青春期上颌快速扩弓对上呼吸道尺寸和功能的影响及长期有效性的系统评价再评价

目的:对青春期上颌快速扩弓(rapid maxillary expansion,RME)对上呼吸道尺寸和功能的影响及长期有效性的系统评价进行再评价.方法:检索Cochrane,EMBASE,Medline和PubMed数据库,搜索公开发表的关于上颌快速扩弓与上呼吸道关系的系统评价,时限均为建库至2020年4月,2名作者...     

上颌快速扩弓联合前方牵引治疗骨性Ⅲ类错牙合畸形对上气道影响的锥形束 CT 分析

目的：研究上颌快速扩弓联合前方牵引治疗骨性Ⅲ类错(牙合)畸形对上气道影响的三维变化。方法：选择53例伴上颌骨横向发育不足的骨性Ⅲ类错(牙合)畸形患者。所有患者先采用 Hyrax 矫治器进行上颌快速扩弓,然后前方牵引矫治。平均扩弓16 d,前方牵引平均5个月。分别于扩弓前（T0）、扩弓结束时（T1）及前方牵引结束时（T2）拍摄锥形束 CT 并进行三维重建和测量。结果：扩弓结束时鼻咽段最小截面积、最小截面积处冠状径和鼻咽段容积显著增大（P ＜0．05）;前方牵引矫治后鼻咽段4项指标与扩弓治疗前相比明显增大（P ＜0．05）。结论：上颌骨快速扩弓联合前方牵引可显著增加鼻咽段上气道容积。     

Effects of symmetric and asymmetric rapid maxillary expansion treatments on pharyngeal airway and sinus volume:: A cone-beam computed tomography study

ObjectiveTo evaluate pharyngeal airway and maxillary sinus volumes following symmetric rapid maxillary expansion (RME) and asymmetric rapid maxillary expansion (ARME) treatment using cone-beam computed tomography (CBCT).Materials and MethodsThe study consisted of 60 patients presenting to the orthodontics clinic with an indication that they required symmetric or asymmetric rapid maxillary expansion treatment. Individuals were included if they were aged 12–15 years and had symmetric (RME group; 14 girls, 16 boys) or asymmetric (ARME group; 16 girls, 14 boys) maxillary deficiency. Maxillary sinus volume (mm³) and pharyngeal airway volume (upper, lower, and total; mm³) were evaluated using CBCT records. The parameters were compared before treatment (T1) and after 3 months in retention (T2).ResultsAll measurements at T2 were increased significantly compared with T1 in the RME group (P < .05). In the ARME group, changes in the lower pharyngeal airway and the nonaffected maxillary sinus volumes (non-affected side of maxillary sinus volumes) were not significant; however, the other measurements increased significantly from T1 to T2 (P < .05). Intergroup comparisons revealed that total pharyngeal airway volume and total maxillary sinus volume changes were significantly greater in the RME group.ConclusionsPharyngeal airway and maxillary sinus volumes increased with both RME and ARME treatment. Both were found to be effective for treating transverse maxillary deficiency.     

Effects of rapid maxillary expansion on upper airway volume: A three-dimensional cone-beam computed tomography study

Objective:To compare changes in pharyngeal airway volume and minimal cross-sectional area (MCA) between patients undergoing rapid maxillary expansion (RME) and a matched control group and to identify markers for predicting airway changes using cone-beam computed tomography (CBCT).Materials and Methods:Pre- and posttreatment CBCT scans were selected of children who had RME (14 girls and 12 boys; mean age, 12.4 years) along with scans of a control group (matched for chronological age, skeletal age, gender, mandibular inclination) who underwent orthodontic treatment for minor malocclusions without RME. Changes in airway volume and MCA were evaluated using a standardized, previously validated method and analyzed by a mixed-effects linear regression model.Results:Upper airway volume and MCA increased significantly over time for both the RME and matched control groups (P < .01 and P = .05, respectively). Although the RME group showed a greater increase when compared with the matched controls, this difference was not statistically significant. A reduced skeletal age before treatment was a significant marker for a positive effect on the upper airway volume and MCA changes (P < .01).Conclusions:Tooth-borne RME is not associated with a significant change in upper airway volume or MCA in children when compared with controls. The younger the skeletal age before treatment, the more positive the effect on the upper airway changes. The results may prove valuable, especially in RME of young children.     

