上海口腔医学

上海口腔医学 ›› 2020, Vol. 29 ›› Issue (3): 281-286.doi: 10.19439/j.sjos.2020.03.010

• 论著 • 上一篇    下一篇

12~14岁骨性Ⅱ类高角女性拔牙矫治前、后髁突位置与上气道结构变化

雷杰, 肖遥, 罗茂璇, 徐晓梅   

  1. 西南医科大学附属口腔医院 正畸科,西南医科大学 口腔颌面修复重建与再生实验室,四川 泸州 646000
  • 收稿日期:2019-10-08 修回日期:2019-11-25 出版日期:2020-06-25 发布日期:2020-07-29
  • 通讯作者: 肖遥,E-mail：495909578@qq.com
  • 作者简介:雷杰（1995-）,男,硕士研究生,医师,E-mail：1067233579@qq.com
  • 基金资助:
    四川省教育厅科研基金资助项目（18ZB0642）; 西南医科大学青年基金项目（2014QN-023）

Effect of extraction on condylar process position and upper airway in 12-14 years old females with skeletal Class Ⅱ high angle

LEI Jie, XIAO Yao, LUO Mao-xuan, XU Xiao-mei   

  1. Department of Orthodontics, Stomatology Hospital Affiliated to Southwest Medical University; Laboratory of Oral and Maxillofacial Reconstruction and Regeneration. Luzhou 646000, Sichuan Province, China
  • Received:2019-10-08 Revised:2019-11-25 Online:2020-06-25 Published:2020-07-29

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摘要： 目的 探讨12~14岁骨性Ⅱ类高角女性患者拔牙矫治前、后髁突位置及上气道结构变化。方法 选取2016年1月—2017年6月西南医科大学附属口腔医院收治的骨性Ⅱ类高角女性患者作为实验组（n=27）,另选择同期来院体检、无错畸形健康人作为对照组（n=30）。实验组给予拔牙矫治,并于治疗前、后分别进行锥形束CT（CBCT）图像采集,对照组于体检时进行CBCT拍摄,使用Mimics 20.0软件处理数据。观察治疗前、后实验组患者髁突位置相关指标关节前间隙（Sa）、关节上间隙（Su）、关节后间隙（Sp）与上气道结构相关指标气道总体积（V总）、鼻咽体积（V鼻）、腭咽体积（V腭）、舌咽体积（V舌）、喉咽体积（V喉）、口咽体积（V口）、口咽段气道最小截面积（SMIN）、上气道于硬腭平面处矢状直径（APHP）、上气道于软腭尖平面处矢状直径（APSP）以及上气道于会厌尖平面处矢状直径（APTE）的变化。采用SPSS 20.0软件包对数据进行统计学分析。结果 实验组治疗前Sa显著大于对照组,Sp显著小于对照组（P<0.05）;实验组治疗前Su与对照组相比无显著差异（P>0.05）;实验组治疗前关节间隙指数显著低于对照组（P<0.05）。治疗前实验组Sa大于本组治疗后（P<0.05）;治疗前、后实验组Sp及Su相比无显著差异（P>0.05）;治疗后实验组关节间隙指数显著高于本组治疗前（P<0.05）。实验组治疗前V总、V舌、V口及SMIN均显著小于对照组（P<0.05）;实验组治疗前V鼻、V腭、V喉、APTE、APHP及APSP与对照组相比无显著差异（P>0.05）。实验组治疗前后V鼻、V喉、APHP及APTE相比无显著差异（P>0.05）;治疗后实验组V总、V舌、V腭、V口、SMIN及APSP均显著大于本组治疗前（P<0.05）。结论 拔牙治疗后,随着咬合关系、下颌平面及咬合平面变化,髁突前间隙减小,髁突位置由后退位恢复至中位,气道结构各指标均有不同程度增大。拔牙矫治可使骨性Ⅱ类高角女性患者髁突位置前移,上气道体积增加。

关键词: 骨性Ⅱ类高角, 拔牙矫治, 髁突, 上气道

Abstract: PURPOSE: To investigate the effect of extraction on condylar process position and upper airway in 12-14 years old females with skeletal ClassⅡhigh angle. METHODS: Twenty seven 12-14 years old females with skeletal ClassⅡhigh angle (experimental group) and 30 physical examinees without malocclusion (control group) in Stomatology Hospital Affiliated to Southwest Medical University from January 2016 and June 2017 were enrolled. All patients received cone-beam CT (CBCT) examinations. Mimics 20.0 was used to process the data. The changes of the condylar process position and upper airway were recorded. The data were analyzed using SPSS 20.0 software package. RESULTS: Before treatment, patients in the experimental group had higher Sa as well as lower Sp than those of the control group (P<0.05), but with no difference in Su between 2 groups before treatment (P>0.05). After treatment, Sa was decreased in the experimental group (P<0.05), but no change was observed in Sp and Su(P>0.05). After treatment, the joint space indexes were increased in the experimental group (P<0.05). Before treatment, the V total, V tongue, V mouth, and SMIN in the experimental group were significantly lower than those of the control group (P<0.05). Before treatment, V nose, V palate, V larynx, APTE, APHP and APSP in the experimental group showed no difference with those of the control group (P>0.05). V nose, V larynx, APHP and APTE showed no difference before and after treatment within the experimental group (P>0.05). After treatment, the V total, V tongue, V palate, V mouth, SMIN and APSP in the experimental group were significantly increased (P<0.05). CONCLUSIONS: Extraction treatment can widen the airway, suggesting that there may be a certain correlation between the changes of condyle position and upper airway volume.

Key words: Skeletal ClassⅡ high angle, Extraction rectification, Condyle, Upper airway

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