安氏Ⅰ类错牙合患者垂直向面型与自然头位及颈椎姿势的关系

Relationships between vertical facial pattern and natural head position,cervical posture in patients with skeletal classⅠrelationship

目的：探讨安氏Ⅰ类错牙合不同垂直向面型患者的自然头位及颈椎姿势,阐明安氏Ⅰ类错牙合垂直向面型与自然头位及颈椎姿势的关系。方法：选取年龄为8～15岁的安氏Ⅰ类错牙合患者94例作为研究对象。根据下颌平面角的不同将受试者分为高角组（31例）、均角组（33例）和低角组（30例）。拍摄患者自然头位头颅侧位片,并进行头影测量,并对3组间表达颅面形态、头位和颅颈姿势的变量进行比较。结果：高角组患者下颌平面与真垂线及颈椎间夹角（ML/VER、ML/OPT和ML/CVT）最小,低角组最大（P〈0.01）;高角组患者代表头位及颅颈姿势的变量（NSL/VER、FH/VER、NSL/OPT、NL/OPT、NSL/CVT和FH/CVT）最大,低角组最小（P〈0.05）;高角组患者下颌支与颈椎间夹角（RL/OPT和RL/CVT）最大,低角组最小（P〈0.01）;颈椎倾斜及颈曲（OPT/HOR、CVT/HOR和OPT/CVT）3组间比较差异无统计学意义（P〉0.05）。结论：安氏Ⅰ类错牙合不同垂直向面型（高、均和低角）患者自然头位及颈椎姿势有明显差异,高角者头位及颈椎姿势明显上扬,低角者相反。

Objective To investigate the natural head position and cervical posture in the patients with different vertical facial patterns with skeletal class Ⅰ relationship,and to clarify the relationships between vertical facial patterns and natural head position, cervical posture in the patients with skeletal class Ⅰ relationship. Methods 94 patients aged 8- 15 years old with skeletal class Ⅰ relationship were selected as the subjects.The subjects were classified into high angle group,average angle group,and low angle group according to their mandibular plane angles.The cephalometric radiographs in natural head position were taken,and the variables representing craniofacial morphology,head position,and craniocervical posture were measured.The intergroup differences in variables were compared.Results The inclinations of mandible to the true vertical and cervical column （ML/VER,ML/OPT,ML/CVT）were smallest in high angle group,and they were largest in low angle group （P 〈0.01）;other variables representing head posture and craniocervical posture （NSL/VER,FH/VER,NSL/OPT,NL/OPT,NSL/CVT,FH/CVT）were largest in high angle group,and they were smallest in low angle group （P 〈0.05）.The inclinations of ramus to cervical column （RL/OPT,RL/CVT）were largest in high angle group and they were smallest in low angle group （P 〈0.01）.There were no significant differences in the inclinations of cervical column and cervical lordosis （OPT/HOR,CVT/HOR,OPT/CVT）among three groups （P 〉0.05）. Conclusion The significant differences exist in natural head position and cervical posture among the patients with skeletal class Ⅰ relationship with different vertical facial patterns （high angle,average angle,low angle）;the subjects with high angle show extended head position and cervical posture,while the subjects with low angle exhibit the opposite tendency.