Three-dimensional alterations in pharyngeal airway and maxillary sinus volumes in Class III maxillary deficiency subjects undergoing orthopedic facemask treatment

Objective:To assess short-term alterations in the volume of pharyngeal airway space and maxillary sinuses associated with rapid maxillary expansion (RME) and facemask (FM) use in growing Class III maxillary-deficient patients.Materials and Methods:Twenty-two patients (14 girls, eight boys) treated with the RME/FM and having pretreatment and posttreatment cone beam–computed tomographic scans were identified from the archives of the Marmara University, Department of Orthodontics. According to the protraction force that was used, they were divided into two groups: a group with 400 g protraction force (12 subjects) and a group with 800 g protraction force (10 subjects). Mean age for the study group was 10 years. All patients were diagnosed with normal/low vertical growth pattern, maxillary deficiency, and normal mandible. No control group was available for this study. For each patient, a hyrax expansion screw with acrylic cap splint was constructed and RME was performed for 10 days. On the seventh day, protraction with a FM started.Results:The results showed a statistically significant increase in the volume of maxillary sinuses after treatment, which was related to the growth. On the other hand, the increase in the volume of pharyngeal airway was not statistically significant.Conclusions:RME/FM treatment did not affect at all the volume of maxillary sinuses and actually inhibited the normal expected increase of the volume of the pharynx when compared with a control group comprising normal individuals.     

Effective three‐dimensional evaluation analysis of upper airway form during oral appliance therapy in patients with obstructive sleep apnoea

The oral appliance (OA) is considered to be an effective treatment modality for obstructive sleep apnoea (OSA). Upper airway enlargement during OA therapy is critical, and lateral cephalometry has been used for the two‐dimensional evaluation of upper airway form during this therapy. However, this method cannot provide an accurate three‐dimensional (3D) view of upper airway form. To confirm the effects of OA on the upper airway in patients with OSAS, we performed CT in the presence and absence of OA in 15 Japanese patients (12 males, 3 females) who responded to OA therapy. CT in the presence and absence of OA was consecutively performed for each patient, and upper airway cross‐sectional area in six arbitrary planes parallel to the palatal plane was measured. Next, 3D image reconstruction was performed; morphological changes in upper airway form were evaluated, and upper airway volume at three levels from the palatal plane to the deepest point of the epiglottis was measured. The cross‐sectional area of two planes in the posterior soft palate region significantly increased in the presence of OA compared with that in the absence of OA. In the presence of OA, upper airway cross‐sectional area and volume significantly increased in the posterior soft palate region compared with those in the posterior tongue region. 3D CT image reconstruction accurately confirmed morphological changes in the upper airway during OA therapy. Continued use of this 3D evaluation is expected to improve the results of OA therapy in the future.     

Effects of different rapid maxillary expansion appliances on facial soft tissues using three-dimensional imaging

Objective:To determine three-dimensional (3D) effects of three different rapid maxillary expansion (RME) appliances on facial soft tissues.Materials and Methods:Forty-two children (18 boys, 24 girls) who required RME treatment were included in this study. Patients were randomly divided into three equal groups: banded RME, acrylic splint RME, and modified acrylic splint RME. For each patient, 3D images were obtained before treatment (T1) and at the end of the 3-month retention (T2) with the 3dMD system.Results:When three RME appliances were compared in terms of the effects on the facial soft tissues, there were no significant differences among them. The mouth and nasal width showed a significant increase in all groups. Although the effect of the acrylic splint RME appliances on total face height was less than that of the banded RME, there was no significant difference between the appliances. The effect of the modified acrylic splint appliance on the upper lip was significant according to the volumetric measurements (P < .01).Conclusions:There were no significant differences among three RME appliances on the facial soft tissues. The modified acrylic splint RME produced a more protrusive effect on the upper lip.     

