Lian Yun-Chia, Huang Yu-Shu, Guilleminault Christian, Chen Kuang-Tai, Hervy-Auboiron Michèle, Chuang Li-Chuan, Tsai Aileen I
Department of Pediatric Dentistry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
Graduate Institute of Craniofacial and Dental Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
J Dent Sci. 2017 Sep;12(3):253-260. doi: 10.1016/j.jds.2017.03.005. Epub 2017 May 12.
BACKGROUND/PURPOSE: The prematurely born and obstructive sleep apnea (OSA) could affect craniofacial and airway growth. The purpose of this study is to compare the differences in craniofacial and airway morphology between preterm and full-term children both with OSA problem.
The differences in craniofacial and airway morphology between preterm children and full-term children both with OSA problem during the prepubertal (age 6-10) and pubertal (age 11-14) period were measured using lateral cephalometric radiograph.
In the prepubertal period, effective maxillary length, and length from Go to Gn were smaller in the preterm group (n = 6) compared to the full-term (n = 8). The length of the soft palate was smaller and the distance soft palate-posterior side of nasopharynx was longer in preterm children. During puberty, (1) position of maxilla relative to cranial base: there was an anteroposterior maxilla and a mandibular discrepancy, a convexity of facial profile, (2) the distance from point A to nasion perpendicular, the distance from Pog to nasion perpendicular, and the ratio of effective maxillary length/effective mandibular length were smaller in the preterm group (n = 5) compare to the full-term (n = 6).
During prepuberty, the preterm children had a significantly shorter effective maxillary and mandibular length but the catch up growth resulted during the pubertal period in reduction in facial profile convexity and more important mandibular vertical growth toward a dolichocephalic profile. Due to preterm birth, OSA children have a different craniofacial morphology compared to the full-term. When using an oral device for passive myofunctional therapy, the treatment outcome maybe different.
背景/目的:早产和阻塞性睡眠呼吸暂停(OSA)可能会影响颅面和气道的生长。本研究的目的是比较患有OSA问题的早产儿童和足月儿童在颅面和气道形态上的差异。
使用头颅侧位X线片测量患有OSA问题的早产儿童和足月儿童在青春期前(6 - 10岁)和青春期(11 - 14岁)期间颅面和气道形态的差异。
在青春期前,与足月组(n = 8)相比,早产组(n = 6)的有效上颌长度以及从下颌角到颏下点的长度较小。早产儿童的软腭长度较小,软腭与鼻咽后侧的距离较长。在青春期,(1)上颌相对于颅底的位置:存在上颌前后向和下颌差异,面部轮廓凸出;(2)与足月组(n = 6)相比,早产组(n = 5)从A点到鼻根垂线的距离、从Pog点到鼻根垂线的距离以及有效上颌长度/有效下颌长度的比值较小。
在青春期前,早产儿童的有效上颌和下颌长度明显较短,但在青春期出现追赶生长,导致面部轮廓凸度减小,更重要的是下颌垂直生长,趋向于长头型轮廓。由于早产,OSA儿童与足月儿童相比具有不同的颅面形态。在使用口腔装置进行被动肌功能治疗时,治疗效果可能会有所不同。