口腔矫治器治疗不同垂直骨面型的骨性Ⅱ类错[牙合]畸形伴阻塞性睡眠呼吸暂停综合征患者上气道形态变化的锥形束CT分析

Morphological change analysis based on cone beam CT of the upper airway for obstructive sleep apnea syndrome patients treated with oral appliance in skeletal classⅡmalocclusion with different vertical patterns

目的通过锥形束CT(CBCT)影像比较研究口腔矫治器治疗不同垂直骨面型的骨性Ⅱ类错[牙合]畸形伴阻塞性睡眠呼吸暂停综合征(OSAS)患者前后上气道三维形态变化。方法采用口腔矫治器对多导睡眠监测仪及白天嗜睡量表诊断为OSAS且为骨性Ⅱ类[牙合]畸形的36例患者进行治疗,戴用矫治器治疗4个月后,进行CBCT扫描分析不同垂直骨面型的OSAS患者治疗前后腭咽、舌咽等不同部位上气道形态的三维改变。结果与治疗前相比,在戴用可调式矫治器4个月时,所有患者的腭咽容积测量值均显著增加(P<0.05);低角和均角患者的舌咽各项测量值均显著提高(P<0.05),高角患者的舌咽测量值中仅矢状向变化有显著差异,其余测量值变化的差异无统计学意义。结论口腔治疗器治疗下颌后缩的OSAS患者时,能显著改善低角患者和均角患者的上气道形态,但高角患者的上气道形态变化不大。

Objective To analyze the morphological changes in the upper airway of obstructive sleep apnea syndrome(OSAS)patients treated with oral appliance in skeletal classⅡmalocclusion with different vertical features by using cone beam CT(CBCT).Methods Thirty-six patients diagnosed with OSAS by polysomnography and daytime sleepiness scale and skeletal classⅡmalocclusion were treated with oral appliance for 4 months.The changes based on CBCT in the morphology of glossopharyngeal and palatopharyngeal before and after treatment in OSAS patients with different vertical features were compared.Results After treatment with oral appliance,the glossopharyngeal and palatopharyngeal morphologies of patients with mild OSAS showed significant changes.After treatment with oral appliance,the glossopharyngeal morphology of all patients showed significant changes(P<0.05).The palatopharyngeal morphology of patients in the lower and average groups also exhibited significant changes(P<0.05).Sagittal changes in the glossopharyngeal measurements of high-angle patients demonstrated significant difference,whereas the other measured values showed no significant difference.Conclusion The morphological changes in the upper airway were significant in OSAS patients with lower and average vertical patterns when treated with oral appliance,but the changes in high vertical patterns were not significant.