上颌扩弓联合双垫矫治器治疗对牙颌畸形口呼吸儿童上气道的影响

doi:10.19439/j.sjos.2021.06.014

上海口腔医学 ›› 2021, Vol. 30 ›› Issue (6): 634-638.doi: 10.19439/j.sjos.2021.06.014

上颌扩弓联合双垫矫治器治疗对牙颌畸形口呼吸儿童上气道的影响

郭靖晗, 於丽明, 李远远, 刘月华

上海市口腔医院,复旦大学附属口腔医院口腔正畸科,口腔生物医学工程实验室,上海 200001

收稿日期:2021-01-15 修回日期:2021-03-06 发布日期:2022-03-09
通讯作者: 刘月华,E-mail:liuyuehua@fudan.edu.cn
作者简介:郭靖晗（1993-）,男,硕士,住院医师,E-mail:tiramisugjh@sina.com
基金资助:
上海市卫健委先进适宜技术推广项目（2019SY041）; 上海市卫健委项目（GWV-10.2-YQ16）; 上海申康医院发展中心促进市级医院临床技能与临床创新三年行动计划（SHDC2020CR2043B）

Effect of maxillary expansion combined with Twin-block on upper airway of children with mouth breathing and dentomaxillofacial malformation

GUO Jing-han, YU Li-ming, LI Yuan-yuan, LIU Yue-hua

Department of Orthodontics, Shanghai Stomatological Hospital, Fudan University; Oral Biomedical Engineering Laboratory, Shanghai Stomatological Hospital, Fudan University. Shanghai 200001, China

Received:2021-01-15 Revised:2021-03-06 Published:2022-03-09

摘要/Abstract

摘要： 目的: 研究牙颌畸形的口呼吸患儿行上颌扩弓联合双垫矫治器（Twin-block,TB）矫治后上气道的变化。方法: 选取12例口呼吸牙颌畸形患儿行上颌扩弓和TB矫治,拍摄治疗前、后的锥形束CT（CBCT）,使用Dolphin 11.8软件对上气道进行测量。采用SPSS 21.0软件包对治疗前、后数据进行配对样本t检验。结果: 患儿上气道各测量数据在联合治疗后总体呈增长趋势,上气道总体积增加3326.44 mm³（P<0.05）。其中,舌咽部体积增加最多,平均增加1146.20 mm³（P<0.05）。口咽部最窄横截面积及鼻咽部、腭咽部、舌咽部横截面积分别扩大33.55 mm²（P>0.05）、71.68 mm²（P<0.05）、46.23 mm²（P<0.05）和54.60 mm²（P<0.05）。鼻咽部、腭咽部、舌咽部横径（P>0.05）及矢状径（P<0.05）均增加,矢状径与横径之比亦显著增大（P<0.05）。治疗后仅口咽部最窄横截面积及鼻咽部、腭咽部、舌咽部横截面处横径的增加无统计学差异。结论: 上颌扩弓联合TB治疗可增加牙颌畸形口呼吸儿童的上气道体积,使上气道形态整体趋向卵圆形,改善口呼吸症状,帮助建立正常鼻呼吸。

关键词: 上颌扩弓, 双垫矫治器, 牙畸形, 儿童, 上气道

Abstract: PURPOSE: This study aimed to investigate the changes of upper airway before and after combined treatment of maxillary expansion and Twin-block(TB) in children with mouth breathing (MB) and malocclusion. METHODS: Twelve children with orthodontic deformities were selected for maxillary expansion and TB. Cone-beam CT was taken before and after treatment, and the images were analyzed using Dolphin imaging software 11.8. The data were analyzed by paired sample t test with SPSS 21.0 software package. RESULTS: The patients' upper airway measurement data showed an overall increase trend after combined treatment, and the upper airway volume increased by 3326.44 mm³（P<0.05）. The glossopharyngeal volume increased the most, with an average increase of 1146.20 mm³（P<0.05）. The narrowest cross-sectional area of the oropharynx and the cross-sectional area of the nasopharynx, palatopharynx, and glossopharynx increased 33.55 mm²（P>0.05）, 71.68 mm²（P<0.05）, 46.23 mm²（P<0.05）, 54.60 mm²（P<0.05）, respectively. The transverse（P>0.05） and sagittal（P<0.05） diameters of the nasopharynx, palatopharynx, and glossopharynx increased, and the ratio of the sagittal diameter to the transverse diameter(P<0.05) all increased. After treatment, only the narrowest cross-sectional area of the oropharynx and the increase in the transverse diameter of the nasopharynx, palatopharynx, and glossopharyngeal cross-sections were not statistically significant. CONCLUSIONS: Maxillary expansion combined with TB treatment can increase the upper airway volume of children with MB and malocclusion. The upper airway shape tends to be oval, respiratory symptoms are improved, which help the children and help establish normal nasal breathing.

