预成型肌功能矫治器（T4K）早期矫治对安氏II类下颌后缩患者上气道的影响

摘要/Abstract

摘要： 目的:本研究探讨预成型肌功能矫治器（T4K）对替牙期安氏II类下颌后缩患者矫治前后上气道的影响。方法：选择从2018年2月到2018年8月在江苏省口腔医院正畸科接受治疗的23例替牙列期安氏II类下颌后缩的患者，平均年龄7.0±1.04岁，使用预成型肌功能矫治器（T4K）对患者进行6个月个月的矫治，拍摄治疗前、后锥形束CT，应用Dolphin 3D 11.9软件进行三维重建，采用SPSS 25.0软件进行统计学分析比较分析患者治疗前、后的测量相关指标变化。结果：患者经过治疗6个月后，除腭咽段外，上气道总体积（V总）、鼻咽段体积（V鼻咽）、舌咽段体积（V舌咽）与治疗前结果有统计学意义，其中鼻咽段体积（V鼻咽）变化最为显著；治疗后上气道鼻咽段、舌咽段最小横截面积有增大变化，差异均有统计学意义。结论：通过预成型肌功能矫治器（T4K）进行颌面功能矫治，有利于患者破除口腔不良习惯，训练舌头的位置和用鼻呼吸有利于恢复口周肌力间的平衡，促进患者颅颌面与气道的正确生长。

关键词: 预成型肌功能矫治器, T4K矫治器, 安氏II类, 早期矫治, 上气道

Abstract: Abstract OBJECTIVE: This study was to investigate the effect of pre-formed muscle function appliance (T4K) on upper airway before and after orthodontic treatment of Class II mandibular retraction in the dentition period.METHODS:Twenty-three patients with Class II mandibular retraction who underwent treatment in the orthodontic department of Jiangsu Provincial Stomatological Hospital from February 2018 to August 2018, with an average age of 7.0 ± 1.04 years were used. The muscle function appliance (T4K) was used to correct the patient for 6 months. The cone beam CT was taken before and after treatment. The Dolphin 3D 11.9 software was used for 3D reconstruction. The statistical analysis was performed by SPSS 25.0 software. And after the measurement related indicators change. RESULTS: After 6 months of treatment, the upper airway total volume、Nasopharyngeal volume、Glossopharyngeal volume and pre-treatment results were excluded except for the pharyngeal segment.Statistically significant,the volume of the nasopharyngeal segment was the most significant; the minimum cross-sectional area of the upper airway nasopharyngeal segment and the pharyngeal segment was increased after treatment,The difference wasstatistically significant Conclusion:The maxillofacail function correction by pre-forming muscle function appliance (T4K) is beneficial to patients to get rid of bad oral habits, training the position of the tongue and using nasal breathing to restore the balance between the muscles of the mouth and the muscles. Proper growth with the airway

Key words: Pre-formed muscle function appliance, T4K appliance, Angle class II, early correction, upper airway

中图分类号:

R783.5

王宝然苏咏宽耿忠楷侯伟胡健陈文静. 预成型肌功能矫治器（T4K）早期矫治对安氏II类下颌后缩患者上气道的影响[J]. , 2019, 39(10): 920-923.

