Chen Xueling, Liu Dongxu, Liu Ju, Wu Zizhong, Xie Yongtao, Li Liang, Liu Hong, Guo Tiantian, Chen Chen, Zhang Shijie
Department of Orthodontics, School of Dentistry, Shandong University, Jinan, China; Department of Orthodontics, Shandong Provincial Key Laboratory of Oral Biomedicine, School of Dentistry, Shandong University, Jinan, China; Department of Stomatology, Qilu Hospital of Shandong University, Jinan, China.
Department of Orthodontics, School of Dentistry, Shandong University, Jinan, China; Department of Orthodontics, Shandong Provincial Key Laboratory of Oral Biomedicine, School of Dentistry, Shandong University, Jinan, China.
PLoS One. 2015 Aug 7;10(8):e0135273. doi: 10.1371/journal.pone.0135273. eCollection 2015.
The aim of this study was to evaluate the morphological changes of upper airway after protraction headgear and rapid maxillary expansion (PE) treatment in growing patients with Class III malocclusion and maxillary skeletal deficiency compared with untreated Class III patients by cone-beam computed tomography (CBCT).
Thirty growing patients who have completed PE therapy were included in PE group. The control group (n = 30) was selected from the growing untreated patients with the same diagnosis. The CBCT scans of the pre-treatment (T1) and post-treatment (T2) of PE group and the control group were collected. Reconstruction and registration of the 3D models of T1 and T2 were completed. By comparing the data obtained from T1, T2 and control group, the morphological changes of the upper airway during the PE treatment were evaluated.
Comparing with the data from T1 group, the subspinale (A) of maxilla and the upper incisor (UI) of the T2 group were moved in the anterior direction. The gnathion (Gn) of mandible was moved in the posterior-inferior direction. The displacement of the hyoid bone as well as the length and width of dental arch showed significant difference. The volume and mean cross-sectional area of nasopharynx, velopharynx and glossopharynx region showed significant difference. The largest anteroposterior/the largest lateral (AP/LR) ratios of the velopharynx and glossopharynx were increased, but the AP/LR ratio of the hypopharynx was decreased. In addition, the length and width of the maxillary dental arch, the displacement of the hyoid bone, the volume of nasopharynx and velopharynx, and the AP/LR ratio of the hypopharynx and velopharynx showed significant difference between the data from control and T2 group.
The PE treatment of Class III malocclusion with maxillary skeletal hypoplasia leads to a significant increase in the volume of nasopharynx and velopharynx.
本研究旨在通过锥形束计算机断层扫描（CBCT）评估生长发育期III类错颌畸形伴上颌骨骨骼发育不足患者在使用前牵引矫治器和快速上颌扩弓（PE）治疗后上气道的形态变化，并与未经治疗的III类患者进行比较。
PE组纳入30例完成PE治疗的生长发育期患者。对照组（n = 30）选自未经治疗的同诊断生长发育期患者。收集PE组和对照组治疗前（T1）和治疗后（T2）的CBCT扫描图像。完成T1和T2三维模型的重建与配准。通过比较T1、T2及对照组获得的数据，评估PE治疗期间上气道的形态变化。
与T1组数据相比，T2组上颌骨棘下点（A）和上前牙（UI）向前移动。下颌骨颏点（Gn）向后下移动。舌骨移位以及牙弓长度和宽度显示出显著差异。鼻咽、腭咽和舌咽区域的体积和平均横截面积显示出显著差异。腭咽和舌咽的最大前后径/最大左右径（AP/LR）比值增加，但下咽的AP/LR比值降低。此外，对照组和T2组数据在上颌牙弓长度和宽度、舌骨移位、鼻咽和腭咽体积以及下咽和腭咽的AP/LR比值方面存在显著差异。
对上颌骨发育不全的III类错颌畸形进行PE治疗可导致鼻咽和腭咽体积显著增加。
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