首页|骨性Ⅲ类患者双颌正颌手术后上气道形态变化与颌骨移动量的相关性研究

骨性Ⅲ类患者双颌正颌手术后上气道形态变化与颌骨移动量的相关性研究

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目的 通过锥形束计算机断层扫描(cone beam computer tomography,CBCT)探究骨性Ⅲ类错牙合畸形患者双颌手术后上气道形态变化,以及颌骨移动与气道变化的关系.方法 本研究纳入44 例Ⅲ类双颌手术患者(男性21 例,女性23 例).采集患者术前及术后 3~6 个月内CBCT数据,使用Dophin3D 11.95 软件行测量分析.采用配对t检验、非参数Wilcoxon秩和检验分析上气道手术前后变化.采用Pearson相关系数分析气道变化与颌骨移动量的相关性.结果 术后患者的上气道容积、正中矢状面纵截面积、最小横截面积明显减少(P<0.01).口咽区容积变化量与B点的变化量相关(P<0.05).随B点后退量的增加,上气道容积降低的显著性增加,当B点后退量>7mm时,上气道各区域容积均显著降低(P<0.01),同时患者气道最小横截面积的危险程度显著升高(P<0.01).结论 骨性Ⅲ类双颌手术可降低患者的上气道容积.术后上气道容积减少量与B点后退量相关.当行大量下颌后退(>7 mm)时,可造成上气道容积的显著减低,增加OSAHS患病风险.对上气道有狭窄倾向的患者,应适当调整方案以减少气道风险.
Correlation between upper airway morphological changes and jaw movement after bimaxillary orthognathic surgery in pa-tients with skeletal Class Ⅲ malocclusion
Objective To investigate the morphological changes in the upper airway after bimaxillary surgery in patients with skeletal Class Ⅲ malocclusion and the relationship between jaw movement and airway changes using CBCT.Methods This study involved 44 individuals(21 males and 23 females)receiving Class Ⅲ bimaxillary surgery.Preoperative and 3-6-month postoperative CBCT data were examined using Dophin3D 11.95 software.The alterations before and after upper airway surgery were analysed using paired t-test and non-parametric Wilcoxon rank sum test.The association between airway alterations and jaw movement was examined using Pearson's correlation coefficient.Results Patients who underwent Class Ⅲ bimaxillary surgery had significantly reduced upper airway volume,sagittal cross-sectional area,and minimum cross-sectional area(P<0.01).A correlation exists between oropharyngeal volume change and point B change(P<0.05).When B point recession was>7 mm,the decrease in upper airway volume increased significantly(P<0.01),as did the risk of minimum cross-sectional area of the patient's airway(P<0.01).Conclusion ClassⅢbimaxillary surgery re-duces upper airway capacity.Postoperative reduction in upper airway capacity coincides with mandibular recession.Mandibular reces-sion(>7 mm)may reduce postoperative upper airway capacity and increase the risk of OSAHS.Patients at risk of upper airway stenosis should have their protocol modified to reduce airway risk.

skeletal Class Ⅲ malocclusionbimaxillary orthognathic surgerypharyngeal airwaycone-beam computed tomography

李根、郭松松、蔡观慧、孙莲、孙雯、王华

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南京医科大学江苏省口腔疾病研究重点实验室,江苏南京(210029)

南京医科大学江苏省口腔转化医学工程研究中心,江苏南京(210029)

南京医科大学附属口腔医院口腔颌面外科,江苏南京(210029)

南京医科大学附属口腔医院正畸科,江苏南京(210029)

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骨性Ⅲ类错牙合畸形 双颌手术 上气道 CBCT

国家自然科学基金

81970961

2024

口腔医学
南京医科大学口腔医学院

口腔医学

CSTPCD
影响因子:0.641
ISSN:1003-9872
年,卷(期):2024.44(7)
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