拔牙与非拔牙矫治骨性Ⅰ类错牙合畸形对口咽气道的影响

摘要/Abstract

摘要： 目的　比较拔牙矫治与非拔牙矫治对Ⅰ类错牙合畸形患者口咽气道容积差异，评估拔牙矫治对口咽气道的影响。方法　本研究选取骨性Ⅰ类错牙合畸形患者40例，其中拔牙矫治（拔除4个前磨牙）及非拔牙矫治各20例，采用锥形束CT（CBCT）头影测量技术，就矫治前、后3个骨性测量项目、4个牙性测量项目及口咽气道大小进行测量比较。配对t检验比较拔牙矫治组与非拔牙矫治组在矫治前（T0）与矫治后（T1）口咽气道容积差异，两样本t检验评估拔牙与非拔牙矫治对口咽气道容积的影响。结果　无论拔牙矫治组还是非拔牙矫治组，矫治后面中部长度及下颌骨有效长度均较矫治前增大（P＜0.01）；在拔牙矫治组，矫治后上切牙唇倾度、下切牙唇倾度、上切牙凸距及下切牙凸距均较矫治前减小（P＜0.01）；拔牙矫治组与非拔牙矫治组，矫治前后口咽气道容积及气道最窄处面积的改变，两组间比较无统计学意义（P＞0.05）。拔牙矫治组8例患者矫治后口咽部最狭窄区域相对牙合平面位置发生改变，而非拔牙矫治组6例患者矫治后口咽部最狭窄区域相对牙合平面位置发生改变。结论　拔牙矫治Ⅰ类错牙合畸形——拔除4个前磨牙，内收上前牙并不影响口咽气道大小。

关键词: 锥形束CT, 头影测量, 口咽气道, 拔牙矫治, 非拔牙矫治

Abstract: Objective　To compare the effects of extraction versus nonextraction orthodontic treatments on oropharyngeal airway volume in patients with skeletal classⅠmalocclusion. Methods　40 patients with skeletal classⅠmalocclusion were selected, including 20 with four premolars extracted (Extraction Group, ExtG) and 20 controls (Non-extraction Group, NExtG). They were screened for pretreatment (T0) and posttreatment (T1) cone beam computed tomography (CBCT) scans. Constructed lateral cephalograms (three skeletal and four dental variables) and oropharyngeal (OP) volumes were measured at T0 and T1. Paired sample t-tests were used to compare the mean changes from T0 to T1 in both ExtG and NExtG. Independent sample t-tests were used to evaluate the different effects of extraction versus non-extraction treatment on oropharyngeal airway volume. Results　Changes in CoA and CoGn from T0 to T1 were found to be significant in both groups (P＜0.01）. In the ExtG alone, significant differences in U1-FH、IMPA、U1-Na Perp and L1-Na Perp were also found at the end of the treatment (P＜0.01). Despite the observed changes, differences in OP volumes and minimal constricted axial areas from T0 to T1 were not significant between two groups（P＞0.05）. In the ExtG, the location of the minAx changed in 8 patients at T1, and the minAx of 6 patients changed in NExtG at T1. Conclusion　Extraction of four premolars with retraction of incisors does not affect OP airway volume in the orthodontic treatment of skeletal classⅠmalocclusion.

Key words: Cone- beam compute tomography, cephalometric, Oropharyngeal airway, Extraction treatment, Non-extraction correction

中图分类号:

R783.5

束嫘周洪邵文龙. 拔牙与非拔牙矫治骨性Ⅰ类错牙合畸形对口咽气道的影响[J]. 口腔医学, 2014, 34(7): 524-527.

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