口腔矫治器长期治疗OSA患者的牙列三维变化评估

The long term three-dimensional occlusal evaluation of oral appliance for obstructive sleep apnea patients

目的 观察长期戴用口腔矫治器治疗OSA后患者的牙列咬合变化。方法 以70例平均戴用下颌前伸型矫治器7年4个月的OSA患者为研究对象。由5位专业正畸医师对比评价每位病人的初始、阶段记存模型，将总样本分为三个疗效评估组：良好变化组（16例）、无/微小变化组（31例）和不良变化组（23例），利用MicroScribc-3DX三维牙颌模型分析系统进行模型测量，分析不同疗效组间咬合变化的差异。结果 不良咬合变化组通常与良好变化组或无／微小变化组之间存在着很多显著性差异，良好变化组和无/微小变化组之间的差异较少。不良变化组的平均变化量通常是三组中最大的。结论 长期使用下颌前伸型矫治器治疗OSA的过程中，牙列咬合状态会在三维方向上发生变化，这种变化可依初始咬合状态的不同而被视为良性作用或不良副作用。治疗前有较深覆牿或／和较深覆盖及安氏Ⅱ类倾向的病例能够在长期戴用中获得较满意的牙列变化。

Objective To evaluate three-dimensional （3D） occlusal changes of long-term oral appliance （OA） effect on obstructive sleep apnca （OSA） patients. Methods Seventy OSA patients had been treated with OA for a mean term of 7 years and 4 months. They were divided into three Evaluation group （favorable; no/minor; unfavorable） based on their baseline and follow-up dental study models by five orthodontists. The study models were analyzed with MicroScribe-3DX system to identify the differences among groups. Results There were many significant differences between unfavorable and favorable/no/ minor changes groups while few differences could be found between favorable and no/minor changes groups. The average changes of unfavorable group were the greatest among three groups. Conclusions The occlusion can be affected in a 3D way during long-term OA use. It can be regarded as a beneficial effects or adverse side-effccts based on the baseline occlusion. The cases with a deeper ovcrbite/overjet and an Angle Ⅱ tendency would be expected better occlusal changes.