口呼吸与鼻呼吸儿童上气道矢状径差异的研究

目的 比较口呼吸与鼻呼吸儿童上气道矢状径的差异,探讨呼吸方式与上气道矢状径的关系。方法 通过口鼻气流同步测定系统的随机检测,选择鼻呼吸比例≤70％（口呼吸组）及≥95％（鼻呼吸组）的11－14岁儿童各34人,比较其头颅定位侧位片中上气道矢状径的差异。结果 口呼吸儿童骨性鼻咽（PNS－Ba）、舌咽部的最小距离（P－T）较鼻呼吸儿童明显减小。结论 鼻咽部骨性狭窄和扁桃体肥大是口呼吸的形态学原因,反映呼吸方式受遗传和环境两方面的影响。     

呼吸方式与舌骨位置关系的研究

目的：揭示呼吸方式与舌骨位置的关系。方法：通过口鼻气流同步测定系统的随机检测，选择鼻呼吸比例≤70％(口呼吸组)及鼻呼吸比例≥95％(鼻呼吸组)的11～14岁儿童各34人，比较其头颅定位侧位片中舌骨位置的差异，及与13呼吸比例的相关关系。结果：13呼吸与鼻呼吸儿童除H—RGn(P＜0．05)外，舌骨位置无统计学差异，单因素相关分析未发现呼吸时口气流所占的比例与舌骨位置存在相关关系(P＞0．05)。结论：呼吸方式与舌骨位置无明显关系。     

口呼吸与鼻呼吸儿童牙弓、基骨形态差异的研究

目的：比较口呼吸与鼻呼吸儿童牙弓、基骨形态的差异，探讨呼吸方式与牙弓、基骨形态的关系。方法：通过口鼻气流同步测定系统的随机检测，选择鼻呼吸比例≤70％(口呼吸组)及≥95％(鼻呼吸组)的11～14岁儿童各34人，测量石膏模型，比较其牙弓、基骨形态的差异。结果：①口呼吸儿童与鼻呼吸儿童相比腭盖较高，上颌基骨较窄，形态相对窄长。②口呼吸儿童比鼻呼吸儿童的上颌中、后段牙弓较长，牙弓形态相对窄长，下颌牙弓后段形态也相对窄长。结论：口呼吸可以引起儿童牙弓、基骨形态的改变。     

TMJ强直患者头影测量与阻塞性睡眠呼吸暂停综合征关系的初步分析

本研究通过１４例颞下颌关节强直继发阻塞性睡眠呼吸暂停综合征（ｏｂｓｔｒｕｃｔｉｖｅｓｌｅｅｐａｐ－ｎｅａｓｙｎｄｒｏｍｅ，ＯＳＡＳ）患者的头影测量结果和多导睡眠检测结果间的相关分析研究，初步建立睡眠呼吸暂停指数（ａｐｎｅａｉｎｄｅｘ，ＡＩ）与最小矢状咽径（ＰＡＳ）和舌、软腭占口咽腔比例（ＴＳＡ／ＯＰＡ）间的相关关系，及睡眠时最低血氧饱和度水平与最小矢状咽径间的关系。研究结果显示：最小矢状咽径与ＡＩ呈显著负相关；舌和软腭占口咽腔比例与ＡＩ呈显著正相关关系；与最低血氧饱和度（ＳａＯ２ｍｉｎ）水平呈显著负相关关系。     

口呼吸与鼻呼吸儿童颅面形态差异的研究

目的　比较口呼吸与鼻呼吸儿童颅面形态的差异 ,探讨呼吸方式与颅面形态的关系。方法　通过口鼻气流同步测定系统的随机检测 ,选择鼻呼吸比例≤ 70 % (口呼吸组 )及≥ 95 % (鼻呼吸组 )的 1 1～ 1 4岁儿童各 34名 ,比较其颅面硬组织形态的差异。结果　口呼吸儿童与鼻呼吸儿童相比 ,面部呈明显的垂直生长型 ,下颌平面角 (MP SN)为 39 3 ,明显大于鼻呼吸组 (33 2 ,P <0 0 1 ) ;下颌体长度较小 ,下颌角开大 ,颏部及面型后缩 (P <0 0 5) ;其矢状骨面型可表现为I、II、III各种类型 ,两组间差异无显著性。结论　口呼吸是造成颅面垂直向发育不调的因素之一。正畸医师应注意及时去除影响鼻呼吸的因素 ,纠正口呼吸的不良习惯 ,使颅面形态朝向正常的方向发展     

侧咬合He型及牙齿接触关系的观察

目的：研究侧咬合Ｈｅ型及牙接触关系，为临床应用提供Ｈｅ基础，材料方法：活体观察１４６名青年人侧咬合Ｈｅ型及牙齿接触关系。结果；侧咬合时，Ｈｅ型分组牙功能Ｈｅ最多，尖牙保护次之，沸合型最少。组牙功能Ｈｅ时，上下牙接触关系分为七种类型，其中以３４５６／３４５６最多（３１．０６％）。结论：青年的侧咬合时以组牙功能Ｈｅ最多，尖牙保护Ｈｅ次之，混合型最少；组牙功能Ｈｅ时，上下颌牙齿接触关系分为七种类型。     

