鼻咽腔大小对阻塞性睡眠呼吸暂停综合征的影响

目的既往对阻塞性睡眠呼吸暂停综合征（ｏｂｓｔｒｕｃｔｉｖｅｓｌｅｅｐａｐｎｅａｓｙｎｄｒｏｍｅ,ＯＳＡＳ）患者的上气道研究集中在口咽部位。作者观察ＯＳＡＳ患者鼻咽部的三维影像特征,探讨鼻咽腔大小对ＯＳＡＳ发病影响。方法２３例ＯＳＡＳ患者与１２名性别、年龄配比的无鼾对照进行上气道ＭＲＩ影像比较;并做睡眠呼吸紊乱指数与上气道ＭＲＩ指标的相关与回归分析。结果ＯＳＡＳ患者鼻咽显著小于无鼾对照,在矢状径、横向径、截面积、体积的比较中都有较大显著性。鼻咽指标与睡眠呼吸紊乱相关密切,鼻咽矢状径与呼吸暂停低通气指数（ａｐｎｏｅａｈｙｐｏｎｏｅａｉｎｄｅｘ,ＡＨＩ）和最低血氧饱和度（ＳａＯ２）相关,鼻咽体积与呼吸暂停指数（ＡＩ）相关。结论虽然ＯＳＡＳ上气道狭窄主要在口咽部,但鼻咽大小对ＯＳＡＳ的发病及严重性均有影响。     

舌刺联合头帽颏兜与前方牵引矫治前牙反的疗效比较

目的:应用头影测量分析,评价舌刺联合头帽颏兜和前方牵引器矫治前牙反的疗效,以及对舌骨位置和气道的影响,以期为临床提供参考.方法:选择应用舌刺联合头帽颏兜和前方牵引器2种矫治方法矫治完成的前牙反病例各30例,应用Winceph 9.0软件及AutoCAD 2016软件对治疗前、后的头颅侧位片进行测量分析.采用SPSS 2...     

生长发育期骨性Ⅱ^1类错[牙合]低角型患者颅面部的特征

目的通过对生长发育期骨性Ⅱ^1类错[牙合]低角型患者的32项X线头影测量值与正常[牙合]进行比较分析,旨在研究此类患者的颅面软硬组织的变化和特征。方法选择生长发育期骨性Ⅱ^1类错[牙合]低角型患者60例,治疗前摄X线头颅定位侧位片（磨牙为远中关系,角ANB〉5°,下颌平面角Go-Gn-SN〈28°）,年龄11～13岁,男、女各半。结果SNA角、ANB角、上颌切牙倾斜度（U1-NA）、下颌切牙倾斜度（L1-GoGn）、腭平面角（PP—FH）、上下齿槽座点到功能性[牙合]平面距离（Wits值）、后下面高（PLFH）、上下中切牙覆[牙合]程度（U1-L1／N-Me）、下中切牙高度（Me-L1／N—Me）均明显增加;下颌平面角（Go-Gn-SN）、[牙合]平面与下颌平面角（OP—MP）、[牙合]平面与眶耳平面角（OP-FH）、上下中切牙交角（U1-L1）、前下面高（ANS-Me）、前下面高／前全面高（ANS-Me／N-Me）、前下面高／后下面高（ALFH／PLFH）、下颌基骨长（B＇-J’）均明显减少;软组织侧貌唇部突度（NB-Pg＇-Ls）、颏唇沟深（Si-Pg＇-Ls）、下唇厚度（Li-L1）明显增加。结论骨性Ⅱ^1类错[牙合]低角型患者具有前下面高减少、后下面高增加、腭平面顺时针旋转,[牙合]平面、下颌平面逆时针旋转,深覆[牙合]加重;软组织呈现出上唇突出、下唇卷缩、颏部后缩的突面型。     

OSTEOSYNTHESIS OF INTRA-ARTICULAR FRACTURES IN THE PROXIMAL INTERPHALANGEAL JOINT WITH KIRSCHNER WIRES

Twenty-eight consecutive patients, aged 4-68 years, who had had an intra-articular fracture of the proximal interphalangeal (PIP) joint were reviewed retrospectively in 1996. All patients were operated on within a median of three days (range 0-26). Only three patients had open injuries while 11 had fracture-dislocations. A median of half the articular surfaces were involved, and dislocations ranged from 1-4 mm. Twelve patients had their fractures anatomically reduced and 13 had postoperative dislocations of less than 1 mm. Eighteen patients were reviewed after 10-49 months, and four were interviewed by telephone. The median reduction in range of movement in the PIP joint at follow-up was 15° (range 0-90°). Nine patients had subjectively slightly reduced movements, and only three of 17 patients stated that they had limited movement. Ten patients had occasional pain, which eight described as mild and two as moderate. Two patients had ulnar instability less than 5°, and the remainder were stable. Twelve patients had a cold sensation in the affected finger joint in cold weather. No patients had changed occupation as a result of their injury, and only two patients said that they were limited in any way in any activity at work or at home. Open and precise reduction and osteosynthesis with Kirschner (K) wires seems to be an effective treatment for most intra-articular fractures of PIP joints.     

