摘要
目的 分析安氏Ⅱ类错(牙合)畸形青少年应用双颌垫功能性矫治器的效果.方法 采用回顾性分析,将在开封市口腔医院救治的62例安氏Ⅱ类错(牙合)畸形患者作为研究对象,病例收集时间为2019年1月-2024年1月,根据治疗方法不同将其分为两组,即观察组(31例,采用TB功能性矫治器)和对照组(31例,采用标准方丝弓矫治器).比较两组上气道形态功能[上齿槽座角(sella-nasion-A point,SNA)、下齿槽座角(sella-nasion-B point,SNB)、上下齿槽座角(angle's A-point over B-point,ANB)、软腭后气道矢状径(maxillary pharyngeal segment,MPS)、咽后壁与软腭之间的距离(soft palate to posterior pharyngeal space distance,SPPS)、第二颈椎最下点与上气道后壁矢状径(inter-pedicular space,IPS)、后鼻腔高度(posterior nasal passage heigh,S-PNS)、鼻咽全长(base to posterior nasal spine,BA-PNS)、舌骨到颈椎的矢状向距离(hyoid-vertebral level,H-VL)、舌骨到蝶鞍中心点的矢状向距离(hy-oid point-sella,H-S)、舌骨到眶耳平面的垂直距离(hyoid point-frankfort horizontal,H-FH)、舌骨到下颌面的垂直距离(hyoid point-mandibular plane,H-MP)、氧减指数(oxygen desaturation index,ODI)、平均血氧饱和度(mean blood oxygen saturation,MSaO2)、最低血氧饱和度(lowest oxygen saturation,LSaO2)]、侧貌变化(下唇基角、颊唇沟角、软组织颊凸角、下唇凸点-H线距离)、正畸效果.结果 正畸12周后,观察组SNB、下唇基角、颊唇沟角均相比对照组较大;MPS、IPS、S-PNS、Ba-PNS均相比对照组较长;SNA、ANB、软组织颊凸角均相比对照组较小;SPPS、下唇凸点-H线距离均相比对照组较短;H-S、H-FH、H-MP、MSaO2、LSaO2均相比对照组较高;H-VL、ODI均相比对照组较低;差异有统计学意义(P＜0.05).观察组总有效率(93.55％)相比对照组总有效率(74.19％)较高,差异有统计学意义(x2=4.292,P＜0.05).结论 安氏Ⅱ类错(牙合)畸形青少年应用TB功能性矫治器,效果明确,不仅能有效改善上气道形态功能,调节舌骨位置,降低对侧貌的影响,还能优化睡眠情况.
Abstract
Objective Analyzing the results of applying a bimaxillary pad functional orthodontic appliance in adolescents with an Ann's Class Ⅱ malocclusion.Methods A retrospective analysis was conducted on 62 patients with class Ⅱ mal-occlusion treated at Kaifeng Stomatological Hospital.The case collection period was from January 2019 to January 2024,and they were divided into two groups based on different treatment methods:the observation group(31 cases,using TB functional appliances)and the control group(31 cases,using standard square wire appliances).Comparison of upper airway morphology and function between the two groups[sella-nasion-A point,SNA、sella nasion B point,SNB、Angle's A-point over B-point,ANB、Maxillary Pharyngeal Segment,MPS、Soft Palate to Posterior Pharyngeal Space Distance,SPPS、inter-pedicular space,IPS、Posterior Nasal Passage Heigh,S-PNS、base to posterior nasal spine,Ba-PNS],hyoid position[hyoid-vertebral level,H-VL、hyoid point-Sella,H-S、hyoid point-Frankfort horizontal,H-FH、hyoid point-mandibular plane,H-MP],sleep condition[oxygen desaturation index(ODI),mean oxygen saturation(MSaO2),minimum oxygen saturation(LSaO2)],lateral appearance changes(angle of lower lip base,angle of bucco-labial sulcus,angle of soft tissuebuccolabial convexity angle,lower lip convexity-H-line distance),and orthodontic outcome.Vertical distance(H-FH),vertical distance from the hyoid bone to the submandibular surface(H-MP),sleep status(Oxygen Deficiency Index(ODI),mean blood oxygen saturation(MSaO2),minimum blood oxygen satura-tion(LSaO2),changes in profile(lower lip base angle,buccal sulcus angle,soft tissue buccal convexity angle,lower lip convexity H-line distance),orthodontic effect.Results After 12 weeks of orthodontic treatment,the SNB,lower lip base angle,and buccal labial sulcus angle in the observation group were larger than those in the control group;MPS,IPS,S-PNS,and Ba PNS were all longer than those in the control group;SNA,ANB,and soft tissue buccal protrusion angle were all smaller compared to the control group;the SPPS and the distance between the lower lip protrusion and the H line were shorter compared to the control group;H-S,H-FH,H-MP,MSaO2,and LSaO2 were all higher than those in the control group;H-VL and ODI were lower compared to the control group;the difference was statistically significant(P＜0.05).The total effective rate of the observation group was 93.55％,which was higher than that of the control group,which was 74.19％,and the difference was statistically significant(x2=4.292,P＜0.05).Conclusion The application of TB functional appliance in teenagers with class Ⅱ malocclusion has a clear effect,which can not only effectively improve the morphology and function of upper airway,adjust the position of hyoid bone,reduce the impact on the profile,but also optimize the sleep condition.
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