安氏Ⅱ类错矫治后上气道矢状径与牙颌指标的相关性

Correlation between Upper Airway Sagittal Diameter and Dental Jaw Indexes in Class Ⅱ Malocclusion after Orthodontic Treatment

目的探讨青少年安氏Ⅱ类错患者矫治前后上气道矢状径、牙颌指标的变化及两者相关性。方法选择2010年7月至2014年7月在泸州医学院附属医院就诊的60例安氏Ⅱ类错患者为研究对象,按照随机数字表法分为拔牙组(30例)和非拔牙组(30例),观察两组患者矫治前后上气道矢状径、牙颌指标的变化,并分析两者的相关性。结果治疗前,两组患者上气道矢状径测量结果比较,差异无统计学意义(P>0.05),拔牙组矫治前后上气道矢状径测量结果比较差异无统计学意义(P>0.05),非拔牙组矫治后后鼻棘点-颅底点(PNS-Ba)显著增加(P<0.05),其余上气道矢状径指标矫治前后比较差异无统计学意义(P>0.05)。矫治后拔牙组上牙槽座点-鼻根点-下牙槽座点(ANB角)、蝶鞍点-鼻根点-上牙槽座点(SNA角)、上颌中切牙牙轴与NA平面的交角(U1-NA角)、上颌中切牙牙轴与SN平面的交角(U1-SN角)、上中切牙切缘至NA连线的垂直距离(U1-NA距)、下中切牙点与NB的距离(L1-NB距)、上中切牙切缘至AP连线的垂直距离(U1-AP距)、下中切牙切缘与AP连线的垂直距离(L1-AP距)均显著减小,上下中切牙角(U1-L1角)明显增加(P<0.05);矫治后非拔牙组下中切牙长轴与下颌平面的交角(L1-MP角)、下切牙长轴与NB连线的交角(L1-NB角)、下中切牙点与NB的距离(L1-NB距)、下中切牙切缘与AP连线的垂直距离(L1-AP距)显著增加,上下中切牙角(U1-L1角)明显减小(P<0.05)。相关性分析显示拔牙组SNB角与TB点-TPPW点(TB-TPPW)、悬雍垂尖点-中咽壁(U-MPW)呈正相关,非拔牙组ANB角与SPP-SPPW呈负相关(均P<0.05)。结论对于安氏Ⅱ类错,拔牙矫治后SNB角与TB-TPPW、U-MPW变化呈正相关,非拔牙矫治后ANB角与SPP-SPPW变化呈负相关,影响矫治后患者气道大小的主要因素是上颌骨前后位置。

Objectlve To explore the upper airway sagittal diameter and dental jaw index changes and the correlation between them in teenager class Ⅱ malocclusion after orthodontic treatment. Methods Total of 60 class Ⅱ malocclusion patients in Luzhou Medical College Affiliated Hospital from Jul. 2010 to Jul. 2014 were included in the study,and were divided into an extraction group（30 cases） and a non-extraction group （30 cases） according to the random number table method, and the upper airway sagittal diameter and jaw index changes before and after treatment of the two groups were observed, and the correlation between them was analyzed. Results The upper airway sagittal diameter of the two group had no statistically significant difference before treatment（P 〉 0. 05 ）. After treatment, the upper airway sagittal diameter of the extraction group had no statistically significance too（ P 〉0. 05 ） ,PNS-Ba in the non-extraction group increased signifi- cantly（P 〈0. 05） ,and the rest of upper airway sagittal diameter indexes in the non-extraction group had no statistically significant difference （ P 〉 0. 05 ）. After treatment, the ANB angle, SNB angle, U1-NA angle, U1-SN angle, U1-NA distance, L1-NB distance, U1-AP distance, L1-AP distance of the extraction group decreased significantly（ P 〈 0. 05 ）, U1-L1 angle increased significantly （ P 〈 0. 05 ）. L1-MP angle, L1-NB angle, L1-NB distance, L1-AP distance of the non-extraction group increased significantly, U1-L1 angle sig- nificantly reduced （ P 〈 0. 05 ）. The correlation analysis showed that the angle of SNB was positively correla- ted with the TB-TPPW and U-MPW, and the ANB angle was negatively correlated with the SPP-SPPW（ P 〈 0. 05）. Conclusion For class Ⅱ malocclusion, after extraction treatment, SNB angle and TB-TPPW, U-MPW are positively related, and after non-extractian treatment, ANB angle and SPP-SPPW is negatively related,the main factors influencing the size of the patient＇s airway is maxillary anterepostorior position.