Twin-block矫治下颌后缩患者前、后的气道变化

目的: 探讨安氏Ⅱ类1分类下颌后缩患者Twin-block矫治前、后上气道的变化,观察不同舌位置患者矫治前、后气道的变化。方法: 选择下颌后缩的安氏Ⅱ类1分类患者33例,平均年龄（11.3±0.89）岁,分为对照组（12例）和试验组（21例）,试验组按锥形束CT（CBCT）显示的舌位置又分为舌低位组及舌高位组。试验组使用Twin-block矫治器进行治疗,对照组不矫治。试验组于治疗前及治疗8个月后拍摄CBCT,对照组在第1个月和第8个月拍摄CBCT。利用Dolphin软件对收集的数据进行三维重建,并测量口咽处气道体积以及最小横截面积的变化。采用SPSS 24.0软件包对数据进行配对t检验和单因素方差分析。结果: 8个月后,对照组口咽处气道体积及最小横截面积均无显著变化,而试验组口咽处气道体积及最小横截面积均显著增大（P<0.001）。舌高位组气道体积及最小横截面积比治疗前显著增加（P<0.01）,舌低位组气道体积及最小横截面积与治疗前相比也显著增加（P<0.05）。结论: Twin-block能够显著增加安氏Ⅱ类1分类下颌后缩患者口咽处气道体积及最小横截面积;下颌前移与气道改善不呈正相关,但在前移过程中,舌位正常有助于气道开放。

Changes of airway before and after Twin-block treatment in patients with mandibular retrusion

PURPOSE: To observe the changes of upper airway and the effect of different tongue position on upper airway volume before and after Twin-block treatment in patients with Class II division 1 malocclusion and mandibular retrusion. METHODS: Thirty-three patients (ages:11.3±0.89) with Class II division 1 malocclusion and mandibular retrusion were included in the study and divided into 2 groups, the control group (12 patients) and experimental group (21 patients). In the experimental group, according to the tongue position shown on cone-beam CT (CBCT), the patients were sub-divided into lower tongue position group and higher tongue position group. Patients in the experimental group were treated with Twin-block appliance, and CBCT was taken before treatment and 8 months after treatment. Patients in the control group underwent CBCT at the first month and eighth month. The changes of oropharyngeal airway volume and the minimal cross-sectional area were measured by using Dolphin software. SPSS 24 software package was used for t test and one-way variance analysis. RESULTS: After 8 months, the airway volume and the minimal cross sectional area of the oropharynx in the control group were not significantly changed, but significantly increased in the experimental group (P<0.001), especially in the higher tongue position group (P<0.05). CONCLUSIONS: Twin-block can significantly increase the oropharyngeal airway volume and minimum cross-sectional area in patients with Class II division 1 malocclusion and mandibular retrusion. In addition, mandibular advancement dose not correlate with airway improvement and the right tongue position has an obvious effect on airway opening in mandibular advancement.