应用颈椎骨龄定量分期法评价正常青少年上下颌骨垂直向及纵向变化的研究

The longitudinal vertical changes of maxilla and mandible according to Quantitative Cervical Vertebral Maturation

目的:以颈椎骨龄定量分期法(QCVM)为划分标准,探讨QCVMI→Ⅳ期上下颌骨垂直向生长量、相对生长速率和生长完成百分比的变化特点。方法:对901名中小学生,每年定期拍摄正中位头颅侧位片及手腕骨片,连续6年,资料完整者87名(女55名,男32名),组成8～18岁正常青少年的混合纵向资料。按照颈椎骨龄定量分期法(QCVM),观察各期上下颌骨垂直向的变化。结果:①.上下颌骨垂直向各参数最大平均生长量均处于QCVM第Ⅱ期,最小生长量均处于QCVM第Ⅳ期;第二大生长量下颌处于第Ⅲ期,上颌处于第Ⅰ期;②.相对生长速率的快慢与生长量的大小并非完全一致。上颌前后部高度最大相对速率均处于QCVM第Ⅰ期,而下颌高度最大相对生长速率发生在第Ⅱ期,第Ⅰ期次之;③.下颌骨高度在QCVM第Ⅱ期结束时仍有约30%的生长潜力,而上颌骨前后高度在QCVM第Ⅱ期完成生长约85%,男女性别没有显著差异。结论:颈椎骨龄定量分期法能评估上下颌骨高度在不同的骨龄发育阶段的生长量、相对生长速率、生长完成百分比,对正畸临床有一定的参考价值。

Objective：To investigate the longitudinal vertical changes of maxilla and mandible according to Quantitative Cervical Vertebral Maturation（QCVM）for adolescents with normal occlusion.Method：Mixed longitudinal data were used.The samples included 87 adolescents aged from 8 to 18 years with normal occlusion（32 males,55 females）selected from 901 candidates.Lateral cephalograms and hand-wrist films were taken once a year,for 6 consecutive years.The growth magnitude（GM）,relative growth rate（RGR）and the percentage of growth remaining（PGR）of vertical parameters according to QCVM were measured and analyzed.Result：GM and RGR were not always consistent.For both genders,the largest GMs of maxillary and mandibular height were both in QCVM stage Ⅱ,with the least being in QCVM stage Ⅳ.The next largest GM of maxilla was in stage Ⅱ,however,for mandible was in stage Ⅲ The largest RGR of maxillary height was in QCVM stage Ⅰ;then,deceleration occurred.The largest RGR of mandibular height was in stage Ⅱ,and the next largest was in stage Ⅰ.Approximate 85 % of maxillary vertical growth and 70 % of mandibular vertical growth completed at the end of QCVM stage Ⅱ.Conclusion：QCVM can assess GM,estimate RGR and predict PGR.It has a bright future in clinical application of orthodontic treatment and orthognathic surgery.