OSAHS患者戴用口腔矫治器后颅面、上气道改变的追踪研究

A follow-up study on the dental and skeletal changes of patients with obstructive sleep apnea and hypopnea syndrome treating by oral appliance

目的观察经口腔矫治器治疗OSAHS的患者牙拾、骨骼以及上气道周围组织变化情况。方法对25例接受口腔矫治器治疗OSAHS的患者，通过治疗前后头影测量分析，观察患者牙耠、骨骼以及上气道周围组织的变化情况。结果25例使用VI腔矫治器的患者，经平均5年使用后，患者的覆盖减小（1．12±O．99）mm（P〈0．001）、覆骀减小（1．46±1．12）mm（P〈0．001），上中切牙内收（3．34±3．36）。（P〈0．001），下中切牙前倾（1．78±3．06）。（P＝0．008），下颌平面角MP-FH增大（1．36±1．41）。（P〈O．001）、下颌平面角MP-SN增大（1．32±1．35）。（P〈O．001），前面高、前下面高及舌骨-眶耳平面距增加。结论患者使用口腔矫治器后，牙齿咬合以及颌骨会发生微小的改变，医生应予以关注。

Objective To investigate dental and skeletal changes of oral appliance treating of obstructive sleep apnea and hypopnea syndrome in long-term treatment. Methods A total of 25 patients were included in the study. The cephalometric study was used to investigate the dental, skeletal and airway changes. Results 25 patients were treated with an oral appliance for a mean duration of 5 years. Significant retroclination of the maxillary incisors （3.34±3.36°, P〈0. 001） and proclination of the mandibular incisors （1.78±3. 06°, P=0. 008） were accompanied by reductions in overbite （1.46±1.12 mm, P〈0. 001） and overjet （1.12±0.99 mm, P〈0. 001）. The MP-FH, MP- SN angles increased 1.3°, the face height and the distance between the hyoid and FH plane increased. Conclusions The orthodontic side-effects on the dental, skeletal and airway are small during the treatment of patients with OSAHS.