参考文献 29

[1]	Gupta DK, Singh SP, Utreja A, et al.Prevalence of malocclusion and assessment of treatment needs in β-thalassemia major children[J].Prog Orthod, 2016, 1(17):7-7
[2]	Tak M, Nagarajappa R, Sharda AJ, et al.Prevalence of malocclusion and orthodontic treatment needs among 12-15 years old school children of Udaipur,India[J].Eur Jo Dent, 2013, 7(Suppl 1):S45-S53
[3]	Shirazi S, Kachoei M, Shahvaghar-Asl N, et al.Arch width changes in patients with Class II division 1 malocclusion treated with maxillary first premolar extraction and non-extraction method[J].J Clin Exp Dent, 2016, 8(4):403-408
[4]	Ali D, Mohammed H, Koo SH, et al.Three-dimensional evaluation of tooth movement in Class II malocclusions treated without extraction by orthodontic mini-implant anchorage[J].Korean J Orthod, 2016, 46(5):280-289
[5]	Feres MF, Raza H, Alhadlaq A, et al.Rapid maxillary expansion effects in Class II malocclusion:a systematic review[J].Angle Orthod, 2015, 85(6):1070-1079
[6]	Alhammadi MS, Fayed MS, Labib A.Three-dimensional assessment of condylar position and joint spaces after maxillary first premolar extraction in skeletal Class II malocclusion[J].Orthod Craniofac Res, 2017, 20(2):71-78
[7]	Tripathi N B, Patil S N.Treatment of class II division 1 malocclusion with myofunctional trainer system in early mixed dentition period[J]J Contemp Dent Pract.2011 Nov 1; 12(6):497-500.[J].J Contemp Dent Pract, 2011, 6(12):497-500
[8]	杨莉, 邓海艳, 张红妤, 等.骨性Ⅱ类错牙合畸形颌骨生长模式与上气道相关研究[J].中国实用口腔科杂志, 2017, 10(2):79-83
[9]	Iwasaki T, Sato H, Suga H, et al.Influence of pharyngeal airway respiration pressure on Class II mandibular retrusion in children:A computational fluid dynamics study of inspiration and expiration[J].Orthod Craniofac Res, 2017, 20(2):95-101
[10]	Prabhakar RR, Saravanan R, Karthikeyan MK, et al.Prevalence of malocclusion and need for early orthodontic treatment in children[J].J Clin Diagn Res, 2014, 8(5):Z-C60
[11]	Kumar P, Datana S, Londhe SM, et al.Rate of intrusion of maxillary incisors in Class II Div 1 malocclusion using skeletal anchorage device and Connecticut intrusion arch[J].Med J Armed Forces India, 2017, 73(1):65-73
[12]	殷治国, 邹茵, 程洋, 等.牵张成骨联合正颌正畸技术治疗颞下颌关节强直的效果分析[J].现代生物医学进展, 2015, 15(35):6911-6914
[13]	Maniewicz Wins S, Antonarakis GS, Kiliaridis S.Predictive factors of sagittal stability after treatment of Class II malocclusions[J].Angle Orthod, 2016, 86(6):1033-1041
[14]	侯伟, 李琥, 耿忠楷, 韩霖霏.双牙合垫矫治器对青少年骨性Ⅱ类下颌后缩患者上气道形态的影响[J].南京医科大学学报自然科学版, 2017, 37(12):1674-1677
[15]	蔡晓熹.患儿口腔不良习惯与错畸形发生情况调查分析[J].全科口腔医学电子杂志, 2016, 3(3):145-145
[16]	苏涵.口腔感觉功能评估[J].台湾医学, 2013, 17(4):435-440
[17]	Das U M, Reddy D.Treatment effects produced by preorthodontic trainer appliance in patients with class II division I malocclusion[J].Indian Soc Pedod Prev Dent, 2010, 28(1):30-33
[18]	李小兵.儿童早期肌功能训练与错畸形预防矫治[J].国际口腔医学杂志, 2015, 42(3):249-254
[19]	Castro-Silva L1, Monnazzi MS2, Spin-Neto R, Cone-beam evaluation of pharyngeal airway space in Class I, II and III patients.[J].Oral Surg Oral Med Oral Pathol Oral Radiol, 2015, 6(120):679-683
[20]	Kim YJ, Hong JS, Hwang YI, Park YH.Three-dimensional analysis of pharyngeal airway in preadolescent children with different anteroposterior skeletal patterns. [J].Am J Orthod Dentofacial Orthop., 2010, 1(137):1-136
[21]	Iwasaki T, Saitoh I, Takemoto Y, et al.Tongue posture improvement and pharyngeal airway enlargement as secondary effects of rapid maxillary expansion: a cone-beam computed tomography study[J].Am J Orthod Dentofacial Orthop., 2013, 2(143):235-245
[22]	]Ferguson KA, Love LL, Ryan CF.Effect of mandibular and tongue protrusion on upper airway size during wakefulness[J].Am J Respir Crit Care Med. , 1997 , 5(155):1748-1754
[23]	王威, 莫仕诚, 王林.矫治下颌后缩患者前、后的气道变化[J].上海口腔医学, 2018, 27(06):607-611
[24]	Restrepo C, A.SANTAMARíA, S. PELáEZ, et al. Oropharyngeal airway dimensions after treatment with functional appliances in class II retrognathic children[J].Oral Rehabil., 2011, 8(38):588-594
[25]	Hong K S, Shim Y S, Park S Y, et al.Oropharyngeal airway dimensional changes after treatment with trainer for kids (T4K) in class II retrognathic children2016 Oct; 45(10):1373-1375.[J].[J]Iran J Public Health, 2016, 10(45):1373-1375
[26]	Harvold EP, Tomer BS, Vargervik K, Chierici G. Primate experiments on oral respiration[J].Am J Orthod, 1981, 4(79):1-372
[27]	Tam BM, Noorwez SM, Kaushal S, et al.Photoactivation-induced instability of rhodopsin mutants T4K and T17M in rod outer segments underlies retinal degeneration in Xlaevis transgenic models of retinitis pigmentosa[J].J Neurosci, 2014, 34(40):13336-13348
[28]	?irgi? E, Kjellberg H, Hansen K.Treatment of large overjet in Angle Class Ⅱ: division 1 malocclusion with Andresen activators versus prefabricated functional appliances—a multicenter, randomized, controlled trial[J].Eur J Orthod., 2015, 5(38):516-524
[29]	李小兵.儿童早期肌功能训练与错畸形预防矫治[J].国际口腔医学杂志, 2015, 42(3):249-254