前方牵引对骨性Ⅲ类口呼吸儿童面型及上气道的影响

The effect of maxillary protraction on facial shape and upper airway in children with skeletal type Ⅲ mouth breathing

目的:研究骨性Ⅲ类口呼吸前牙反[牙合]患儿在前方牵引矫治器治疗后面部形态及上气道的变化与治疗效果。方法:选取2019~2022年就诊于上海市儿童医院的16例骨性Ⅲ类口呼吸前牙反[牙合]患儿资料作为研究对象,男女各8例,平均年龄(6.81±1.80)岁,入组患儿均行单纯面具前方牵引矫治器进行治疗,治疗前后拍摄头颅侧位片,观察并对比治疗前后儿童面部形态及上气道间隙的变化。结果:治疗后上气道上间隙、中上间隙、鼻唇角、ANB均较治疗前增大(P<0.05)。上气道中间隙、下间隙、人中长度、上唇长度、面下1/3长度以及上唇/面下比例均较治疗前增大,上气道中下间隙、人中/上唇比例、面型角则较治疗前减小,除人中/上唇比例外,其余结果均无统计学意义。结论:对骨性Ⅲ类口呼吸前牙反[牙合]儿童行前方牵引矫治可增大上气道间隙并改善患者的侧貌面型,在改善患者口呼吸症状的同时促进上颌骨生长发育。

Objective:To study the changes in the posterior morphology and upper airway of children with skeletal Class Ⅲ respiratory anterior teeth crossbite treated with a maxillary protraction,and to observe the therapeutic effect of maxillary protraction on skeletal Class Ⅲ respiratory anterior teeth crossbite.Methods:Sixteen patients with skeletal Class Ⅲ respiratory anterior crossbite who visited Shanghai Children's Hospital from 2019 to 2022 were selected as the study subjects,including 8 males and 8 females,with an average age of(6.81±1.80)years.All enrolled patients were treated with a simple maxillary protraction.Cranial lateral films were taken before and after treatment to observe and compare the changes in facial morphology and upper airway space in children before and after treatment.Results:After treatment,the upper airway space,middle and upper airway space,nasolabial angle and ANB were significantly larger than those before treatment(P<0.05).The upper airway middle space,lower space,philtrum length,upper lip length,lower 1/3 of face length and upper lip/lower face ratio increased compared with those before treatment,while the upper airway middle and lower space,philtrum/upper lip ratio and face shape angle decreased compared with those before treatment.The results were not statistically significant except for the philtrum/upper lip ratio.Conclusion:Maxillary protraction can increase the upper airway space and improve the patient's profile in children with skeletal Class Ⅲ respiratory anterior teeth malocclusion,which not only improves the patient's respiratory symptoms but also promotes maxillary growth and development.