正畸联合正颌治疗骨性Ⅲ类畸形患者上气道临床研究

Clinical study of orthodontic combined with orthognathic treatment of upper airway in patients with bony Ⅲ type malformation

目的利用锥形束计算机扫描成像技术(CBCT)与Mimics软件分析正畸联合正颌治疗骨性Ⅲ类畸形患者的上气道体积、表面积及横截面积的变化。方法选取于北部战区总医院2015—2020年接受正畸联合正颌治疗的30例骨性Ⅲ类错牙合畸形患者为研究对象。将患者的CBCT文件导入Mimics 17.0中,测量气道体积(V_(1)、V_(2)、V_(3))、表面积(S_(4)、S_(5)、S_(6))与横截面积(S_(1)、S_(2)、S_(3))变化。结果患者矫治后的气道体积(V_(1)、V_(2)、V_(3))、表面积(S_(4)、S_(5)、S_(6))与横截面积(S_(1)、S_(3))均小于矫治前,但差异无统计学意义(P>0.05)。患者矫治后的横截面积S_(2)小于矫治前,差异有统计学意义(P<0.05)。结论正畸联合正颌治疗的骨性Ⅲ类畸形患者,矫治前后的气道体积、表面积与横截面积均减小,其中,口咽区过悬雍垂与舌接触点作平行于眶耳平面的水平面改变最大。

Objective The volume, surface area and cross-sectional area of the upper airway in patients with bony Ⅲ type deformity treated by orthodontic combined with orthognathic treatment were analyzed using cone beam computed tomography(CBCT)and Mimics software.Methods Thirty patients with bony Ⅲ type malocclusion who received orthodontic combined orthognathic treatment from 2015 to 2020 in the Department of Stomatology of the General Hospital of Northern Theater Command were selected as the research objects.CBCT files of patients were imported into Mimics 17.0,and changes in airway volume(V_(1),V_(2),V_(3)),surface area(S_(4),S_(5),S_(6))and cross-sectional area(S_(1),S_(2),S_(3))were measured.Results The airway volume(V_(1),V_(2),V_(3)),surface area(S_(4),S_(5),S_(6))and cross-sectional area(S_(1),S_(3))of the patients after treatment were all lower than before treatment, but the difference was not statistically significant(P>0.05).The cross-sectional area S_(2) after treatment was smaller than that before treatment, and the difference was statistically significant(P<0.05).Conclusion The volume, surface area and cross-sectional area of the airway in the patients with bony Ⅲ type deformity treated by orthodontic combined with orthognathic treatment all decreased before and after orthodontic treatment, and the greatest horizontal change was found at the contact point between the uvula in the oropharyngeal area and the tongue parallel to the orbital ear plane.