骨性Ⅲ类畸形正颌外科术后咽腔间隙短期及长期影响的锥形束CT分析被引量：1

Cone-beam computed tomography evaluation of short-and long-term airway changes in patients with skeletal Class Ⅲ malocclusion treated by orthodontic therapy and bimaxillary surgery with or without mandibular setback surgery

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摘要目的 :评价正畸联合单颌或双颌手术治疗骨性Ⅲ类畸形对咽腔间隙短期及长期的影响。方法 :选取骨性Ⅲ类患者54例(男28例,女26例),A组(28例)采用正畸联合下颌支矢状劈开术治疗。B组患者(26例)采用正畸联合上颌支Le Fort I型加下颌矢状劈开术治疗,正畸治疗前1周(T0)、术后6个月(T1)及术后3年(T2)拍摄锥形束CT(CBCT),三维重建上气道模型,对治疗前、后各段矢状径、冠状径、截面积和容积进行定量分析。采用SPSS17.0软件包进行统计学分析,比较治疗前、术后6个月及3年上气道的三维变化。结果:A组患者术后6个月各段矢状径和截面积均显著减小(P<0.05),口咽段、舌咽段容积及总容积显著小于治疗前(P<0.05)。术后3年,除第一颈椎平面处矢状径和截面积恢复到治疗前水平(T2-T0:P>0.05,T2-T1:P<0.05)外,其余部位均有所增加但未恢复到治疗前水平。B组患者术后6个月第二、三、四颈椎平面处矢状径和截面积显著减少,但在术后3年大部分缩窄的部位恢复到治疗前水平。结论:正畸-正颌联合治疗骨性Ⅲ类畸形会造成咽腔缩窄,随着时间延长,会有一定程度的恢复,但不能完全恢复到治疗前水平。 PURPOSE： To evaluate the short-term and long-term effects of pharyngeal airway in skeletal Class Ⅲ malocclusion patients who underwent bimaxillary surgery or isolated mandibular setback-orthodontic treatment. METHODS： The sample included 54 patients （28 males, 26 females） who were diagnosed with skeletal Class Ⅲ malocclusion. Patents in group A （n=28） underwent mandibular setback surgery and orthodontic treatment. Cone-beam CT （CBCT） was taken at one week before treatment （T0）, 6 months （T1） and 3 years after surgery （T2）.Patents in group B（n=26） underwent Le Fort I procedures with bilateral split ramus osteotomies-orthodontic treatment; The raw data reconstructed into 3D model. Sagittal and transversal measurements, cross sectional areas, partial and total volumes were evaluated. The data were statistically analyzed using SPSS 17.0 software package to determine the changes in each group. RESULTS： Six months after surgery, the sagittal diameters and cross sectional areas of each section in group A were significantly decreased （P〈0.05）. Oropharyngeal volume, hypopharyngeal volume and total volume were significantly narrowed （P〈0.01）. Three years after surgery, only sagittal and cross sectional areas in the first cervical vertebra plane were returned to the original levels （T2-T0：P〉0.05, T2-T1： P〈0.05）. In group B, the sagittal diameters and cross sectional areas of each section （except CV1 plane） were significantly decreased（P〈0.05） 3 years after surgery, but most measurements returned to the original levels. CONCLUSIONS： Pharyngeal airway space decreased after combined therapy in the short term; however, relapse occurred and not to its original position in the long term.

作者王宏伟李丽艳齐素青闫明张超任素峰班建东

机构地区河北省眼科医院口腔正畸科河北省眼科医院口腔外科

出处《上海口腔医学》 CAS CSCD 2016年第4期487-491,共5页 Shanghai Journal of Stomatology

关键词正畸-正颌联合治疗骨性Ⅲ类畸形咽腔锥形束CT Orthodontic-surgery treatment Skeletal Class Ⅲ malocclusion Pharyngeal airway Cone-beam CT

分类号 R783.5 [医药卫生—口腔医学]

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参考文献15

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