预成型肌功能矫治器(T4K)早期矫治对安氏Ⅱ类下颌后缩患者上气道的影响

Effect of early correction of pre-formed muscle function appliance (T4K) on upper airway of patients with ClassⅡ mandibular retraction

目的本研究探讨预成型肌功能矫治器(T4K)对替牙期安氏Ⅱ类下颌后缩患者矫治前后上气道的影响。方法选择从2018年2月到2018年8月在江苏省口腔医院正畸科接受治疗的23例替牙列期安氏Ⅱ类下颌后缩的患者,平均年龄(7.0±1.04)岁,使用预成型肌功能矫治器(T4K)对患者进行6个月的矫治,拍摄治疗前后CBCT,应用Dolphin 3D 11.9软件进行三维重建,采用SPSS 25.0软件进行统计学分析比较分析患者治疗前、后的测量相关指标变化。结果患者经过治疗6个月后,上气道总体积(V总)、鼻咽段体积(V鼻咽)、舌咽段体积(V舌咽)与治疗前结果相比,有统计学意义(P<0.05),其中鼻咽段体积(V鼻咽)变化最为显著;治疗后上气道鼻咽段最小横截面积(S鼻咽)、舌咽段最小横截面积(S舌咽)有增大变化,差异均有统计学意义(P<0.05);矫治前后腭咽段体积(V腭咽)与最小横截面(S腭咽)积增大,但无统计学意义。结论通过T4K肌功能矫治器引导下颌向前移动,有利于扩张上气道扩张,对改善安氏Ⅱ类患者气道具有一定的疗效。通过早期的肌功能训练,有利于患者破除口腔不良习惯,训练舌头的位置和纠正口呼吸,恢复口周肌力的平衡,促进患者颅颌面与气道的正常生长。但对于不同骨型、不同错牙合畸形的影响仍待进一步研究。

Objective To investigate the effect of pre-formed muscle function appliance(T4 K) on upper airway before and after orthodontic treatment of Class Ⅱ mandibular retraction in the dentition period. Methods Twenty-three patients with ClassⅡ mandibular retraction who underwent treatment in the orthodontic department of Jiangsu Provincial Stomatological Hospital from February 2018 to August 2018, with an average age of 7.0 ± 1.04 years were selected. The muscle function appliance(T4 K) was used to correct the patients for 6 months. The cone beam CT was taken before and after treatment. The Dolphin 3 D 11.9 software was used for 3 D reconstruction. The statistical analysis was performed by SPSS 25.0 software to compare the changes of related indicators before and after treatment. Results After 6 months of treatment, the total volume, nasopharyngeal volume, and the glossopharyngeal volume of the upper airway were statistically significant compared with the results before treatment(P<0.05), wherein the volume of the nasopharyngeal changed most significantly(P=0.01). After treatment, the minimum cross-sectional area of the nasopharyngeal and the glossophary-ngeal increased, and the differences were statistically significant(P<0.05). The volume and the minimum cross-sectional area of the Velopharynx increased after treatment, but the difference was not statistically significant(P>0.05). Conclusion The maxillofacail function correction by pre-forming muscle function appliance(T4 K) guides the mandibular movement forward, which is conducive to the expansion of the upper airway expansion, and has certain curative effect on improving the airway of Class Ⅱ patients. Through early muscle function training, it is beneficial for patients to get rid of bad oral habits, train the position of the tongue and correct mouth breathing, restore the balance of the perioral muscle strength, and promote the normal growth of the cranial and maxillofacial and airway. However, the effects on different bone types and different malformations remain to be further studied.