儿童呼吸方式与颅面、气道、牙(牙合)形态的相关性研究

目的研究儿童呼吸方式与颅面、气道、牙骀形态的相关性。方法选择72例11～14岁的正畸科初诊患者，使用口鼻气流同步测量仪测量其口、鼻气流比例并计算口呼吸比例，在X线头影测量片和牙模型上测量颅面、气道、牙骀的形态学指标86项，通过t检验筛选出16项有统计学意义及临床意义的指标，进行多元回归分析（向后法）和简单直线回归分析。结果下面高与全面高之比（ANS-Me／N-Me）、下颌角（Ar-Go-Me）、扁桃体或舌根后缘与咽后壁的最小距离（P-T）、上颌基骨宽度（SHJK）与口呼吸比例的密切程度逐渐降低（P〈0．05），多元回归系数分别为3．359，0．012，-0．013，-0．021。结论儿童呼吸方式与颅面形态具有一定相关性。     

颞下颌关节紊乱病、错(牙合)患者及大学生咬合的比较研究

目的 探讨评价咬合的2项指标（近远中向的安氏错He分类及垂直向和唇（颊）舌向的覆He覆盖关系）在颞下颌关节紊乱病（temporomandibular disorders,TMD)组、大学生志愿者（US）组及错He患者（MAL）组间有无明显差别。方法 100例TMD、100例MAL、268名US，共468人，取研究模观察。结果 ①MAL组安氏I类的比例低于其他2组（P＜0.05)；②MAL组前牙反He和深覆盖比例明显高于其他2组（P＜0.05)；③覆He覆盖异常指数（后牙每1处积5分，前牙每1处积分积3分），MAL组明显高于US组（P＜0.05)，而TMD组与MAL组和US组差异均无显著性（P＞0.05)。结论 影响美观的前牙异常治疗需求高，而咬合异常与TMD未见显著相关关系。     

楔状缺损与咬合力关系的研究

目的 临床研究楔状缺损与He力的关系。方法 将123例患不同程度楔状缺损的中老年患者，按楔状缺损的程度分为无、轻、中、重度4组；使用电阻应变式咬合力计测量上颌尖牙、第一、二双尖牙、第一磨牙牙齿咬合力；用光He法测定上颌牙齿最高He接触强度。结果 楔状缺损患牙的咬合力低于无楔状缺损牙。上颌第一双尖牙的楔状缺损患牙的最高He接触强度高于未患牙、楔状缺损组中的第一磨牙和第一双澡牙相对于其邻牙的最高He接触强度增高。结论 He力与楔状缺损的发生有关。     

固定平面导板的临床应用研究

目的：分析固定平面导板在矫治深覆He时对牙、颌、面的影响。方法：对12例因深覆殆而无法粘贴下前牙托槽的错He患者，使用固定平面导板。治疗前后拍摄X线头颅侧位定位片，进行统计分析。结果：上下后牙齿槽高度明显增加，腭平面一下颌平面角治疗前后有显著差异。结论：固定平面导板矫治深覆He快速有效，且可调节面部比例关系，使面容更趋协调美观。     

不同鼻通气量硬腭上表面压强分布的有限元研究

目的通过测定不同鼻通气量硬腭上表面的压强,分析口呼吸对腭盖下降及错畸形影响的机制。方法利用锥形束计算机断层扫描(CBCT)数据和有限元相关软件重建1名健康志愿者的上气道及鼻腔三维模型,并修复空洞、平滑模型、网格划分后进行不同呼吸方式下的边界条件设定和数值模拟。结果成功建立健康人鼻呼吸上气道模型及鼻腔模型,获取了鼻呼吸的吸、呼两相上气道及不同截面的压力云图和不同鼻通气量吸、呼两相压力云图,计算得到不同鼻通气量时硬腭上表面的压强。结论随着鼻通气量的减小,吸气相气流对硬腭上表面压强逐渐增大,呼气相气流对硬腭上表面压强逐渐减小。二者均逐渐接近大气压。吸、呼两相鼻腔内压强梯度均逐渐减小。     

Effect of upper costal and costo-diaphragmatic breathing types on electromyographic activity of respiratory muscles

Aim:

To compare electromyographic (EMG) activity in young–adult subjects with different breathing types.

Methodology:

This study included 50 healthy male subjects with complete natural dentition, and no history of orofacial pain or craniomandibular-cervical-spinal disorders. Subjects were classified into two groups: upper costal breathing type, and costo-diaphragmatic breathing. Bipolar surface electrodes were located on sternocleidomastoid, diaphragm, external intercostal, and latissimus dorsi muscles. Electromyographic activity was recorded during the following tasks: (1) normal quiet breathing; (2) speaking the word ‘Mississippi’; (3) swallowing saliva; and (4) forced deep breathing.