Key words: Maxillary expansion, Twin-block, Malocclusion, Child, Upper airway

中图分类号:

R783.5

郭靖晗, 於丽明, 李远远, 刘月华. 上颌扩弓联合双垫矫治器治疗对牙颌畸形口呼吸儿童上气道的影响[J]. 上海口腔医学, 2021, 30(6): 634-638.

GUO Jing-han, YU Li-ming, LI Yuan-yuan, LIU Yue-hua. Effect of maxillary expansion combined with Twin-block on upper airway of children with mouth breathing and dentomaxillofacial malformation[J]. Shanghai Journal of Stomatology, 2021, 30(6): 634-638.

参考文献

[1] 朱敏. 张口呼吸的诊断与治疗[J]. 中国临床医生, 2013, 41(7): 8-9.
[2] Izu SC, Itamoto CH, Pradella-Hallinan M, et al.Obstructive sleep apnea syndrome (OSAS) in mouth breathing children[J]. Braz J Otorhinolaryngol, 2010, 76(5): 552-556.
[3] Bresolin D, Shapiro GG, Shapiro PA, et al.Facial characteristics of children who breathe through the mouth[J]. Pediatrics, 1984, 73(5): 622-625.
[4] Jefferson Y.Mouth breathing: adverse effects on facial growth, health, academics, and behavior[J]. Gen Dent, 2010, 58(1): 18-25.
[5] 刘月华. 正畸医生在生命全周期上气道管理中的作用[J]. 中国实用口腔科杂志, 2017, 10(2): 65-69.
[6] Paolantonio EG, Ludovici N, Saccomanno S, et al.Association between oral habits, mouth breathing and malocclusion in Italian preschoolers[J]. Eur J Paediatr Dent, 2019, 20(3): 204-208.
[7] Grippaudo C, Paolantonio EG, Antonini G, et al.Association between oral habits, mouth breathing and malocclusion[J]. Acta Otorhinolaryngol Ital, 2016, 36(5): 386-394.
[8] Izuka EN, Feres MF, Pignatari SS.Immediate impact of rapid maxillary expansion on upper airway dimensions and on the quality of life of mouth breathers[J]. Dental Press J Orthod, 2015, 20(3): 43-49.
[9] Pirelli P, Saponara M, De Rosa C, et al.Orthodontics and obstructive sleep apnea in children[J]. Med Clin North Am, 2010, 94(3): 517-529.
[10] Zhang C, He H, Ngan P.Effects of twin block appliance on obstructive sleep apnea in children: a preliminary study[J]. Sleep Breath, 2013, 17(4): 1309-1314.
[11] Cappellette M Jr, Nagai LHY, Gonçalves RM, et al.Skeletal effects of RME in the transverse and vertical dimensions of the nasal cavity in mouth-breathing growing children[J]. Dental Press J Orthod, 2017, 22(4): 61-69.
[12] 刘月华, 曾祥龙, 傅民魁, 等. 阻塞性睡眠呼吸暂停综合征患者上气道及周围结构的头影测量[J]. 中华口腔医学杂志, 1999, 34(4): 213-244.
[13] Osorio F, Perilla M, Doyle DJ, et al.Cone beam computed tomography: an innovative tool for airway assessment[J]. Anesth Analg, 2008, 106(6): 1803-1807.
[14] Moshiri M, Scarfe WC, Hilgers ML, et al.Accuracy of linear measurements from imaging plate and lateral cephalometric images derived from cone-beam computed tomography[J]. Am J Orthod Dentofacial Orthop, 2007, 132(4): 550-560.
[15] Chung Leng Munzo I, Beltri Orta P. Comparison of cephalometric patterns in mouth breathing and nose breathing children[J]. Int J Pediatr Otorhinolaryngol, 2014, 78(7): 1167-1172.
[16] Zhong Z, Tang Z, Gao X, et al.A comparison study of upper airway among different skeletal craniofacial patterns in nonsnoring Chinese children[J]. Angle Orthod, 2010, 80(2): 267-274.
[17] Yildirim N, Fitzpatrick MF, Whyte KF, et al.The effect of posture on upper airway dimensions in normal subjects and in patients with the sleep apnea/hypopnea syndrome[J]. Am Rev Respir Dis, 1991, 144(4): 845-847.
[18] 杨莉, 韩蓓蕾, 邓海艳, 等. 矢状骨面型错畸形对成年人上气道影响的CBCT研究[J]. 口腔医学, 2017, 37(2): 144-148.

