Pliska Benjamin T, Tam Isaac T, Lowe Alan A, Madson Alisa M, Almeida Fernanda R
Assistant professor, Division of Orthodontics, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada.
Private practice, Vancouver, British Columbia, Canada.
Am J Orthod Dentofacial Orthop. 2016 Dec;150(6):937-944. doi: 10.1016/j.ajodo.2016.05.013.
The aim of this study was to examine the effects of orthodontic treatment with and without extractions on the anatomic characteristics of the upper airway in adults.
For this retrospective study, the pretreatment and posttreatment cone-beam computed tomography scans of 74 adult patients meeting defined eligibility criteria were analyzed. Imaging software was used to segment and measure upper airway regions including the nasopharynx, the retropalatal, and retroglossal areas of the oropharynx, as well as the total airway. The Wilcoxon signed rank test was used to compare volumetric and minimal cross-sectional area changes from pretreatment to posttreatment.
The reliability values were high for all measurements, with intraclass correlation coefficients of 0.82 or greater. The volumetric treatment changes for the extraction and nonextraction groups were as follows: total airway, 1039.6 ± 3674.3 mm vs 1719.2 ± 4979.2 mm; nasopharynx, 136.1 ± 1379.3 mm vs -36.5 ± 1139.8 mm; retropalatal, 412.7 ± 3042.5 mm vs 399.3 ± 3294.6 mm; and retroglossal, 412.5 ± 1503.2 mm vs 1109.3 ± 2328.6 mm. The treatment changes in volume or minimal cross-sectional area for all airway regions examined were not significantly (P >0.05) different between the extraction and nonextraction groups.
Orthodontic treatment in adults does not cause clinically significant changes to the volume or the minimally constricted area of the upper airway. These results suggest that dental extractions in conjunction with orthodontic treatment have a negligible effect on the upper airway in adults.
本研究的目的是探讨拔牙与不拔牙的正畸治疗对成人上气道解剖特征的影响。
在这项回顾性研究中，分析了74例符合既定入选标准的成年患者治疗前和治疗后的锥形束计算机断层扫描。使用影像软件对上气道区域进行分割和测量，包括鼻咽部、口咽的腭后区和舌后区以及整个气道。采用Wilcoxon符号秩检验比较治疗前到治疗后体积和最小横截面积的变化。
所有测量的可靠性值都很高，组内相关系数为0.82或更高。拔牙组和不拔牙组的体积治疗变化如下：整个气道，1039.6±3674.3立方毫米对1719.2±4979.2立方毫米；鼻咽部，136.1±1379.3立方毫米对-36.5±1139.8立方毫米；腭后区，412.7±3042.5立方毫米对399.3±3294.6立方毫米；舌后区，412.5±1503.2立方毫米对1109.3±2328.6立方毫米。拔牙组和不拔牙组在所有检查的气道区域的体积或最小横截面积的治疗变化差异均无统计学意义（P>0.05）。
成人正畸治疗不会对上气道的体积或最小缩窄区域产生临床上显著的变化。这些结果表明，正畸治疗联合拔牙对成人上气道的影响可以忽略不计。