Mandibular cervical headgear vs rapid maxillary expander and facemask for orthopedic treatment of Class III malocclusion

OBJECTIVE: To compare the effectiveness of the rapid maxillary expander and facemask (RME/ FM) and mandibular cervical headgear (MCH) protocols when followed by fixed appliances and evaluated at a postpubertal observation in patients with dentoskeletal Class III malocclusion. MATERIALS AND METHODS: The sample treated with the RME/FM followed by fixed appliances included 32 patients (12 boys and 20 girls). The sample treated with the MCH followed by fixed appliances included 26 patients (eight boys and 18 girls). Cephalometric analysis was performed at T(1) (before treatment) and T(2) (after the first phase of orthopedic therapy and the second phase of fixed appliances). T(1)-T(2) changes were evaluated by means of t-tests. RESULTS: Midfacial length, mandibular length, and the sagittal position of the chin all showed significantly smaller increases in the MCH group than in the RME/FM group. The amount of increase in the overjet was also significantly smaller in the MCH group, whereas the amount of molar correction was greater. The upper incisors were significantly less proclined and the lower incisors were significantly less retroclined in the MCH group when compared with the RME/FM group. CONCLUSIONS: RME/FM therapy appears to be indicated in Class III patients with a component of maxillary retrusion, whereas MCH therapy is preferable in patients with mandibular prognathism.     

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目的探讨早期骨性Ⅲ类错患者上腭快速扩弓联合前方牵引矫治后咽腔的改变。方法选择2007年6月至2009年5月大连医科大学附属第一医院口腔正畸门诊收治的早期骨性Ⅲ类错患者30例,行上腭快速扩弓联合前方牵引治疗,并测量矫治前后各指标变化。结果与矫治前比较,矫治后上齿槽座点到Y轴的距离(Y-A)增加,下齿槽座点到Y轴的距离(Y-B)和颏前点到Y轴的距离(Y-Pog)减小,上咽腔宽(UPW)、中咽腔宽(MPW)增加,鼻咽部面积(nasopharynx)和口咽上部面积(oropharynx1)增加(均P<0.01);下咽腔宽(LPW)、口咽下部面积(oropharynx2)及头位角(SN-CVT)变化差异无统计学意义(均P>0.05)。结论上颌前方牵引能改变咽腔大小。     

Effects of face mask treatment with and without rapid maxillary expansion in young adult subjects

Objectives:To investigate the skeletal, dental, and soft tissue effects of the face mask (FM) treatment with and without rapid maxillary expansion (RME) in young adult subjects with maxillary retrognathia.Materials and Methods:Pretreatment and posttreatment cephalometric radiographs from 32 subjects who had a skeletal Class III malocclusion were analyzed. The subjects were divided into two groups: FM group (N  =  17; 3 male and 14 female subjects; mean [SD] age 14.47 [0.89] years) was treated with FM only, while the RME+FM group (N  =  15; 3 male and 12 female subjects; mean [SD] age 14.67 [1.28] years) was treated with both FM and RME. Ten cephalometric linear and nine angular variables were measured to assess dentofacial changes. Within-group and between-group comparisons were determined by a paired t-test and Student''s t-test, respectively.Results:Forward displacement of the maxilla and a clockwise rotation of the mandible occurred in both groups. The maxillary-mandibular relationship improved and soft tissue changes resulted in a more convex profile. The maxillary incisors were more proclined in the FM group than in the RME+FM group, the only difference between the two groups. Notably, the mandibular incisors moved backward in both groups.Conclusions:Forward movement of the maxilla can be obtained in young adults after face mask treatment. However, there was no difference in this phenomenon between the FM and RME+FM groups.     

Comparison of facemask therapy effects using skeletal and tooth-borne anchorage:: A longitudinal retrospective study

ObjectivesTo investigate long-term outcomes of dentoskeletal changes induced by facemask therapy using skeletal anchorage in Class III patients and compare them to those of conventional tooth-borne anchorage.Materials and MethodsThis retrospective study included 20 patients who received facemask (FM) therapy with miniplates as anchorage for maxillary protraction (Miniplate/FM group, 10.6 ± 1.1 years old [mean ± SD]) and 23 patients who were treated with facemask with rapid maxillary expander (RME/FM group, 10.0 ± 1.5 years old [mean ± SD]). Dentoskeletal changes were evaluated using lateral cephalograms at pretreatment (T1), after facemask therapy (T2), and at the post-pubertal stage (T3). Cephalometric changes were compared between groups and clinical success rates at T3 were evaluated.ResultsSNA and A to N perpendicular to FH increased significantly more in the Miniplate/FM group than in the RME/FM group when comparing short-term effects of facemask therapy (T1–T2). ANB, Wits appraisal, Angle of convexity, mandibular plane angle, and overjet decreased significantly more in the RME/FM group than in the Miniplate/FM group after facemask therapy (T2–T3). A more favorable intermaxillary relationship was observed in the Miniplate/FM group than in the RME/FM group in long-term observations (T1–T3). Clinical success rate at T3 was 95% in the Miniplate/FM group and 85% in the RME/FM group.ConclusionsFacemask therapy with skeletal anchorage showed a greater advancement of the maxilla and more favorable stability for correction of Class III malocclusion in the long-term than conventional facemask therapy with tooth-borne anchorage.     

