成年女性骨性Ⅱ类下颌后缩患者颏部与气道结构特征及相关性研究

Study of the characteristics and correlation of the chin and airway in skeletal ClassⅡadult female patients with mandibular retraction

目的探讨成年女性骨性Ⅱ类下颌后缩患者颏部与气道结构特征及其相关性,为临床诊断及治疗提供参考。方法本研究获得医院医学伦理委员会审批。选取成年女性骨性Ⅱ类下颌后缩均角患者40例为研究组,骨性Ⅰ类均角患者60例为对照组,拍摄锥形束CT(cone beam computed tomography,CBCT)并用三维测量软件测量,分析颏部形态位置、上气道形态相关指标。结果与骨性Ⅰ类患者相比,骨性Ⅱ类下颌后缩患者颏前厚度、颏部基骨体积、总体积小,颏角、颏凹陷、颏曲度、牙槽突面积大,差异具有统计学意义(P<0.05);Gn-V线距离、Gn-H线距离、Po-NB距离、面角小,Y轴角大,差异具有统计学意义(P<0.05);上气道总体积、舌咽上界横径、矢状径小,差异具有统计学意义(P<0.05)。骨性Ⅱ类下颌后缩患者颏部形态、位置与上气道形态相关性分析显示,骨性Ⅱ类下颌后缩患者颏角与喉咽长度呈负相关(r=-0.277,P<0.01);Po-NB距离与腭咽长度呈负相关(r=-0.222,P<0.05);颏高度(r=-0.261,P<0.01)、颏部基骨面积(r=-0.225,P<0.05)与腭咽上界横径呈负相关;颏最小厚度(r=0.245,P<0.05)、颏角(r=0.249,P<0.05)、牙槽突面积(r=0.213,P<0.05)与腭咽上界矢状径呈正相关;Gn-V线(r=0.217,P<0.05)、Po-NB距离(r=0.208,P<0.05)与舌咽上界横径呈正相关;颏前厚度与喉咽上界矢状径呈负相关(r=-0.211,P<0.05);颏凹陷与喉咽下界矢状径呈负相关(r=-0.237,P<0.05);颏曲度与喉咽下界横径呈正相关(r=0.231,P<0.05)。结论骨性Ⅱ类下颌后缩患者颏部发育不足,形态偏薄,颏部矢状向位置偏后,垂直向位置偏上,舌咽气道相对狭窄。骨性Ⅱ类下颌后缩患者颏部形态、位置与上气道形态存在相关性。

Objective To explore the characteristics and correlation of the chin and airway in females with skeletal ClassⅡmandibular retraction for reference for clinical diagnosis and therapy.Methods This study was approved by the hospital Medical Ethics Committee.Forty cases of skeletal ClassⅡmandibular retraction adult females with aver-age angle were selected as the research group,and sixty cases of skeletal ClassⅠpatients with average angle were se-lected as the control group.Cone-beam computed tomography(CBCT)images for all subjects were analyzed using three-dimensional modeling software.Measurements included the chin morphology,position,and upper airway morphology.Results Compared with skeletal Class I patients,patients with skeletal ClassⅡmandibular retraction had smaller an-terior chin thickness,base bone volume,chin total volume,and larger chin angle,chin depression,chin curvature,and alveolar area with statistically significant differences(P<0.05).Gn-V,Gn-H,Po-NB distance,and facial angle were smaller,and the Y-axis angle was larger in patients with skeletal ClassⅡmandibular retraction with statistically signifi-cant differences(P<0.05).Upper airway total volume,transverse and sagittal diameter of the glossopharynx upper boundary were smaller in patients with skeletal ClassⅡmandibular retraction with statistically significant differences(P<0.05).The correlation analysis between the morphology and position of the chin and the morphology of the upper airway in patients with ClassⅡmandibular retraction showed that there was a negative correlation between chin angle and laryngopharynx length in patients with ClassⅡmandibular retraction(r=-0.277,P<0.01).There was a negative correlation between Po-NB distance and palatopharyngeal length(r=-0.222,P<0.05).Chin height(r=-0.261,P<0.01)and basal bone area(r=-0.225,P<0.05)were negatively correlated with the transverse diameter of the palato-pharyngeal upper boundary.The minimum chin thickness(r=0.245,P<0.05),chin angle(r=0.249,P<0.05),and al-veolar area(r=0.213,P<0.05)were positively correlated with the sagittal diameter of the palatopharyngeal upper boundary.Gn-V(r=0.217,P<0.05)and Po-NB distance(r=0.208,P<0.05)were positively correlated with the trans-verse diameter of the glossopharynx upper boundary.Anterior chin thickness was negatively correlated with the sagittal diameter of the laryngopharynx upper boundary(r=-0.211,P<0.05).Chin depression was negatively correlated with the sagittal diameter of the laryngopharynx lower boundary(r=-0.237,P<0.05).Chin curvature was positively corre-lated with the transverse diameter of the laryngopharynx lower boundary(r=0.231,P<0.05).Conclusion Patients with skeletal ClassⅡmandibular retraction exhibit thinner chins.The sagittal position of the chin is backward,and the vertical position is upward.Patients with skeletal ClassⅡmandibular retraction have a narrow glossopharyngeal airway.There is a correlation between the morphology and position of the chin and the morphology of the upper airway in pa-tients with ClassⅡmandibular retraction.