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上颌交替式快速扩缩后气道的二维和三维变化 被引量:2

2-D and 3-D Evaluation of Upper Airway Changes After Maxillary Expansion with the Alt-RAMEC Protocol
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摘要 目的:利用头影测量和CBCT三维重建评估上颌快速扩缩后气道变化。方法:选择上颌发育不足的Ⅲ类儿童43例(男20,女23)。患者扩弓矫治器,并按要求扩缩6周。扩缩前后分别拍摄CBCT和头颅侧位片并进行测量分析,所有结果通过配对t检验和Meta回归进行数据分析。结果:上颌扩缩后,SNA、ANS-TVL、PNS-AD1、AD2-PNS、鼻咽腔直径和PNS-Ba长度改变较为明显(P<0.001),Ba-AD1和Ptm-Ba扩弓前后没有明显变化,腭咽和舌咽体积均有明显增大(P<0.005)。HP、SP和SCV平面的横截面积也明显增大(P<0.005),HP平面上气道横截面积和ANS-TVL长度有相关性(r2=0.78).结论:上颌交替式快速扩缩可促进上颌骨向前发育,增加气道容积,明显改善上颌发育不足的Ⅲ类错畸形患儿的通气状况。 Objective:To evaluate the upper airway changes after maxillary expansion with the AltRAMEC protocol using lateral cephalometric radiographs and CBCT.Methods:A total of 43children(20male,23female)with ClassⅢ malocclusion and maxillary deficiency(average age 9.2±1.8years)who required maxillary expansion with the Alt-RAME protocol as part of the comprehensive orthodontic treatment was included in the study.Patients were instructed to turn the jack screw two turns(0.5mm)per day during the first week and close it two turns(0.5mm)per day the following week.This procedure was repeated for six weeks CBCT images and lateral cephalometric radiographs were taken before and after treatment.Data were analyzed using a two-tailed paired Student's t-test and a meta-regression.Results:After maxillary expansion,the cephalometric variable SNA increased significantly from 78.2°to 79.9°(P〈0.001)and ANS-TVL length decreased significantly from 8.53 mm to 7.59mm(P〈0.001)with the alt-RAMEC protocol.No significant differences were found in terms of SNB,AD1-Ba and Ba-Ptm.However,the oropharyngeal volumes and cross sectional areas for the three planes evaluated by CBCT were all found to increase significantly after treatment(P〈0.05).The cross sectional areas in the HP planewere strongly correlated with the ANS-TVL length(r2=0.78).Conclusion:Maxillary expansion using the Alt-RAMEC protocol resulted in forward movement of the maxilla and increase in nasal airway volume.Patients with mild ClassⅢ malocclusion,narrow maxilla and nasal airway insufficiency may benefit from treatment with this expansion protocol.
出处 《武汉大学学报(医学版)》 CAS 2016年第6期960-964,共5页 Medical Journal of Wuhan University
关键词 交替式扩缩 Ⅲ类错 气道 Alt-RAMEC ClassⅢ Malocclusion Airway
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