Comparison of the effects of RME and fan-type RME on nasal airway by using acoustic rhinometry

Objective:To evaluate and compare the nasal airway changes following rapid maxillary expansion (RME) and fan-type RME using acoustic rhinometry (AR).Materials and Methods:The study sample consisted of three groups. The RME group comprised 15 subjects with maxillary transverse discrepancies and posterior crossbites. The fan-type RME group comprised 15 subjects, who had an anteriorly constricted maxilla with a normal intermolar width. The third group included 15 patients who had an ideal occlusion and received no orthodontic treatment and served as the control group. AR was used to measure nasal volume and the minimal cross-sectional area (MCA) before expansion (T1), after expansion (T2), and 6 months after expansion (T3). Each AR recording was performed with and without the use of a decongestant. Two-way analysis of variance was used to determine differences among the groups and three-way analysis of variance was used for the differences between groups. If evidence of statistically significant differences was found, a Bonferroni test was used.Results:The results showed that nasal volume and MCA were significantly increased with RME and fan-type RME immediately after expansion (P < .05). At the end of retention, nasal volume and MCA values of RME showed significant differences with both expansion fan-type RME and control groups (P < .05).Conclusions:RME and fan-type RME had similar effects on the nasal airway immediately after expansion. The increase in nasal volume and MCA was more stable in the RME group than in the fan-type RME group at the end of the retention period.     

Dentofacial effects of two facemask therapies for maxillary protraction: Miniscrew implants versus rapid maxillary expanders

Objective:To compare the dentofacial effects of maxillary protraction with two facemask therapies in growing Class III patients: facemask in association with miniscrew implants (MSI/FM) and facemask with rapid maxillary expanders (RME/FM).Materials and Methods:Forty-three Chinese patients with Class III malocclusion and maxillary deficiency were randomly assigned to a MSI/FM sample of 20 patients and a RME/FM sample of 23 subjects. The changes in dentofacial cephalometric variables from the beginning (T1) to the end of treatment (T2) were compared with t-test for paired samples in both groups and for independent samples between the two groups.Results:No significant cephalometric differences were observed between the two groups in active treatment effects except for maxillary dental variables. However, significant favorable changes in both maxillary and mandibular skeletal components were noted in two groups after treatment. Sagittal measurements showed the maxilla was advanced, mandibular projection was reduced, and the relative sagittal intermaxillary discrepancy improved. Patients experienced additional unfavorable outcomes of clockwise rotation of the mandible as well as retroclination of the lower incisors. The soft tissue profile was improved remarkably in both groups. Proclination of the maxillary incisors and mesialization of the maxillary dentition were significantly different between the two groups. The increases in U1-SN, U1-VR, and U6-VR were 6.41°, 2.78 mm, and 1.24 mm less in the MSI/FM group than in the RME/FM group, respectively.Conclusions:Compared with the RME/FM therapy, the MSI/FM protocol using a smaller magnitude of protraction force improves skeletal relationships and soft tissue profile and reduces the undesired dentoalveolar effects.     

Volumetric upper airway assessment in patients with transverse maxillary deficiency after surgically assisted rapid maxillary expansion

Transverse maxillary deficiency is commonly found in patients with sleep apnea and is also related to abnormal breathing patterns. Maxillary expansion procedures promote widening of the nasal floor and reduce the resistance to airflow, and have a positive influence on nasopharynx function. In order to evaluate volume changes in the upper airway, 15 adult patients with transverse maxillary deficiency underwent surgically assisted rapid maxillary expansion (RME) until a slight overcorrection of the crossbite was obtained. Cone beam computed tomography (CBCT) volumetric images were obtained at three predefined time points. The mean age of the patients was 30.2 (±7.4) years; nine were females and six were males. The area, volume, and the smallest transverse section area of the airway were assessed using Dolphin Imaging 3D software. Statistical comparisons were made of the changes between time periods. No statistically significant differences were found for volume or area. However a significant difference was found between the preoperative and immediate postoperative smallest transverse section area (P < 0.05). Maxillary expansion, as an isolated procedure, does not result in a statistically significant improvement in the airway dimensions and results in an inferior relocation of the smallest transverse section area.     

