上颌快速扩弓对鼻上颌复合体及上气道影响的CBCT研究

发布时间：2018-04-29 00:01

本文选题：上颌快速扩弓 + 鼻上颌复合体　；参考：《贵州医科大学》2017年硕士论文

【摘要】：目的:利用CBCT和Dolphin软件研究生长发育期上颌横向宽度不足患者经上颌快速扩弓治疗后短期内鼻上颌骨复合体及上气道形态的改变,并进一步分析两者变化协调性,从而为正畸临床制定合理、可行的矫治计划提供重要参考依据。方法:选择2014年12月至2016年9月于贵阳市口腔医院正畸科就诊的上颌横向宽度发育不足生长发育期错患者30例,男性8例,女性22例,平均年龄(13.14±1.45)岁。所有患者均采用Hyrax扩弓器进行上颌快速扩弓矫治,矫治前(T0)后(T1)均拍摄锥体束计算机断层扫描(CBCT),用Dolphin软件进行图像处理、三维重建、定点及分析,在影像冠状面测量矫治前后上颌双侧尖牙、前磨牙及磨牙的牙根和牙冠的距离变化;上颌骨宽度、前后鼻腔及鼻底颌骨宽度变化;在正中矢状面上确定气道分段平面,并测量后鼻棘平面、第二颈椎平面及第三颈椎平面气道的矢状径、冠状径、横截面积及各段气道高度和容积等项目。使用SPSS(Version19.0,SPSS,Chicago,USA)软件进行数据处理,应用配对t检验进行分析,通过比较T0和T1的数据,评价上颌快速扩弓对鼻上颌复合体及上气道形态的影响。结果:生长发育期患者经上颌快速扩弓治疗后,牙性及骨性的冠向测量指标均有显著变化。鼻外侧宽度增加(2.13±1.80)mm,上颌骨宽度增加(4.12±2.15)mm,矫治前后差异有统计学意义(P0.05)。扩弓后硬腭平面气道冠状径增加(3.30±2.56)mm,面积增加(75.37±53.92)mm,矫治前后差异具有统计学意义(P0.05),而矢状径无明显变化;鼻咽部气道表面积增加(33.57±57.10)mm2,容积增加(1009.59±1350.91)mm3,矫治前后差异具有统计学意义(P0.05)。腭咽及舌咽气道表面积及容积无明显变化。各段气道高度无明显变化。结论:生长发育期上颌横向宽度不足患者经上颌快速扩弓矫治后,在短期内能有效扩大鼻上颌复合体宽度,增大鼻咽气道容积,但对上气道口咽段及喉咽段影响较小。
[Abstract]:Objective: to study the morphologic changes of nasal and maxillary complex and upper airway in patients with maxillary transverse width deficiency after rapid maxillary arch expansion in a short period of time by using CBCT and Dolphin software, and to further analyze the coordination between the two changes. So as to establish a reasonable and feasible orthodontic clinical treatment plan to provide an important reference. Methods: from December 2014 to September 2016, 30 patients (8 males and 22 females, mean age of 13.14 卤1.45) were selected from orthodontic department of Guiyang Stomatology Hospital. All the patients were treated with Hyrax extender for maxillary rapid bowing. Before and after the correction, all the patients were photographed with Cone beam computed tomography (Dolphin) software for image processing, 3D reconstruction, fixed point and analysis. The distance between root and crown of maxillary bilateral canines, premolars and molars, the width of maxillary bone, the width of nasal cavity and nasal floor were measured on the coronal plane before and after orthodontic treatment, and the segmental plane of airway was determined on the median sagittal plane. The sagittal diameter, coronal diameter, cross-sectional area and airway height and volume of the posterior nasal spine plane, the second cervical spine plane and the third cervical plane airway were measured. The data were processed with SPSSV version 19.0 and analyzed by paired t-test. By comparing the data of T _ 0 and T _ 1, the effect of rapid maxillary arch expansion on the morphology of nasal and maxillary complex and upper airway was evaluated. Results: after rapid maxillary arch expansion, the coronal measurements of tooth and bone were significantly changed in patients with growth and development. The lateral nasal width increased 2.13 卤1.80 mm, and the maxillary width increased 4.12 卤2.15 mm. The difference was statistically significant before and after treatment (P 0.05). The coronal diameter and area of the airway were increased by 3.30 卤2.56mm and 75.37 卤53.92mm. the difference before and after treatment was statistically significant (P 0.05), but the sagittal diameter did not change, the surface area of nasopharynx airway increased by 33.57 卤57.10mm2, the volume increased by 1009.59 卤1350.91mm3, the difference before and after treatment was statistically significant. The surface area and volume of palatopharynx and glossopharyngeal tract did not change significantly. There was no significant change in airway height in each section. Conclusion: after rapid maxillary expansion in patients with insufficient transverse maxillary width during growth and development period, the width of nasomaxillary complex can be effectively enlarged and the volume of nasopharynx airway can be increased in a short time, but the effect on the oropharyngeal segment and larynx segment of upper airway is relatively small.
【学位授予单位】：贵州医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R783.5

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