Results:

Sternocleidomastoid and latissimus dorsi EMG activity was not significantly different between breathing types, whereas diaphragm and external intercostal EMG activity was significantly higher in the upper costal than costo-diaphragmatic breathing type in all tasks (P<0·05; Wilcoxon signed rank-sum test).

Conclusion:

Diaphragm and external intercostal EMG activity suggests that there could be differences in motor unit recruitment strategies depending on the breathing type.     

Dentofacial morphology and upper respiratory function in 8-10-year-old children

Mouth breathing has been associated with many unfavorable sequelae, the most significant of which are features such as excessively long and tapered (dolicofacial) face form, increased lower face height, and narrow maxillary arch form. The aim of this preliminary study was to assess the nature of associations between selected dentofacial morphological variables and respiratory mode as measured by percent nasality (%N), as part of an ongoing longitudinal study. Ninety-eight normal children (mean age = 8.95 years) were tested using a modified version of the Simultaneous Nasal and Oral Respirometric Technique for determining %N. Selected dentofacial morphological variables including total and lower anterior face heights, face width, and palatal arch width were measured. Statistical analysis was performed to test the strength of association between the measured dentofacial variables and %N. Small associations between morphologic features and respiratory mode were found, but none were statistically significant.     

Effects of breathing type on electromyographic activity of respiratory muscles at different body positions

Aim: To compare the effect of breathing type on the activity of respiratory muscles at different body positions.

Methodology: Two groups of 20 subjects each, one with upper costal and the other with costodiaphragmatic breathing, were studied. Electromyographic activity of sternocleidomastoid (SCM), diaphragm (DIA), external intercostal (EIC), and latissimus dorsi (LAT) muscles was recorded at standing and lateral decubitus positions during swallowing and maximal voluntary clenching.

Results: All muscles showed higher activity during standing in upper costal breathing subjects except the SCM muscle. EIC activity was higher during standing in the costodiaphragmatic breathing group. Subjects with upper costal breathing showed higher DIA activity than subjects with costodiaphragmatic breathing at both body positions and higher SCM activity at lateral decubitus position, whereas, EIC activity was only higher during swallowing.

Conclusions: Subjects with upper costal breathing presented higher respiratory effort than subjects with costodiaphragmatic breathing, being most prominent at the lateral decubitus position.     

腺样体肥大与牙颌面畸形的相关性研究

目的:分析不同程度腺样体肥大与牙颌面畸形相关性.方法:纳入10～14岁不同程度腺样体肥大者60例,其中口呼吸患者15例,10～14岁无腺样体肥大患者30例,作为对照组(A组).测量其头影侧位片A/N比值、牙颌面各项数据,按A/N比值大小分为3个组(A组:A/N ＜0.60;B组:0.60≤A/N ＜0.70;C组:A/N≥0.70,其中15例为无口呼吸者C1组,伴口呼吸者15例为C2组),每组30例.应用统计学分析各项项目的变异程度与腺样体肥大等级的相关性,以及单纯腺样体肥大患者与腺样体肥大伴口呼吸患者牙颌面畸形的差异.结果:A组与B组各项检测指标差异无统计学意义,C组U 1NA角和L1 NB角大于A组(P≤0.05).C2组NPogSN小于及GoGnSn角大于C1组(P≤0.05).结论:重度腺样体肥大(A/N≥0.70)伴MB患者表现为明显的下颌后缩,下颌平面角增大和牙齿唇倾,建议上述患者于6岁前行腺样体切除术.     

Changes in oropharyngeal airway and respiratory function during sleep after orthognathic surgery in patients with mandibular prognathism

The aim of this study was to examine the effects of mandibular setback surgery on pharyngeal airway space and respiratory function during sleep. The subjects were 22 patients in whom mandibular prognathism was corrected by bilateral sagittal split ramus osteotomy; either one jaw or two jaw surgery. Polysomnography was performed before surgery and 6 months after surgery, and the apnea hypopnea index (AHI) and arterial oxygen saturation during sleep were measured to assess respiratory function during sleep. Morphological changes were studied using cephalograms taken immediately before, a few days after and 6 months after surgery. As a control, 10 subjects without sleep-disordered breathing underwent the same examinations. AHI was not changed significantly after surgery, although two patients were diagnosed with mild obstructive sleep apnea (OSA) syndrome after surgery. They were not obese, but the amounts of mandibular setback at surgery were large. In conclusion, a large amount of mandibular setback might inhibit biological adaption and cause sleep-disordered breathing, and it might be better to consider maxillary advance or another technique that does not reduce the airway for patients with skeletal class III malocclusions who have large anteroposterior discrepancy and/or maxillary hypoplasia.