不同矢状向骨性错[牙合]患者的舌骨位置比较

Comparison of hyoid bone positions among patients with different sagittal skeletal malocclusions

目的比较三类矢状向骨性错[牙合]患者的舌骨位置差异,为临床治疗提供参考。方法选取284例正畸患者的头颅侧位片,根据ANB角大小确定患者的矢状向骨性错[牙合]类型:骨性Ⅰ类(1°≤ANB≤5°)、Ⅱ类(ANB>5°)、Ⅲ类(ANB<1°);使用10项指标确定舌骨位置;比较三类患者的舌骨位置并基于性别和年龄进行分层分析。结果骨性Ⅰ类、Ⅱ类和Ⅲ类患者的人口学和垂直面型特征差异均无统计学意义(P>0.05)。骨性Ⅱ类患者的下颌角点-舌骨点连线与舌骨点-颏下点连线的夹角(angle between Gonion-hyoid point line and hyoid point-Menton line,Go-Hy-Me)小于Ⅰ类患者,Ⅲ类患者的第三颈椎最前下点-舌骨点连线与舌骨点-蝶鞍点连线的夹角(angle between most anterior and inferior point of third cervical vertebra-hyoid point line and hyoid point-Sella line,C3-Hy-S)小于Ⅰ类患者(P<0.05)。年龄分层分析显示,未成年群体中,男性及女性Ⅲ类患者的C3-Hy-S均小于Ⅰ类患者(P<0.05)。成年群体中,女性Ⅱ类患者的Go-Hy-Me小于Ⅰ类患者,舌骨点至下颌平面的距离(distance from hyoid point to mandibular plane,Hy-MP)大于Ⅰ类患者(P<0.05),男性Ⅱ类患者的舌骨位置与Ⅰ类患者差异无统计学意义(P>0.05)。结论成年女性骨性Ⅱ类患者比Ⅰ类患者的舌骨更远离下颌;未成年骨性Ⅲ类患者比Ⅰ类患者的舌骨更远离颈椎与后颅底。

Objective To compare the hyoid bone position among patients with different sagittal skeletal malocclusions to provide a reference for clinicians to formulate treatment plans.Methods Lateral cephalograms of 284 orthodontic patients were selected.According to ANB angles,the types of skeletal malocclusion of patients were determined as follows:Class Ⅰ(1°≤ANB≤5°),Class Ⅱ(ANB>5°)and Class Ⅲ(ANB<1°).Ten parameters were used to determine hyoid positions.After comparing the hyoid positions of the three groups,stratified analyses based on sex and age were conducted.Results No significant differences in demographic and vertical facial type features among skeletal Classes Ⅰ,Ⅱ and Ⅲ patients were observed(P>0.05).The angle between the Gonion-hyoid point line and the hyoid point-Menton line(Go-Hy-Me)of Class Ⅱ patients was significantly smaller than that of Class Ⅰ patients,and the angle between the most anterior and inferior point of the third cervical vertebra-hyoid point line and the hyoid point-Sella line(C3-Hy-S)of ClassⅢpatients was smaller than that of Class Ⅰ patients(P<0.05).Age-stratified analysis showed that in the juvenile group,the C3-Hy-S of Class Ⅲ patients was significantly smaller than that of Class Ⅰ patients in males and females(P<0.05).In the adult female group,the Go-Hy-Me of Class Ⅱ patients was significantly smaller,and the distance from the hyoid point to the mandibular plane(Hy-MP)was larger than that noted in Class Ⅰ patients(P<0.05);no significant difference in hyoid position between male Class Ⅱ and Ⅰ patients was observed(P>0.05).Conclusions Compared with Class Ⅰ patients,the hyoid bone of Class Ⅱ patients in adult females was farther away from the mandible and that of Class Ⅲ patients in juveniles was farther away from the cervical vertebra and posterior cranial base.