Department of Orthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China.
Department of Radiology, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, People's Republic of China.
Head Face Med. 2022 Apr 19;18(1):14. doi: 10.1186/s13005-022-00317-2.
Bimaxillary surgery is often performed for class III malocclusion, and its complex influence on the upper airway has been well considered. The aim of this research was to provide a scaled formula between upper airway volume changes and bone movements in Class III patients after orthognathic surgery.
Using a retrospective study design, the investigators enrolled a total of 30 class III malocclusion patients who were undergoing bimaxillary surgery as the study subjects. The subjects included 15 males and 15 females, and their average age was 23.3 ± 3.4 years. CBCT (cone beam tomography) was performed both before and one year after the surgery for each patient. The changes in the soft palate, tongue and upper airway were measured by using CBCT data that was collected before and after surgery. 3D superimposition of CBCT was performed to calculate three-dimensional jaw movements. A multiple regression analysis was used to calculate the quantitative relationship between airway volume changes and jaw movements.
The nasopharynx airway volume was observed to be increased by 1064.0 ± 1336.2 mm, whereas the retropalatal and retroglossal airway volumes were observed to be decreased by 1399.0 ± 2881.6 mm and 1433.8 ± 3043.4 mm, respectively, after the surgery. One millimetre forward and downward movements of the PNS resulted in increases of 626.90 mm and 392.18 mm in nasopharynx airway volume, respectively. Moreover, one millimetre retrogression of the B point caused decreases of 314.6 mm and 656.6 mm in the retropalatal and retroglossal airway volume, respectively. The changes in the soft palate contributed to the decrease in the retropalatal airway volume, whereas the tongue compensated for the decrease in the retroglossal airway volume.
The movements of the PNS and B points could be used to predict upper airway volumetric changes in Class III patients after maxillary advancement and mandibular setback.
双颌手术常用于治疗 III 类错颌畸形，其对上气道的复杂影响已得到充分考虑。本研究旨在为正颌手术后 III 类患者的上气道容积变化与骨骼运动之间提供一种比例公式。
采用回顾性研究设计，共纳入 30 例接受双颌手术的 III 类错颌畸形患者作为研究对象。其中男性 15 例，女性 15 例，平均年龄 23.3±3.4 岁。每位患者均在术前和术后 1 年进行 CBCT（锥形束 CT）检查。通过对术前和术后 CBCT 数据的测量，比较软腭、舌及上气道的变化。通过 3D 叠加 CBCT 计算三维颌骨运动。采用多元回归分析计算气道容积变化与颌骨运动之间的定量关系。
术后患者的鼻咽气道容积增加了 1064.0±1336.2mm，而腭后气道和舌后气道容积分别减少了 1399.0±2881.6mm 和 1433.8±3043.4mm。PNS 前下移动 1mm 可使鼻咽气道容积分别增加 626.90mm 和 392.18mm。此外，B 点后移 1mm 可使腭后气道和舌后气道容积分别减少 314.6mm 和 656.6mm。软腭的变化导致腭后气道容积减小，而舌则代偿了舌后气道容积的减小。
PNS 和 B 点的运动可用于预测上颌前突和下颌后退术后 III 类患者的上气道容积变化。
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