骨性Ⅱ类错畸形颌骨生长模式与上气道相关研究

Evaluation of pharyngeal space in different growth pattern of Class Ⅱ skeletal malocclusion

目的评价安氏Ⅱ类错畸形患者上下颌骨矢状向不同生长模式对上气道位置形态的影响。方法选取2015年2月至2016年3月就诊于乌鲁木齐市口腔医院正畸科的安氏Ⅱ类均角错畸形汉族男性患者40例,按照78.5°≤SNA角≤86.8°为上颌正常、76.2°≤SNB角≤84.0°为下颌正常标准,将患者分为上下颌正常组(A组)12例、上颌正常下颌后缩组(B组)10例、上颌前突下颌正常组(C组)9例、双颌后缩组(D组)9例。分析患者术前颅面部锥体束计算机断层扫描(CBCT)片。结果上下颌不同生长型组ANB角、FMA角、下颌骨总长、下颌骨体长、ad1-PNS、ad2-PNS、ANS-PNS to PPW、AAO-PNS、P-PP、PH-PPH、ANS-PNS to P角、P-SN及M-SN等差异均有统计学意义(均P<0.05);并且各组间比较结果均有不同程度的差异性,且差异性具有统计学意义。结论安氏Ⅱ类错畸形患者上下颌骨矢状向不同生长模式间口咽部及软腭部形态存在着显著差异,根据生长模式的不同运用合适的矫治器可以在一定程度上改善呼吸。

Objective To assess whether morphology and dimension of pharyngeal airway is different in untreated skeletal Class Ⅱ subjects with normal facial pattern characterized by various growth patterns of maxilla and mandible.Methods Fourty young men＆#39;s CBCT of Class Ⅱ malocclusion with normal facial vertical pattern were selected from February 2015 to March 2016 in Urumqi Stomatological Hospital Orthodontic Division.The 78.5° ≤SNA≤86.8° was regarded as normal maxilla and 76.2° ≤ SNB ≤ 84° as normal mandible,and the samples were accordingy divided into four groups：12 cases in normal group （group A）,10 cases in retrognathic mandible with normal maxilla group （group B）,9 cases in prognathic maxilla with normal mandible group （group C）,9 cases in retrognathic double jaw group （group D）.Analyze the pretherapeutic cone-beam computed tomography（CBCT）scans.Results There was significant difference in the linear measurements in different groups,including∠ ANB,∠ FMA,∠ ANS-PNS to P,adl-PNS,ad2-PNS,ANS-PNS to PPW,AAO-PNS,P-PP,PH-PPH,P-SN,M-SN,the mandible length and the somatic part of mandible length,and the difference was statistically significant.The comparison results among groups also had difference,and the difference had statistical significance.Conclusion A significant relation exists between oropharynx pattern and the sofi palate pattern and growth pattern of maxilla and mandible with normal facial vertical pattern in Class Ⅱ subjects.According to various growth patterns,different growth modification appliance can be used to improve the pharyngeal airway.