阻塞性睡眠呼吸暂停综合征患者戴入口腔矫治器后髁状突的位置变化

目的 明确阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea,OSA）患者戴入治疗有效的口腔矫治器后髁状突的位置变化.方法 选取21例使用口腔矫治器成功治疗的OSA患者参加研究,采用经颅咽方向投照双侧颞下颌关节的方法摄取闭口位、最大开口位及戴有效的口腔矫治器后双侧颞下颌关节的数字化X线片.测量髁状突的位置并作三个不同下颌位置的比较,对髁状突位置的变化及戴用口腔矫治器后的疗效变化作相关分析.结果 三个髁状突位置明显不同.患者戴入治疗有效的口腔矫治器后髁状突的最上点座标为X（-1.21±1.98）mm,Y（-0.68±1.08）mm.髁状突位置的变化与口腔矫治器疗效的变化无明显相关性,x值的相关系数为r=0.057,y值的相关系数为r=0.024.结论 戴入有效的口腔矫治器后髁状突的最上点为靠近于颞下颌关节的结节点.

Condyle displacement in obstructive sleep apnea patients with oral appliance

Objective The aim of this paper is to quantify the condyle position of obstructive sleep apnea（OSA） patients using effective mandibular advancement appliances.Methods Twenty-one OSA patients,who had been successfully treated with mandibular advancement appliances,were recruited for the study.The digital film imaging of the temporomandibular joint by transcranial projection was recorded bilaterally at three conditions：the intercuspid occlusion,the maximum open bite position before treatment,and the occlusion when the appliance was in place.The anterior-posterior and vertical location of the condyle were measured from the film imaging.Paired t-tests were used to compare condyle positions among three occlusions.Correlation between the change of condyle position and effectiveness of the oral appliance were calculated.Results The condyle positions significantly differed among three occlusions （P〈0.05）.The upper point on the condyle of the patient wearing a mandibular advancement appliance was positioned at X（-1.21±1.98）mm and Y（-0.68±1.08）mm.The correlation between the change of condyle position and the effectiveness of the oral appliance were poor （protrusion r=0.057,inferiorly r=0.024）.Conclusion The upper most point of the condyle in the OSA patients wearing the effective mandibular advancement appliance was close to the articular tubercle point of the temporomandibular joint.