阻塞性睡眠呼吸暂停综合征患者舌后区上呼吸道CT测量

目的 对阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea syndrome,OSAS)患者和健康人的舌体及舌后区上呼吸道的CT测量资料进行对比研究。方法 OSAS患者共59例，年龄与性别相近的健康成年人57名，采用螺旋CT对上呼吸道进行连续扫描，观察2组舌后区上呼吸道形态学的差异，测量并比较舌后区气道和舌体各测量参数的差别。结果 患者多表现为气道前后径大于左右径、颏舌肌分离、舌根与软腭接触和舌正中切迹。患者组舌后区上呼吸道的横截面积、左右径明显小于对照组；咽侧壁软组织厚度、舌体宽度、颏舌肌宽度、舌骨舌肌宽度和舌体横截面积均明显大于对照组；呼吸道前后径、咽后壁软组织厚度和舌体长度与对照组相比无明显变化。结论 OSAS患者舌后区上呼吸道较健康对照组狭窄，除咽侧壁软组织增厚外，颏舌肌、舌骨舌肌和舌体宽度的增加也是造成舌后区上呼吸道狭窄的主要原因。     

Short-term effects produced by rapid maxillary expansion and facemask therapy in Class III patients with different vertical skeletal relationships

Objective:To evaluate the dentoskeletal short-term effects of rapid maxillary expansion and facemask therapy (RME/FM) in a sample of Class III patients showing different vertical skeletal relationships.Materials and Methods:Seventy-nine patients (35 females and 44 males) having Class III malocclusion were consecutively treated using RME/FM therapy with application of the protraction force in a downward and forward direction and inclination of about 30° to the occlusal plane. All patients were evaluated at the beginning (T1; mean age, 7.7 years) and at the end (T2; mean age, 9.2 years) of orthopedic therapy and divided into three groups according to their vertical skeletal relationships: normal group (NG), hypodivergent group (HypoG), and hyperdivergent group (HyperG). Statistical comparisons between the three groups were performed on the starting forms (T1), the final forms (T2), and the treatment changes (T1–T2) using the ANOVA with Tukey''s post hoc tests.Results:Favorable modification in terms of maxillary advancement (changes in SNA ranging from 1.4° to 1.8°) and intermaxillary sagittal skeletal relationships (changes in Wits appraisal ranging from 2.5 mm to 3.5 mm) were recorded in all groups. The three groups showed no statistically significant differences in changes in either sagittal or vertical skeletal variables.Conclusions:The various vertical skeletal features do not influence the short-term outcomes of RME/FM therapy.     

正畸联合双颌手术治疗骨性Ⅲ类畸形对上气道长期影响的CBCT分析

目的:研究正畸联合双颌手术治疗骨性Ⅲ类畸形对上气道的长期影响。方法:选取骨性Ⅲ类患者26例(男12例,女14例),采用正畸联合上颌LeFort I型骨切开术和下颌升支矢状骨劈开术治疗,正畸矫治前1周(T0),正颌术后6个月(T1)及正颌术后3年(T2)拍摄锥束CT,三维重建上气道模型,对治疗前后各段矢状径、冠状径、截面积和容积进行定量分析。采用SPSS17.0软件包进行统计分析,采用方差分析SNK检验治疗前、术后6个月及3年上气道的三维变化。结果:术后6个月第二、三、四颈椎平面处矢状径和截面积显著减少,但在术后3年大部分缩窄的部位能恢复到治疗前水平。结论:正畸正颌联合治疗骨性Ⅲ类畸形会造成咽腔缩窄,随着时间会有一定程度的恢复,但部分咽腔部位不能完全恢复到治疗前水平。     

The Influence of Implant Diameter on Its Survival: A Meta‐Analysis Based on Prospective Clinical Trials

