OSAHS患者戴用自行调节式口腔矫治器主诉症状指数及其髁突位置变化

目的为自行调节式口腔矫治器治疗阻塞性睡眠呼吸暂停低通气综合征(Obstructive Sleep ApneaHypopnea Syndrome,OSAHS)的下颌定位提供颞下颌关节的髁突位置和主诉症状变化的参考。方法选择48例经多导睡眠生理检查(PSG)诊断为OSAHS轻、中度且戴用自行调节式口腔矫治器治疗OSAHS临床效果理想的患者为研究对象,所有患者分别于戴用矫治器前、医师经验位和患者调节位时拍摄X线头影测量片,并测量颞下颌关节间隙变化及Helkimo主诉症状指数(即Helkimo Ai)。结果 48例患者经过治疗后医师经验位和患者调节位对髁突位置的改变作用均显著提高(P<0.01),其中经验位和患者调节位间差异有统计学意义(P<0.05)。经过自行调节式口腔矫治器治疗后,其主诉症状指数在医师经验位和患者调节位时分别发生了改变。Ai 0例数明显增多,Ai I减少,AiⅡ减少明显,其中患者调节位的改变最为明显。结论从颞下颌关节的髁突位置和主诉症状变化来看,患者调节位时下颌骨的位置更能使颞下颌关节在保证疗效的基础上更易于被患者所接受。

Study on the position changes of condylar position and clinical manifestation in OSAHS patients cured by self-adjustable oral appliances

Objective To provide the changes of condylar position and clinical manifestation for the treatment of OSAHS by using the self-adjustable oral appliances.Methods 48 patients who were diagnosed with PSG as mild-to-moderate OSAHS and detected to be valid by the PSG were selected as research subjects,all the subjects were performed X-ray cephalometric before treatment,on the physicians experience position and the patient self-adjustable position respectively,and the condylar position and clinical manifestation were measured and analyzed as well.Results There was significant difference in the condylar position between the physicians experience position and the patient self-adjustable position(P<0.05).The chief compliant index of the two positions was changed compared with before,and there was much obvious in the patient self-adjustable position.Conclusion From the temporomandibular joint,the patient self-adjustable position is more suitable and stable.