恒牙列Ⅱ类高角骨面型MIA支持下拔牙矫治后上气道矢状径和舌骨位置的比较研究

发布时间：2018-05-24 14:35

  本文选题：正畸 + II类错牙合　； 参考：《广西医科大学》2017年硕士论文

【摘要】：目的对比恒牙列II类高角骨面型MIA支持下拔牙矫治后牙颌颅面结构的变化;比较恒牙列II类高角骨面型上气道矢状径与无鼾正常中国人之间的差异;对比II类高角骨面型MIA支持下拔牙矫治后上气道矢状径及舌骨位置的变化;探讨II类高角骨面型MIA支持下拔牙矫治后固有口腔容积的改变对上气道结构的影响。为临床诊疗提供参考。方法按纳入排除标准选取22例恒牙列II类高角骨面型患者,其中男7例、女15例,年龄14~34岁(19.82±5.90岁),ANB角5°~9°(6.82°±1.54°),SN-MP角40°~55°(45.48°±4.45°),所有病例拔牙设计,直丝弓矫治技术,配合种植钉支抗矫治。主动矫治时间20~28月,矫治完成后医患双方对矫治结果满意。矫治后前后牙尖窝关系良好,颌骨矢状向不调得到改善,垂直向得到一定的控制。X线头影测量方法测量比较恒牙列II类高角骨面型上气道矢状径与无鼾正常中国人之间的差异,测量比较恒牙列II类高角骨面型MIA支持下拔牙矫治前、后牙颌颅面结构的变化,测量比较II类高角骨面型MIA支持下拔牙矫治前、后上气道矢状径及舌骨位置的变化。SPSS17.0统计学软件,计量资料用t检验;对牙颌颅面结构、上气道矢状径及舌骨位置的相关指标进行Pearson相关分析。结果1.恒牙列ii类高角骨面型男、女性上气道鼻咽段、腭咽段、喉咽段较无鼾正常中国男、女性窄;恒牙列ii类高角骨面型女性上气道舌咽段较无鼾正常中国女性窄;差异均有统计学意义(p≤0.05)。2.恒牙列ii类高角骨面型mia支持下拔牙矫治后sna、anb、sn-mp、u1-sn角较矫治前减小,差异有统计学意义(p≤0.05);u1-l1角较矫治前增大,差异有统计学意义(p≤0.05)。3.恒牙列ii类高角骨面型mia支持下拔牙矫治后上气道矢状径鼻咽段、腭咽段、舌咽段较矫治前窄,喉咽段较矫治前增宽,但差异均无统计学意义(p0.05)。4.恒牙列ii类高角骨面型患者拔牙矫治后舌骨水平距离、垂直距离增大,矫治前后差异有统计学意义(p≤0.05)。5.矫治前后y轴角变化值与舌骨水平距离变化值呈正相关(p≤0.05);其余矫治前后牙颌颅面测量项目与上气道矢状径及舌骨位置变化值无相关性(p0.05)。结论1.恒牙列ii类高角骨面型mia支持下拔牙矫治后,上下颌骨矢状向不调得到良好改善,垂直向位置得到有效控制,提示临床完善的支抗设计及上下颌骨矢状向、垂直向的有效控制是该类错牙合正畸掩饰性治疗后牙颌颅面形态位置得以改善的基础;2.恒牙列ii类高角骨面型患者上气道矢状径各段均较无鼾正常中国人狭窄,研究结果进一步证明了前人“ii类高角骨面型患者具有狭长的上气道矢状径”之研究结论;3.恒牙列ii类高角骨面型mia支持下拔牙矫治后,上气道各段均发生了程度不同的狭窄、舌骨位置更趋低位,虽然矫治前后比较差异无统计学意义,但仍为不利于上气道正常功能行使的结果,也是OSAHS的发生隐患,需提请临床重视。
[Abstract]:Objective to compare the changes of maxillary craniofacial structure after extraction with the support of class II high horned bone facial type (MIA) of permanent dentition, and to compare the sagittal diameter of upper airway between class II hyperhorn bone type of permanent dentition and normal Chinese without snoring. To compare the changes of sagittal diameter and hyoid position of upper airway after extraction with the support of class II high horned bone MIA, and to investigate the effect of the changes of oral volume on the upper airway structure after extraction with MIA support of class II high horned bone. To provide reference for clinical diagnosis and treatment. Methods according to the exclusion criteria, 22 patients (male 7, female 15, age 14, 34 卤5.90 years old) with type II high horned facial type of permanent teeth were selected. The angle of ANB was 19.82 卤5.90 years old. The angle of SN-MP was 40 掳, 55 掳, 45.48 掳卤4.45 掳. All the patients were treated with straight wire orthodontic technique. The time of active correction was 20 ~ 28 months. After orthodontic treatment, the relationship of cusp fossa was good, the sagittal direction of jaw was improved, and the vertical direction was controlled. X-ray cephalometry was used to measure the difference between the sagittal diameter of the upper airway of class II of permanent teeth and the normal Chinese without snoring. The changes of maxillary craniofacial structure were measured before and after extraction with the support of class II high horned bone facial type (MIA) of permanent teeth. The changes of craniofacial structure were measured and compared before and after extraction with MIA support of class II high horned bone facial type. The changes of sagittal diameter and hyoid position of posterior upper airway. SPSS 17.0 statistical software was used to measure the data with t test, and Pearson correlation analysis was carried out on the structure of maxillary craniofacial, the sagittal diameter of upper airway and the position of hyoid bone. Result 1. The upper airway nasopharynx segment, palatopharynx segment and larynx segment were narrower in female than that in normal Chinese, and the upper airway glossopharyngeal segment was narrower in female than that in non-snoring group II. The difference was statistically significant (p 鈮，

本文编号：1929407