隐形矫治器治疗骨性Ⅱ类高角患者上气道前后径及颌骨的变化

目的：探讨隐形矫治治疗骨性Ⅱ类高角患者上气道前后径及颌骨的变化。方法：将2016年6月—2018年6月西安交通大学口腔医院收治的拟进行隐形矫治的37例错畸形患者纳入研究。矫治前和矫治后18个月评估矫治效果,采用锥形束CT（CBCT）检查、测定上气道容积和舌体位置,头颅侧位片检查、测定上气道前后径和舌骨位置。收集大陆明星和患者矫治前、后侧面像制作侧貌剪影图,采用10级评分法评估侧貌美学效果。采用SPSS 20.0软件包对数据进行统计学分析。结果：矫治后患者口咽容积、舌咽容积和上气道最小截面积较矫治前显著增加（P<0.05）;矫治后患者下颌平面后部上气道前后径较矫治前显著增加（P<0.05）;矫治后患者ANB角、GoGn-SN角、OPP-SN角、Y轴角、UI-SN角、UI-PP角、UI-AP角和UI-AP距离较矫治前显著减小,SNB角和UI-LI角较矫治前显著增加（P<0.05）;矫治后患者侧貌美学评分显著大于矫治前（P<0.05）;矫治后患者侧貌美学评分显著小于明星（P<0.05）。结论：隐形矫治有利于骨性Ⅱ类高角患者上气道开放和颌骨畸形的纠正,具有良好的治疗效果并可获得满意的侧貌美学效果。

Effect of invisalign on anterior and posterior upper airway and maxillary bone changes in the treatment of high-angle skeletal Class Ⅱ malocclusion

PURPOSE: To investigate the effect of invisalign on anterior and posterior upper airway and maxillary bone changes in the treatment of high-angle skeletal Class II malocclusion. METHODS: Thirty-seven patients with malocclusion undergoing invisible orthodontic treatment in Hospital of Stomatology of Xi'an Jiaotong University from June 2016 to June 2018 were enrolled. Before and 18 months after correction, the correction effect was evaluated. Cone-beam CT (CBCT) was performed to measure the upper airway volume and tongue position. Cephalometric examination was performed to determine the anteroposterious diameter of the upper airway and the position of hyoid bone. The pre-therapy and post-treatment facial profile images of patients and stars were graded by 0-10 numerical rating scale. SPSS 20.0 software package was used to analyze the data. RESULTS: After correction, oropharyngeal volume, glossopharyngeal volume and minimum cross-sectional area of upper airway significantly increased(P<0.05). Sagittal diameter of the upper airway at mandibular plane significantly increased after correction (P<0.05). After correction, ANB angle, GoGn-SN angle, OPP-SN angle, Y-axis angle, UI-SN angle, UI-PP angle, UI-AP angle, and UI-AP distance significantly decreased, SNB angle and UI- LI angle significantly increased(P<0.05). The aesthetics scores of facial profile images significantly increased after correlation(P<0.05), which was significantly lower than that of the stars(P<0.05). CONCLUSIONS: Invisalign can effectively correct open upper airway and malocclusion, achieving better treatment results and satisfactory facial aesthetics effect.