夜间打鼾青少年安氏Ⅱ类错[牙合]患者应用SGTB功能矫治前、后上气道的变化

Changes of the upper airway in children with ClassⅡmandibular retrusion and snoring during night before and after functional treatment by sagittal-guidance Twin-block appliance

目的:使用SGTB功能矫治器治疗安氏Ⅱ类打鼾合并下颌骨后缩的患者,比较治疗前、后患者上气道的三维变化以及舌骨位置变化。方法:选择25例下颌骨后缩伴打鼾患者,采用SGTB矫治器治疗,于治疗前、后分别拍摄锥形束CT (CBCT),应用Dolphin 11.95软件进行气道三维测量,分析并比较功能矫治前后患者上气道的变化。利用Mimics 17.0软件对下颌骨进行三维重建,比较治疗前、后下颌骨及舌骨位置的变化。采用SPSS 16.0软件包进行数据处理。结果:治疗后,患者上气道总体积、鼻咽体积、口咽体积均较治疗前增大,差异有统计学意义(P<0.05);治疗后,患者会厌顶平面(TE)上气道的截面积较治疗前增大,会厌顶平面、会厌底平面横径均增大,差异均有统计学意义(P<0.05)。治疗后,患者舌骨位置较治疗前水平前移2 mm,具有统计学意义(P<0.05)。结论:SGTB功能矫治器治疗能显著增加下颌骨后缩儿童上气道体积,改善患者呼吸阻塞情况。

PURPOSE: To study the changes of dimension and morphology of upper airway in children with Class Ⅱmandibular retrusion after functional treatment by sagittal-guidance Twin-block appliance. METHODS: Cone-beam CT(CBCT) data of upper airway of the subjects were measured by Dolphin 11.5 software and Mimics 17.0 software, and the changes of dimension and morphology of upper airway before and after functional treatment with sagittal-guidance Twinblock(SGTB) appliance were compared. SPSS 16.0 software package was used for data processing. RESULTS: After functional treatment,the volume of total upper airway,nasopharynx airway, oropharynx airway, the sectional area of tip of the epiglotti(TE), the lateral diameter of TE, the base of the epiglottis(EB) significantly increased(P<0.05) in children with SGTB appliance. CONCLUSIONS: SGTB functional treatment is effective in the treatment of skeletal Class Ⅱmandibular retrusion of children by increase of the upper airway and improvement of respiration.