上颌扩弓联合双垫矫治器治疗对牙颌畸形口呼吸儿童上气道的影响

Effect of maxillary expansion combined with Twin-block on upper airway of children with mouth breathing and dentomaxillofacial malformation

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	翟利云, 姚宁, 孔佳新, 丁志民, 徐杨, 赵超男. 学龄前儿童龋病相关口腔健康行为潜在类别及异质关联分析[J]. 上海口腔医学, 2024, 33(4): 415-420.
[2]	李杨, 赵梦珺, 卢红巧, 刘建国, 刘云坤, 吴家媛. 基于16S rDNA高通量测序技术的重度低龄儿童龋患者口腔微生物及肠道菌群群落分析[J]. 上海口腔医学, 2024, 33(2): 164-169.
[3]	伏丽林, 刘波, 周妮, 李珊珊, 吕长海, 马雪婷. 120例全麻下儿童牙科治疗回顾分析[J]. 上海口腔医学, 2024, 33(2): 195-199.
[4]	黄骏, 韩轩, 马其钊, 邹静. 低龄儿童龋相关口腔微生物特点分析[J]. 上海口腔医学, 2024, 33(1): 59-63.
[5]	王萌, 陶李明, 胡亚男. Twin-block联合上颌扩弓器矫治下颌后缩儿童前后舌位的改变及上气道的三维变化[J]. 上海口腔医学, 2023, 32(6): 635-639.
[6]	鄢洁雅, 林怡君, 李雅欣, 劳安, 廖盛轩, 刘加强. 骨性Ⅲ类错𬌗畸形患者双颌手术后上气道形态变化及相关性分析[J]. 上海口腔医学, 2023, 32(5): 485-490.
[7]	黄仲敏, 张赟, 李小兵. 替牙列早期上颌慢速扩弓对上颌中段牙及牙槽嵴的影响[J]. 上海口腔医学, 2023, 32(5): 501-507.
[8]	苏红如, 吴祎培, 钱文昊, 张鸿军. 上海市城郊一年级儿童的口腔健康行为及家长认知调查[J]. 上海口腔医学, 2023, 32(5): 536-540.
[9]	周琼, 刘敏, 王霄, 陈薇. 母亲患龋风险对儿童龋易感性的影响[J]. 上海口腔医学, 2023, 32(1): 63-68.
[10]	马浩然, 刘子晗. 南京市860名1~6岁儿童口腔微生物与肠道菌群构成差异分析[J]. 上海口腔医学, 2022, 31(3): 270-273.
[11]	周勇, 周政权, 刘雪威, 张力木, 王也, 林晓萍. 儿童外周血微量营养素与4种口腔黏膜病的关系：217例临床分析[J]. 上海口腔医学, 2022, 31(3): 274-281.
[12]	蔡文燕, 周淑, 林良缘. 三重抗生素糊剂对乳牙感染根管中微生物的影响[J]. 上海口腔医学, 2021, 30(4): 374-378.
[13]	曾晓莉, 张颖, 王艳, 张皓, 江一巍, 笪东欣, 虞瑾, 王沪宁. 上海市残障儿童及家长口腔健康知、信、行调查分析[J]. 上海口腔医学, 2021, 30(4): 379-383.
[14]	李丽, 金昊, 盛恺, 季萍萍, 丁琴, 侯黎莉. 儿童口腔健康认知和行为对其口腔健康状况的影响[J]. 上海口腔医学, 2021, 30(4): 406-409.
[15]	毛晓燕, 杨佳音, 李佳, 徐睿. 成人骨性Ⅱ类错畸形上气道与上、下颌骨形态分析[J]. 上海口腔医学, 2021, 30(4): 419-423.