Gender differences in morphological and functional outcomes after mandibular setback surgery

Purpose

The aim of this study was to examine and compare morphological and functional outcomes after either isolated mandibular setback or bimaxillary surgery in males and females.

Forsus和Dynamax矫治器对下颌骨生长改形的效果比较

目的比较Forsus矫治器与Dynamax矫治器对下颌骨形态的影响。方法选择30例治疗成功的骨性Ⅱ类错[牙合]患者,15例采用Forsus矫治器治疗,15例采用Dynamax矫治器治疗,以矫治前后的X线头影测量片评价其疗效,并进行对比。结果两种矫治器均能明显增加下颌骨长度,但Dynamax矫治器对下颌平面角的影响更大。结论在选择两种矫治器矫治骨性Ⅱ类错[牙合]患者时应考虑患者的下颌角因素。     

阻塞性睡眠呼吸暂停低通气综合征患者手术选择的初步探讨

目的通过不同手术方法对上气道结构的影响,为阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)手术适应症的选择提供有关依据.方法 12例经夜间睡眠监测(polysomnography,PSG)确诊的OSAHS患者全部行悬雍垂腭咽成型术(uvulopalatopharyngoplasty,UPPP),其中7例行UPPP 颏前徙术 舌骨悬吊术,1例行UPPP 舌骨悬吊术,1例行UPPP 舌根组织部分切除前移悬吊术,手术前后对患者行头影测量分析评估.结果 UPPP可以扩大腭咽气道,颏前徙术及舌骨悬吊术有助于扩大舌咽气道及下咽气道.结论术前应对OSAHS患者上气道做全面评估,根据上气道的阻塞状态选择适当的手术方法.     

Surgery-first orthognathic approach for the correction of facial asymmetry

We aimed to compare the reliability of the surgery-first approach and the traditional orthodontic-first approach for the correction of facial asymmetry based on the new classification of facial asymmetry.Patients with facial asymmetry who underwent orthognathic surgery between January 2016 and January 2019 were included. Cephalometric changes and relapse ratios were analyzed 12 months before and after surgery. Patients were divided into horizontal and vertical asymmetry groups based on the asymmetry vector, and subgroup analysis was conducted.The surgery-first approach without presurgical orthodontic treatment and the orthodontic-first approach showed a similar degree of asymmetry correction and skeletal stability. The relapse ratios of the maxilla height in the surgery-first and orthodontic-first groups were 0.25 ± 0.21 and 0.27 ± 0.25, respectively (p = 0.63), the relapse ratios of the maxilla width were 0.31 ± 0.32 and 0.21 ± 0.2, respectively (p = 0.14), the mandibular height relapse ratios were 0.34 ± 0.58 and 0.29 ± 0.36, respectively (p = 0.69), and the mandibular width relapse ratios were 0.12 ± 0.22 and 0.26 ± 0.31, respectively (p = 0.058). The treatment period of the surgery-first group (18.5 ± 5.3 months) was significantly shorter than that of the orthodontic-first group (22.9 ± 7.5 months, p = 0.024). Among the surgery-first group, patients with vertical asymmetry (15.0 ± 3.2 months) had a shorter treatment than those with horizontal asymmetry (21.6 ± 6.8 months, p = 0.006).Although contesting traditional standards is always challenging, the surgery-first orthognathic approach may lead to a new era in traditional orthognathic approaches. This new classification of facial asymmetry could be useful and practical when treating patients with facial asymmetry regardless of the etiology.     

Research Reports

Abstract

The aim of this study was to evaluate the dentoskeletal relationships in children with juvenile idiopathic arthritis (JIA) compared to healthy children without significant differences in relation to age and sex, by means of lateral cephalometric radiographs. Cephalometric, as well as dental panoramic radiographs were taken of 66 JIA children (27 males and 39 females; age range: 6–19 years; mean age: 11?9 years). The control group consisted of 37 healthy children unaffected by JIA seeking orthodontic treatment, with Class I occlusion (17 males and 20 females; age range: 7?5–17 years; mean age: 11?9 years). All cephalometric landmarks were identified and digitized, and calculations were performed by means of a computerized cephalometric system.

The cephalometric findings indicated a tendency towards retrognathism with a short mandible. The lower facial height was increased and the growth pattern of the face was biased towards the vertical direction (clockwise, i.e. with a tendency to open bite) and the interincisal angle was less in the JIA children compared to the healthy children. These findings were in general more pronounced by the JIA children with polyarticular type of the disease as well as with affected condyles.

Our study indicated that the dentoskeletal morphology in children with JIA presented some special characteristics when compared to healthy children, which could be attributed to the effects of the disease.     

Supernumerary premolar teeth in siblings.

Abstract

The familial nature of supernumerary teeth is discussed in this paper and illustrated with a report showing the development of supernumeraries in siblings. The orthodontic treatment and possible sequelae to the development of supernumerary teeth in the premolar region is highlighted.