成人骨性Ⅱ类错(牙合)口咽气道形态的CBCT研究

摘要

目的:应用锥形束CT(CBCT)测量成人骨性Ⅱ类错(牙合)患者口咽气道形态特征,分析上下颌骨的位置对气道的影响,为正畸临床评估骨性Ⅱ类错验患者气道三维结构,制定合理有效的治疗方案提供指导.方法:筛选CBCT资料,按纳入标准分为骨性Ⅱ类下颌后缩组和上颌前突组,以骨性Ⅰ类错(牙合)为对照组(各40例),采用Invivo 5软件测量相关指标并对数据进行统计分析.结果:在气道各段截面积、体积、矢状径、冠状径、气道角度及舌骨位置等测量项目上,骨性Ⅱ类下颌后缩组相对于骨性Ⅱ类上颌前突组及骨性Ⅰ类组有较显著的统计学差异(P＜0.05).骨性Ⅱ类下颌后缩患者明显呈现狭长、向后倾斜的口咽气道形态,而骨性Ⅰ类患者气道形态更为直立,且骨性Ⅱ类下颌后缩患者口咽气道截面最狭窄.结论:成人不同骨性错(牙合)畸形口咽气道三维特征不同,下颌骨矢状位置、长度较上颌骨对口咽气道形态影响更为显著.%Objective:To measure the oropharyngeal airway morphology of adults class Ⅱ skeletal malocclusion by cone-beam CT (CBCT) and analyze the influence on the position of the mandible on the airway to provide guidance for clinical treatment.Methods:One hundred and twenty cases were randomly selected from CBCT data and divided into three groups,including class Ⅰ skeletal malocclusion,class Ⅱ maxillary protrusion and mandibular retraction.Invivo 5 software was used to measure correlation index.Results:On the measuring items of cross-sectional area,volume,sagittal diameter,crown diameter,airway angle and hyoid position,class Ⅱ mandibular retraction group had statistically significant differences from maxillary protrusion group (P＜0.05).The pharyngeal airway morphology of class Ⅱ mandibular retraction was longer,narrower and more backward than class Ⅰ skeletal malocclusion.Furthermore,the cross-sectional area of class Ⅱ mandibular retraction was the narrowest one.Conclusion:The mandibular sagittal position and length have more significant influences on the morphology of the pharyngeal airway.The study states that the oropharynx airway morphologies of different skeletal malocclusions have significantly differences.