Ozbilen Elvan Onem, Papaefthymiou Petros, Yilmaz Hanife Nuray, Küçükkeleş Nazan
Department of Orthodontics, School of Dentistry, Marmara University, Istanbul, Turkey.
Department of Orthodontics, Bezmialem Vakıf University Faculty of Dentistry, Istanbul, Turkey.
Korean J Orthod. 2023 Jan 25;53(1):35-44. doi: 10.4041/kjod22.117.
Surgically assisted maxillary protraction is an alternative protocol in severe Class III cases or after the adolescent growth spurt involving increased maxillary advancement. Correction of the maxillary deficiency has been suggested to improve pharyngeal airway dimensions. Therefore, this retrospective study aimed to analyze the airway changes cephalometrically following surgically assisted maxillary protraction with skeletal anchorage and Class III elastics.
The study population consisted of 15 Class III patients treated with surgically assisted maxillary protraction combined with skeletal anchorage and Class III elastics (mean age: 12.9 ± 1.2 years). Growth changes were initially assessed for a mean of 5.5 ± 1.6 months prior to treatment. Airway and skeletal changes in the control (T0), pre-protraction (T1), post-protraction (T2), and follow-up (T3) periods were monitored and compared using lateral cephalometric radiographs. Statistical significance was set at < 0.05.
The skeletal or airway parameters showed no statistically significant changes during the control period. Sella to nasion angle, N perpendicular to A, Point A to Point B angle, and Frankfort plane to mandibular plane angle increased significantly during the maxillary protraction period ( < 0.05), but no significant changes were observed in airway parameters ( > 0.05). No statistically significant changes were observed in the airway parameters in the follow-up period either. However, Sella to Gonion distance increased significantly ( < 0.05) during the follow-up period.
No significant changes in pharyngeal airway parameters were found during the control, maxillary protraction, and follow-up periods. Moreover, the significant increases in the skeletal parameters during maxillary protraction were maintained in the long-term.
手术辅助上颌前牵引是治疗严重Ⅲ类错颌病例或青春期生长高峰期后上颌前突增加的一种替代方案。上颌骨不足的矫正已被认为可改善咽气道尺寸。因此，本回顾性研究旨在通过头颅侧位片分析采用骨支抗和Ⅲ类牵引进行手术辅助上颌前牵引后气道的变化。
研究对象为15例接受手术辅助上颌前牵引联合骨支抗和Ⅲ类牵引治疗的Ⅲ类错颌患者（平均年龄：12.9±1.2岁）。治疗前平均5.5±1.6个月对生长变化进行初步评估。使用头颅侧位片监测并比较对照组（T0）、牵引前（T1）、牵引后（T2）和随访期（T3）的气道和骨骼变化。设定统计学显著性水平为<0.05。
对照组期间骨骼或气道参数无统计学显著变化。上颌前牵引期间，蝶鞍至鼻根点角、N垂直于A、A点至B点角以及法兰克福平面至下颌平面角显著增加（<0.05），但气道参数无显著变化（>0.05）。随访期气道参数也未观察到统计学显著变化。然而，随访期蝶鞍至下颌角距离显著增加（<0.05）。
在对照组、上颌前牵引期和随访期，咽气道参数均未发现显著变化。此外，上颌前牵引期间骨骼参数的显著增加在长期内得以维持。
