Aras Isil, Pasaoglu Aylin, Olmez Sultan, Unal Idil, Aras Aynur
Department of Orthodontics, Faculty of Dentistry, Ege University, 35080, Bornova, Izmir, Turkey.
Cihangir Mah. Kaptan Sokak Avcılar, Istanbul, Turkey.
J Orofac Orthop. 2016 Nov;77(6):454-462. doi: 10.1007/s00056-016-0062-0. Epub 2016 Oct 21.
Purpose of the present study was to determine and compare possible changes in the dimensions of the pharyngeal airway, morphology of the soft palate, and position of the tongue and hyoid bone after single-step or stepwise mandibular advancement using the Functional Mandibular Advancer (FMA).
The sample included 51 peak-pubertal Class II subjects. In all, 34 patients were allocated to two groups using matched randomization: a single-step mandibular advancement group (SSG) and a stepwise mandibular advancement group (SWG). Both groups were treated with FMA followed by fixed appliance therapy; the remaining 17 subjects who underwent only fixed appliance therapy constituted the control group (CG). The study was conducted using pre- and posttreatment lateral cephalometric radiographs. Data were analyzed by paired t test, one-way analysis of variance, and Pearson's correlation coefficient.
In the SWG and SSG, although increases in nasopharyngeal airway dimensions were not significant compared with those in the CG, enlargements in the oropharyngeal airway dimensions at the level of the soft palate tip and behind the tongue, and decreases in soft palate angulation, were significant. Tongue height increased significantly only in the SWG. Compared with the CG, while forward movement of the hyoid was more prominent in SSG and SWG, the change in the vertical movement of the hyoid was not significant. No significant difference between SWG and SSG was observed in pharyngeal airway, soft palate, tongue or hyoid measurements.
The mode of mandibular advancement in FMA treatment did not significantly affect changes in the pharyngeal airway, soft palate, tongue, and hyoid bone.
本研究的目的是确定并比较使用功能性下颌前移器（FMA）进行单步或逐步下颌前移后咽气道尺寸、软腭形态以及舌和舌骨位置的可能变化。
样本包括51名青春期高峰II类患者。总共34例患者通过匹配随机化分为两组：单步下颌前移组（SSG）和逐步下颌前移组（SWG）。两组均接受FMA治疗，随后进行固定矫治器治疗；其余仅接受固定矫治器治疗的17名受试者构成对照组（CG）。该研究使用治疗前和治疗后的头颅侧位X线片进行。数据采用配对t检验、单因素方差分析和Pearson相关系数进行分析。
在SWG和SSG中，尽管与CG相比，鼻咽气道尺寸的增加不显著，但软腭尖端水平和舌后口咽气道尺寸的增大以及软腭角度的减小是显著的。仅在SWG中舌高度显著增加。与CG相比，虽然SSG和SWG中舌骨向前移动更明显，但舌骨垂直移动的变化不显著。在咽气道、软腭、舌或舌骨测量方面，SWG和SSG之间未观察到显著差异。
FMA治疗中下颌前移的方式对咽气道、软腭、舌和舌骨的变化没有显著影响。
