恒牙早期骨性Ⅱ类错■畸形下颌后缩患者Twin-block矫治后舌骨位置及上气道矢状径的变化

CHANGES IN HYOID BONE POSITION AND SAGITTAL DIAMETER OF THE UPPER AIRWAY AFTER TWIN-BLOCK CORRECTION IN PATIENTS WITH MANDIBULAR RETRACTION DUE TO CLASS Ⅱ SKELETAL MALOCCLUSION DEFORMITY IN EARLY PERMANENT DENTITION

目的评估恒牙早期的骨性Ⅱ类错[牙合]畸形下颌后缩患者经Twin-block矫治器治疗后,舌骨位置及上气道矢状径的变化,为临床预防阻塞性睡眠呼吸暂停综合征(OSAHS)提供理论支持。方法选取恒牙早期的骨性Ⅱ类错[牙合]畸形下颌后缩患者20例为试验组,采用Twin-block矫治器矫治;选取恒牙早期的骨性Ⅱ类错[牙合]畸形下颌后缩患者20例为对照组,采用固定矫治器矫治。试验组矫治时间为(18.4±2.6)个月,对照组矫治时间为(18.6±2.0)个月,其中试验组包括佩戴Twin-block矫治器及建立稳定咬合关系两个阶段,两组分别于佩戴矫治器前2周及矫治完成后拍摄头颅侧位X线片。利用WinCeph 8.0软件对收集的数据进行测量,采用SPSS 17.0软件对矫治前后的数据进行配对t检验。结果矫治完成后,对照组舌骨位置及上气道矢状径无显著变化(P<0.05);试验组AH-SN、AH-FH、AH-MP、AH-OP、AH-PP、AH-Ge、AH-Me、AH-C3、AH-NPo、C3-Me距离显著增加,AH-O距离显著减少(t=-5.178^-2.382,P<0.05);PNS-Ba、PNS-UPW、SPP-SPPW、Mc1-Mc2、U-MPW、TB-TPPW、V-LPW距离均显著增加(t=-6.728^-3.716,P<0.05)。结论 Twin-block矫治器可使恒牙早期骨性Ⅱ类错[牙合]畸形下颌后缩患者的上气道矢状径明显增大,舌骨前下移位。

[Objective]To investigate the changes in hyoid bone position and sagittal diameter of the upper airway after Twin-block correction in patients with mandibular retraction due to classⅡskeletal malocclusion deformity in early permanent dentition,and to provide theoretical support for clinical prevention of obstructive sleep apnea/hypopnea syndrome(OSAHS).[Me-thods]A total of 40 patients with mandibular retraction due to classⅡskeletal malocclusion deformity in early permanent dentition were enrolled,among whom 20 treated with Twin-block appliance were enrolled as experimental group and 20 treated with a fixed appliance were enrolled as control group.The correction time was(18.4±2.6)months in the experimental group and(18.6±2.0)months in the control group.The patients in the experimental group underwent two stages of wearing the Twin-block appliance and establishing a stable occlusion relationship.Lateral cephalometric radiograph was obtained at 2 weeks before the wearing of the appliance and after correction.WinCeph 8.0 was used for measurement,and SPSS 17.0 was used to perform the paired t-test of related data before and after correction.[Results]After correction,the control group had no significant changes in hyoid bone position and sagittal diameter of the upper airway(P<0.05),while the experimental group had significant increases in the distances of AH-SN,AH-FH,AH-MP,AH-OP,AH-PP,AH-Ge,AH-Me,AH-C3,AH-NPo,and C3-Me and a significant reduction in AH-O distance(t=-5.178--2.382,P<0.05),as well as significant increases in the distances of PNS-Ba,PNS-UPW,SPP-SPPW,Mc1-Mc2,U-MPW,TB-TPPW,and V-LPW(t=-6.728--3.716,P<0.05).[Conclusion]In patients with mandibular retraction due to classⅡskeletal malocclusion deformity in early permanent dentition,Twin-block appliance can significantly increase the sagittal diameter of the upper airway and lead to lower-front displacement of the hyoid bone.