Laranjo Filipe, Pinho Teresa
Instituto Superior de Ciências da Saúde-Norte, CESPU, Portugal.
Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS), CESPU; Department of Orthodontics, Instituto Superior de Ciências da Saúde-Norte, CESPU, Rua Central de Gandra, 1317 4585-116 Gandra PRD, Portugal.
Int Orthod. 2014 Dec;12(4):467-82. doi: 10.1016/j.ortho.2014.10.005. Epub 2014 Nov 13.
Open bite is related to various etiological factors and, in many cases, is difficult to diagnose. The present study is aimed at evaluating, through cephalometric analysis, the dimensions of the upper airways and dentoalveolar heights in open bite (OB) patients versus normal overbite patients. The relationship between the width of the upper airways and the lack of overbite is also studied, in order to differentiate between dental open bite (DOB) and skeletal open bite (SOB).
Eighty X-rays were selected from files of orthodontic patients to form the control sample (n=40) and open bite sample (n=40). Dimensions of the upper airways and dentoalveolar heights were measured in both samples, using 16 linear measurements, two angle values and one ratio.
In OB patients, anteroposterior narrowing of the upper airways, mainly in the nasopharynx and oropharynx, was observed, together with forward displacement of the hyoid bone and increased maxillary and mandibular dentoalveolar heights, and anterior facial height. In SOB, the overbite was more negative and facial growth was more clockwise-oriented than in DOB. Greater narrowing of the airways in the anteroposterior orientation was also noted. In DOB, there was evidence of muscular adaptation, as shown by increased values of the hyoid bone displacement to a more anterior and lower position, and increased values of the vertical dimensions of the airways. An increase in posterior facial height was also observed allowing anterior rotation of the mandible.
The results suggest that the airway's dimensions reflect a tendency to open bite. The variable vertical airway length (Val) and the position of the hyoid bone allow the adaptive potential of these individuals to be determined and make the treatment of open bites more predictable.
开(牙合)与多种病因相关,且在许多情况下难以诊断。本研究旨在通过头影测量分析,评估开(牙合)(OB)患者与正常覆(牙合)患者上气道的尺寸和牙槽高度。还研究了上气道宽度与覆(牙合)缺失之间的关系,以区分牙性开(牙合)(DOB)和骨性开(牙合)(SOB)。
从正畸患者档案中选取80张X线片,组成对照样本(n = 40)和开(牙合)样本(n = 40)。使用16项线性测量、两个角度值和一个比率,测量了两个样本中上气道的尺寸和牙槽高度。
在开(牙合)患者中,观察到上气道前后径变窄,主要发生在鼻咽部和口咽部,同时舌骨向前移位,上颌和下颌牙槽高度增加,以及面前部高度增加。在骨性开(牙合)中,覆(牙合)比牙性开(牙合)更呈负值,面部生长更偏向顺时针方向。还注意到气道在前后方向上变窄更明显。在牙性开(牙合)中,有肌肉适应的证据,表现为舌骨移位到更前下方位置的值增加,以及气道垂直尺寸的值增加。还观察到面后部高度增加,使下颌骨向前旋转。
结果表明气道尺寸反映了开(牙合)的倾向。可变的垂直气道长度(Val)和舌骨位置有助于确定这些个体的适应潜力,并使开(牙合)的治疗更具可预测性。