中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2022, Vol. 20 ›› Issue (4): 354-359.doi: 10.19438/j.cjoms.2022.04.007

• 论著 • 上一篇    下一篇

关节功能板联合正颌-正畸治疗对特发性髁突吸收患者上气道结构变化的影响

朱柏恺*, 刘旌毅*, 吕政展, 郑美里, 汪席均, 河奈玲, 江凌勇   

  1. 上海交通大学医学院附属第九人民医院 口腔颅颌面科,上海交通大学口腔医学院,国家口腔医学中心, 国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海 200011
  • 收稿日期:2022-04-13 修回日期:2022-06-01 出版日期:2022-07-20 发布日期:2022-07-20
  • 通讯作者: 江凌勇,E-mail: jianglingyong@sjtu.edu.cn
  • 作者简介:朱柏恺（1996-），男，硕士研究生，E-mail: grigorzhu@gmail.com； 刘旌毅（1998-），男，硕士研究生，E-mail: liujy0406@126.com。*并列第一作者
  • 基金资助:
    国家自然科学基金（81870740,82071083）; 上海市优秀学术/技术带头人计划（20XD1422300）; 上海市“医苑新星”青年医学人才培养资助计划—杰出青年医学人才项目（HWJRS2019-72）; 上海申康医院发展中心临床三年行动计划资助（SHDC2020CR4084）; 上海交通大学医学院附属第九人民医院临床研究推助计划（临+计划）（JYLJ201807）; 上海交通大学医学院附属第九人民医院生物样本库项目（YBKB201919）

Structural alterations of upper airway space in idiopathic condylar resorption patients receiving combined orthodontic and orthognathic treatment with functional splint therapy: a CT-based study

ZHU Bo-kai, LIU Jing-yi, LYU Zheng-zhan, CHUNG Miri, WANG Xi-jun, HA Nayoung, JIANG Ling-yong   

  1. Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology. Shanghai 200011, China
  • Received:2022-04-13 Revised:2022-06-01 Online:2022-07-20 Published:2022-07-20

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摘要： 目的: 探讨关节功能板联合正颌-正畸治疗对特发性髁突吸收（idiopathic condylar resorption, ICR）患者上气道结构特征的影响。方法: 纳入2015年12月—2018年12月上海交通大学医学院附属第九人民医院收治的ICR患者14例,所有患者均接受关节功能板联合正颌-正畸治疗,平均治疗时间（55.2±8.4）个月。在关节功能板联合正颌-正畸治疗前（T0）、功能板治疗后（T1）和关节功能板联合正颌-正畸治疗后6个月（T2）,分别进行CT检查。对上气道矢状向距离、上气道容积和最小横截面积以及下颌骨和舌骨矢状向和垂直向的位置变化进行测量。采用SPSS 26.0软件包中的重复测量方差分析,检验不同治疗阶段各测量指标的差异。结果: 重复测量方差分析显示,关节功能板联合正颌-正畸治疗后,ICR患者下颌骨显著前移,上气道矢状向距离、上气道容积和最小横截面积显著增加（P<0.05）;但功能板治疗后表现为下颌骨后退,上气道各指标显著降低（P<0.05）。舌骨在治疗过程中无明显位置变化。结论: ICR患者关节功能板联合正颌-正畸治疗后,下颌骨显著前移、侧貌明显改善,上气道容积显著提高;但经过第一阶段功能板治疗后上气道有一定程度缩窄,伴下颌骨后退。

关键词: 特发性髁突吸收, 上气道, 关节功能板, 正颌-正畸治疗

Abstract: PURPOSE: To investigate the changes of upper airway characteristics in patients with idiopathic condylar resorption(ICR) receiving combined orthodontic and orthognathic treatment with functional splint therapy. METHODS: A total of 14 ICR patients admitted from 2015.12 to 2018.12 in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine were included in this study. They received combined orthodontic and orthognathic treatment with functional splint therapy, with an average treatment duration of 55.2±8.4 months. CT plain scanning was taken before functional splint therapy (T0), after functional splint therapy (T1) and 6 months after orthognathic surgery (T2). Changes in anteroposterior distance, total volume and minimal axial area(MAA) of upper airway, anteroposterior and vertical position of the mandible as well as the hyoid bone were assessed on CT scans. The significance of changes in all parameters among T0, T1 and T2 were tested using repeated-measures one-way analysis of variance(ANOVA) with SPSS 26.0 software package. RESULTS: Repeated-measures ANOVA revealed that the anteroposterior distance, total volume and MAA of PAS were significantly increased after combined orthodontic and orthognathic treatment with functional splint therapy, with mandible shifted anteriorly(P<0.05). After functional splint therapy, significant decreases were shown in all parameters above, while the mandible translated posteriorly(P<0.05). Hyoid bone did not present significant positional change after the treatment. CONCLUSIONS: After combined orthodontic and orthognathic treatment with functional splint therapy, the mandible translated anteriorly, while upper airway volume increased. After phase I of functional splint therapy, the upper airway volume decreased with mandible shifted posteriorly.

Key words: Idiopathic condylar resorption, Upper airway space, Functional splint therapy, Combined orthodontic and orthognathic treatment

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