Karacay Seniz, Akin Erol, Ortakoglu Kerim, Bengi A Osman
Department of Orthodontics, Dental Sciences Center, Gulhane Military Academy, Ankara, Turkey.
Angle Orthod. 2006 Nov;76(6):1057-65. doi: 10.2319/112005-405.
Tongue thrust usually develops in the presence of anterior open bite in order to achieve anterior valve function. In the literature, tongue thrust is described both as the result and the cause of open bite. If it is an adaptation to malocclusion, then tongue posture and deglutitive tongue movements should change after treatment. In this case report, an adult who had skeletal open bite and Class II malocclusion caused by mandibular retrusion was treated surgically. The mandible was advanced in a forward and upward direction with a sagittal split osteotomy. The open bite and Class II malocclusion were corrected and an increase in the posterior airway space (PAS) was observed. Pretreatment and posttreatment dynamic magnetic resonance imaging (MRI) revealed that tongue tip was retruded behind the incisors and contact of the tongue with the palate increased. It was also determined that the anterior and middle portions descended, whereas the posterior portion was elevated at all stages. Advancement of the mandible, correction of open bite, and an increase in PAS affected not only the tongue posture and deglutitive movements, but also the breathing pattern of the patient.
吐舌习惯通常出现在前牙开牙合的情况下,以实现前牙瓣功能。在文献中,吐舌习惯既被描述为开牙合的结果,也被描述为开牙合的原因。如果它是对错牙合的一种适应,那么在治疗后舌姿势和吞咽时的舌运动应该会发生变化。在本病例报告中,一名因下颌后缩导致骨骼性开牙合和安氏II类错牙合的成年人接受了手术治疗。通过矢状劈开截骨术将下颌向前上方推进。开牙合和安氏II类错牙合得到矫正,并且观察到后气道间隙(PAS)增加。治疗前和治疗后的动态磁共振成像(MRI)显示,舌尖退缩到切牙后方,舌与腭的接触增加。还确定在各个阶段舌的前部和中部下降,而后部升高。下颌前突、开牙合的矫正以及PAS的增加不仅影响了舌姿势和吞咽运动,还影响了患者的呼吸模式。