletal classⅢmalocclusion at the Department of Orthodontics,the Affiliated Stomatological Hospital of Nanjing Medical University from September 2018 to December 2023 were divided into two groups:orthodontic-orthognathic treatment group(18 patients)and camouflage orthodontic treatment group(18 patients).Changes in airway volume,cross-sectional area,palatal angle,mandibular,and tongue positions were observed through pre-and post-operative cone beam computed tomography and 3D cephalometric measurements.Results In the camouflage orthodontic treatment group,nasopharyngeal volume and oropharyngeal volume statistically increased after treatment(P<0.05).In the orthodontic-orthognathic treatment group,changes in nasopharyngeal volume,nasopharyngeal airway,distance from posterior tongue to pharyngeal wall,palatal angle,mandibular rotation,and hyoid bone displacement were statistically significant after surgery(P<0.05).In the comparison between the two groups after treatment,changes in the distance from posterior tongue to pharyngeal wall,palatal angle,and distance from hyoid bone to sella turcica point were statistically significant(P<0.05).Conclusion Patients in the orthodontic-orthognathic treatment group showed significantly greater changes in oropharyngeal cross-sectional area,palate angle,and tongue position compared with patients in the camouflage orthodontic treatment group.As individuals susceptible to OSAHS often exhibit mandibular retrusion and decreased minimum airway cross-sectional area,special attention should be paid to airway morphology changes when adopting orthodontic-ort

关 键 词：掩饰性正畸治疗 正畸正颌联合治疗 骨性Ⅲ类错[牙合]畸形 气道容积 舌骨位移 阻塞性睡眠呼吸暂停低通气综合征 

分 类 号：R783.5[医药卫生—口腔医学]