Journal of Prevention and Treatment for Stomatological Diseases ›› 2021, Vol. 29 ›› Issue (8): 541-547.DOI: 10.12016/j.issn.2096-1456.2021.08.006

• Clinical Study • Previous Articles     Next Articles

Two methods of treatment for skeletal Class Ⅲ malocclusion on airway changes before and after clinical research

LIU Li1(),ZHOU Yan2(),ZHANG Daling2,WANG Yuanyuan2   

  1. 1. Department of Orthodontics, Affiliated Stomatological Hospital of Guilin Medical University, Guilin 541001, China
    2. Department of Orthodontics, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
  • Received:2021-01-08 Revised:2021-03-11 Online:2021-08-20 Published:2021-05-13
  • Contact: Yan ZHOU
  • Supported by:
    Guangxi Scientific Research and Technology Development Program(GKG1598012-5);Project to improve the basic scientific research ability of young and middle-aged teachers in Guangxi Universities(2020KY12027)

两种方法矫治骨性Ⅲ类错牙合前、后上气道变化的临床研究

刘莉1(),周嫣2(),张大灵2,王源元2   

  1. 1.桂林医学院附属口腔医院口腔正畸科,广西壮族自治区 桂林(541001)
    2.广西壮族自治区人民医院口腔正畸科,广西壮族自治区 南宁(530021)
  • 通讯作者: 周嫣
  • 作者简介:刘莉,主治医师,硕士,Email:kqysll@163.com
  • 基金资助:
    广西科学研究与技术开发计划项目(GKG1598012-5);广西高校中青年教师科研基础能力提升项目(2020KY12027)

Abstract:

Objective To investigate the changes in the sagittal diameter of the upper airway before and after the treatment of skeletal Class Ⅲ malocclusion in adults with microimplant anchorage and class Ⅲ intermaxillary elastics and to provide a reference for clinical treatment. Methods A total of 35 adult patients with skeletal Class Ⅲ malocclusion were selected to be treated with the straight-wire technique. Microimplant group, 15 cases (group A): patients with severe skeletal Class Ⅲ malocclusion (vertical high angle) were treated with the straight-wire technique combined with microimplant anchorage; class Ⅲ intermaxillary elastics group, 20 cases (group B): Patients with mild or moderate skeletal Class Ⅲ malocclusion (vertical low angle and average angle) were treated with the straight-wire technique combined with class Ⅲ intermaxillary elastics, and cephalometric radiographs obtained before and after treatment in the upper airway in the two groups were measured and analyzed. Results Changes in cranial and maxillofacial measurements after correction: in group A, (sella-nasion-supramental angle) the SNB angle decreased significantly (P < 0.05), and (subspinale-nasion-supramental angle) the ANB angle increased significantly (P < 0.05). In group B, the SNB angle decreased significantly (P < 0.05), while (subspinale-nasion-subspinale angle) the SNA angle、ANB angle and anterior skull base plane-mandibular plane angle (Sn-MP) angle increased significantly (P < 0.05). Changes in sagittal diameter of the upper airway measurements after corrections: In group A, the width of the glossopharyngeal segment of the upper airway (TB-TPPW) decreased significantly (P < 0.05). In group B, first segment width of the upper airway behind the hard palate (PNS-R) increased significantly (P < 0.05). After correction, the decreased SNB and increased ANB in group A was higher than that in group B, and the difference was statistically significant (P < 0.05). The decreased of TB-TPPW in upper airway of group A was greater than that of group B, and the difference was statistically significant (P < 0.05). Conclusions In the treatment of skeletal class Ⅲ malocclusion with microimplant anchorage, the sagittal diameter of the glossopharyngeal segment of the upper airway has a negative impact.

Key words: sagittal diameter of the upper airway, Class Ⅲ intermaxillary elastics, microimplant, skeletal Class Ⅲ malocclusion, orthodontic treatment, cephalometric radiographs, obstructive sleep and hypopnea syndrome, mandibular plane angle

摘要:

目的 探讨微种植体支抗与颌间Ⅲ类牵引矫治成人骨性Ⅲ类错牙合前后上气道矢状径的变化,为临床治疗提供参考。方法 选取35例成人骨性Ⅲ类错牙合患者,利用直丝弓矫治技术矫治,微种植体组15例(A组):骨性Ⅲ类错牙合重度病例(垂直高角)选择配合微种植体支抗;颌间Ⅲ类牵引组20例(B组):骨性Ⅲ类错牙合轻、中度病例(垂直低角、均角)选择配合颌间Ⅲ类牵引,测量分析矫治前后的头颅定位侧位片。结果 矫治后颅颌面测量指标的变化:A组蝶鞍中心-鼻根点-下牙槽座点构成的角(sella-nasion-supramental angle,SNB角)减小(P < 0.05),上牙槽座点-鼻根点-下牙槽座点构成的角(subspinale-nasion-supramental angle,ANB角)增大(P < 0.05);B组SNB角减小(P < 0.05),蝶鞍中心-鼻根点-上牙槽座点构成的角(sella-nasion-subspinale angle,SNA角)、ANB角、下颌平面角(anterior skull base plane-mandibular plane angle,SN-MP角)增大(P < 0.05)。矫治后上气道矢状径测量指标的变化:A组上气道矢状径舌咽段(TB-TPPW)减小(P < 0.05);B组上气道矢状径鼻咽第一段(PNS-R)增大(P < 0.05)。矫治后A组SNB减小、ANB增大的量大于B组,差异有统计学意义(P < 0.05);A组上气道TB-TPPW减小的量大于B组,差异有统计学意义(P < 0.05)。结论 利用微种植体支抗矫治成人骨性Ⅲ类错牙合,对上气道矢状径舌咽段产生消极影响。

关键词: 上气道矢状径, 颌间Ⅲ类牵引, 微种植体, 骨性Ⅲ类错牙合, 正畸矫治, 头颅定位侧位片, 阻塞性睡眠呼吸暂停低通气综合征, 下颌平面角

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