华西口腔医学杂志 ›› 2012, Vol. 30 ›› Issue (6): 650-654.doi: 10.3969/j.issn.1000-1182.2012.06.021

• 专栏论著 • 上一篇    下一篇

下颌后退术后舌骨、舌体位置和咽腔间隙变化的锥形束CT分析

王宏伟1 齐素青1 王建国2 蔡智芳2 李创3   

  1. 1.邢台市眼科医院正畸科， 邢台054001； 2.天津市口腔医院正畸科， 天津300041； 3.石家庄市第二医院口腔科， 石家庄050051
  • 收稿日期:2012-04-27 修回日期:2012-06-05 出版日期:2012-12-01 发布日期:2012-12-01
  • 通讯作者: 齐素青，Tel：0319-7615242
  • 作者简介:王宏伟（1984—），男，河北人，住院医师，硕士

Detection to changes in hyoid and tongue positions, and pharyngeal airway following mandibular setback surgery by cone beam CT

Wang Hongwei1, Qi Suqing1, Wang Jianguo2, Cai Zhifang2, Li Chuang3.   

  1. 1. Dept. of Orthodontics, Xingtai Eye Hospital, Xingtai 054001, China; 2. Dept. of Orthodontics, Tianjin Stomatological Hospital, Tianjin 300041, China; 3. Dept. of Stomatology, The Second Hospital of Shijiazhuang, Shijiazhuang 050051, China
  • Received:2012-04-27 Revised:2012-06-05 Online:2012-12-01 Published:2012-12-01

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摘要：

目的研究正畸—正颌联合治疗骨性Ⅲ类错畸形对舌骨、舌体位置和咽腔间隙的影响，分析下颌后退与舌骨、舌体位置改变和咽腔间隙缩窄之间的相关性。方法选取经正畸—正颌联合治疗的患者20例为研究对象，于正颌手术前1周及术后6个月拍摄锥形束CT，三维重建颅颌面、气道及舌骨的立体模型，建立以蝶鞍中心（S）点为原点的三维坐标系。测量治疗前后咽腔各段最窄处的矢状径、冠状径、截面积，各段容积和咽腔总容积，同时测量颏前点、舌骨点、舌根点的三维位置，分析颏前点的变化与咽腔间隙及舌骨、舌体位置变化的相关性。结果治疗后，咽腔间隙呈现整体缩窄趋势。舌骨发生了后下移位，其中向后、向下平均移动距离分别为5.72、2.76 mm（P<0.05）；舌根点向后平均移动了4.04 mm（P<0.01）。19项相关性比较中，有统计学意义的项目有14项，其中下颌后退量与咽腔总容积改变的相关性最强（r=0.834，P<0.01）。结论正畸—正颌联合治疗骨性Ⅲ类错畸形可造成咽腔缩窄，舌骨后下移位，舌体向后移位；下颌后退量与咽腔间隙缩窄、舌骨和舌体位置的改变具有较强的相关性。

关键词: 正畸&mdash, 正颌联合治疗, 骨性Ⅲ类错畸形, 咽腔, 锥形束CT

Abstract:

Objective To observe changes in tongue and hyoid position, and pharyngeal airway in patients with skeletal class Ⅲ malocclusion after the combined orthodontic and orthognathic treatment. Methods Twenty patients were involved in this study. Cone beam CT（CBCT） was performed on patients one week before and six months after treatment. Raw data were reconstructed into three-dimensional model. To set up a three-dimensional reference frame, which was based by point “S”, the sagittal and transversal measurements, cross sectional areas, partial and total volumes were computed. The three-dimensional position changes of chin, hyoid bone and tongue were measured in order to analyze the amount of mandibular setback relationship with the changes of pharyngeal airway, hyoid bone and tongue positions. Results After treatment, the pharyngeal airway was constricted significantly. The hyoid significantly moved inferoposteriorly by 5.72 mm（backward） and 2.76 mm（downward） and the tongue moved posteriorly by 4.04 mm after surgery（P<0.05）. Among the 19 correlated indexes between the amount of mandibular setback and other measurements, 14 of which were significantly correlated（P<0.05）. The strongest correlation was found between the amount of mandibular setback and total volumes of pharyngeal airway（r=0.834, P<0.01）. Conclusion Following combination therapy, the pharyngeal airway space decreased, the hyoid moved inferoposteriorly and tongue moved posteriorly. There were great correlations between the amount of mandibular setback and the changes.

Key words: combined orthodontic and orthognathic treatment, skeletal class Ⅲ malocclusion, pharyngeal airway, cone beam CT

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