Background: The use of narrow‐diameter implants has been proposed to restore small edentulous spans, thus avoiding extensive bone augmentation procedures and reducing the surgical complexity of implant rehabilitations. Although success rates of narrow‐diameter implants have already been analyzed in the literature, to the best of the authors’ knowledge, no meta‐analysis based on prospective and randomized controlled trials has been performed. The aim of this study is to analyze the survival rates of narrow‐diameter implants compared with standard or wide‐diameter implants. Methods: An electronic search from three databases and a hand search in implant‐related journals of studies published in English before September 1, 2012 were performed. Prospective human clinical studies with at least 10 implants and a follow‐up period of 1 year were included in the meta‐analysis. Implants were divided into two groups based on their diameters. Results: The initial search yielded 484 articles, of which 49 were evaluated in full text for eligibility. Finally, 16 studies were chosen and separated into two groups: 1) implants of diameter <3.3 mm (group 1) and 2) implants of diameter ≥3.3 mm (group 2). A meta‐analysis performed for groups 1 and 2 showed survival rates of 75% and 87%, respectively. Conclusions: This meta‐analysis showed that narrower implants (<3.3 mm) had significantly lower survival rates compared with wider implants (≥3.3 mm). Other variables, such as type of prosthesis, implant surface, and timing of prosthetic loading, were found to have influenced the implant survival rates.     

Development of a three‐dimensional imaging system for analysis of facial change

The objective of this report is to present facial changes produced by the Twin Block appliance in three‐dimensional visual and numerical formats. Using a C3D system, stereophotogrammetric records were made of two children with Class II division 1 malocclusions prescribed treatment with a Twin Block appliance. Three‐dimensional images of their faces were captured. Comparison of specified regions of the three‐dimensional images was made using landmark identification and superimpositions. In addition to obvious visual evidence, numerical data in the form of surface area measurements were also generated. The three‐dimensional, C3D, system, provides a flexible imaging tool which should become increasingly useful as more improvements are made.     

儿童上呼吸道阻塞对错牙合畸形患病率和颅颌面生长发育影响研究

目的　研究上呼吸道阻塞患儿错牙合畸形的患病率情况,并利用头影测量分析上呼吸道阻塞对颅颌面生长发育的影响。方法　（1）错牙合畸形患病率调查：选取2017年5—9月于中国医科大学附属盛京医院耳鼻喉科门诊就诊的上呼吸道阻塞患儿176例为病例组（ENT组）,另选取2017年6月于辽宁省沈阳市光明中学七年级和塔湾小学三年级进行口颌面错牙合畸形普查的中小学生485名为对照组（GS组）。比较两组人群不同牙合期和整体错牙合畸形的患病率,并统计不同牙合期错牙合畸形的安氏分类构成比。（2）头影测量分析：选取2017年5—9月于中国医科大学附属盛京医院耳鼻喉科门诊就诊的上呼吸道阻塞并进行正畸治疗的患儿32例为病例组（H组）,另选取2016年1月至2017年12月于中国医科大学附属口腔医院正畸科就诊的上呼吸道通畅并进行正畸治疗的患儿32例为对照组（N组）。分别对两组患儿的颅颌面软硬组织、气道矢状径间隙和舌骨位置进行测量,采用独立样本t检验对两组测量值进行统计学分析。结果　（1）ENT组患儿替牙牙合期、乳牙牙合期以及整体错牙合畸形的患病率均高于GS组,差异有统计学意义（P＜0.001）,但恒牙牙合期两组患病率的差异无统计学意义（P＞0.05）。（2）H组和N组患儿,在颅颌面软硬组织测量指标中,仅下颌平面角（SNGoGn）测量结果差异具有统计学意义（P＜0.05）;在气道间隙矢状径测量中,软腭上后气道间隙（PNS-UPW）、软腭中后气道间隙（SPP-SPPW）、气道间隙最窄处距离（Mc1-Mc2）3项指标测量结果差异具有统计学意义（P＜0.05）;在舌骨垂直向位置测量中,H点到腭平面的距离（H-PP）、H点与后鼻棘点的距离（H-PNS）、H点到下颌平面的距离（H-MP）和H点与第三颈椎垂直距离［H-C3（V）］4项指标测量结果差异具有统计学意义（P＜0.05）。结论　上呼吸道阻塞患儿的错牙合畸形患病率明显高于普通人群。在生长发育期,上呼吸道阻塞易导致下颌骨的垂直向生长、咽腔上部矢状间隙的减小和舌骨位置下降改变。