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拔牙矫治对骨性Ⅱ类高角青少年患者上气道形态及舌骨位置的影响
陈玉1,胡敏2*
0
(1. 海军军医大学(第二军医大学)第一附属医院口腔科, 上海 200433;
2. 吉林大学口腔医院正畸科, 长春 130021
*通信作者)
摘要:
目的 探讨拔牙矫治对骨性Ⅱ类高角青少年患者上气道及舌骨位置的影响。方法 从吉林大学口腔医院正畸科病例库中选取2013年1月至2019年1月就诊且结束治疗的骨性Ⅱ类高角青少年患者 60例为研究对象,均采用直丝弓矫治技术。按矫治策略将患者分为拔牙组和非拔牙组,每组30例。对患者矫治前后头颅定位侧位X线片的上气道、舌骨及颅颌面组织进行定点描绘和测量分析。结果 与矫治前比较,拔牙组患者矫治后上牙槽座点-鼻根点-下牙槽座点角(ANB)、上中切牙长轴与前颅底平面的下内角(U1-SN)、下中切牙长轴与下颌平面的上内角(L1-MP)均减小,后鼻棘点与上咽壁点的线距(PNS-UPW)、后鼻棘点与会厌谷点的线距(PNS-V)、舌骨点与蝶鞍点的距离(H-S)、(牙合)平面与前颅底平面的夹角(OP-SN)、上中切牙长轴与下中切牙长轴的夹角(U1-L1)均增加,差异均有统计学意义(P均<0.05)。与矫治前比较,非拔牙组患者矫治后ANB减小,PNS-V、H-S、OP-SN增加,差异均有统计学意义(P均<0.05)。结论 由于生长发育的优势,骨性Ⅱ类高角青少年患者在拔牙矫治与非拔牙矫治后上气道矢状径和垂直高度均有一定程度增加,舌骨位置呈向下、向前移位的趋势,拔牙矫治对骨性Ⅱ类高角青少年患者的上气道几乎未产生不利影响。
关键词:  拔牙矫治  骨性Ⅱ类  高角  上气道  舌骨
DOI:10.16781/j.CN31-2187/R.20230440
投稿时间:2023-08-04修订日期:2023-10-14
基金项目:国家自然科学基金(81870795).
Effects of extraction orthodontic treatment on upper airway morphology and hyoid bone position in adolescent patients with skeletal class Ⅱ high angle
CHEN Yu1,HU Min2*
(1. Department of Stomatology, The First Affiliated Hospital of Naval Medical University(Second Military Medical University), Shanghai 200433, China;
2. Department of Orthodontics, Hospital of Stomatology, Jilin University, Changchun 130021, Jilin, China)
Abstract:
Objective To explore the effects of extraction orthodontic treatment on upper airway morphology and hyoid bone position in adolescent patients with skeletal class Ⅱ high angle. Methods Sixty adolescent patients with skeletal classⅡ high angle who were treated in the Department of Orthodontics, Hospital of Stomatology, Jilin University from Jan. 2013 to Jan. 2019 were enrolled. All of them were treated with straight wire appliance. According to the different treatment strategies, they were divided into extraction group and non-extraction group, with 30 cases in each group. The upper airway, hyoid bone, and craniomaxillofacial tissue of the lateral cephalograms were fixed-point, depicted, and measured before and after orthodontic treatment. Results Compared with before treatment, the extraction group showed decreases in subspinale-nasion-supramental angle (ANB), upper incisor-SN plane (U1-SN), and lower incisor-mandibular plane (L1-MP) after treatment, while showed increases in posterior nasal spine-upper pharyngeal wall (PNS-UPW), posterior nasal spine-vallecula (PNS-V), hyoid-sella (H-S), occlusal plane-SN plane (OP-SN), and upper incisor-lower incisor (U1-L1), with statistically significant differences (all P<0.05). Compared with before treatment, the non-extraction group showed a decrease in ANB and increases in PNS-V, H-S, and OP-SN after treatment, also with statistically significant differences (all P<0.05). Conclusion Due to the growth and development of adolescents, the sagittal diameter and vertical height of the upper airway in adolescent patients with skeletal classⅡ high angle increase to a certain extent after treatment in both groups, and the hyoid bone position shows a trend of downward and forward displacement. Therefore, extraction orthodontic treatment has almost no adverse effect on the upper airway of adolescent patients with skeletal class Ⅱ high angle.
Key words:  orthodontic treatment with extraction  skeletal class Ⅱ  high angle  upper airway  hyoid bone