Kim Min-Ah, Park Yang-Ho
Resident, Department of Orthodontics, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
Professor, Department of Orthodontics, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
J Oral Maxillofac Surg. 2014 Jan;72(1):165.e1-10. doi: 10.1016/j.joms.2013.09.020.
The purpose of this study was to assess the pharyngeal airway volume change after bimaxillary surgery in patients with skeletal Class III malocclusion and evaluate the difference in postoperative pharyngeal airway space between upper premolar extraction cases and nonextraction cases.
Cone-beam computed tomographic scans were obtained for 23 patients (13 in extraction group and 10 in nonextraction group) who were diagnosed with mandibular prognathism before surgery (T0) and then 2 months (T2) and 6 months after surgery (T3). Using InVivoDental 3-dimensional imaging software, volumetric changes in the pharyngeal airway space were assessed at T0, T2, and T3. The Wilcoxon signed-rank test was used to determine whether there were significant changes in pharyngeal airway volume between time points. The Mann-Whitney U test was used to determine whether there were significant differences in volumetric changes between the extraction and nonextraction groups.
Volumes in all subsections of the pharyngeal airway were decreased (P < .05) except for changes in the oropharyngeal airway volume in the nonextraction group from T0 to T2. There were significant differences between the extraction and nonextraction groups in the changes of oro- and total pharyngeal airway volumes from T0 to T3.
The null hypothesis was rejected. The extraction of upper premolars rather than nonextraction decreased the pharyngeal airway space more in patients with mandibular prognathism who planned to have bimaxillary surgery.
本研究旨在评估骨性Ⅲ类错牙合患者双颌手术后咽气道容积的变化,并评估上前磨牙拔除病例与非拔除病例术后咽气道间隙的差异。
对23例患者(拔除组13例,非拔除组10例)进行锥形束计算机断层扫描,这些患者在手术前(T0)、术后2个月(T2)和术后6个月(T3)被诊断为下颌前突。使用InVivoDental三维成像软件,在T0、T2和T3评估咽气道间隙的容积变化。采用Wilcoxon符号秩检验来确定不同时间点之间咽气道容积是否有显著变化。采用Mann-Whitney U检验来确定拔除组与非拔除组在容积变化上是否存在显著差异。
除了非拔除组从T0到T2口咽气道容积有变化外,咽气道所有亚节段的容积均减小(P <.05)。从T0到T3,拔除组与非拔除组在口咽气道和总咽气道容积变化方面存在显著差异。
原假设被拒绝。对于计划进行双颌手术的下颌前突患者,拔除上前磨牙而非不拔牙会使咽气道间隙减小得更多。