Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan.
Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, 6F, 199, Tung Hwa North Road, Taipei, 105, Taiwan.
Sci Rep. 2023 Jun 6;13(1):9210. doi: 10.1038/s41598-023-36467-9.
Orthodontic treatment with premolar extractions is typically used to relieve dental crowding and retract anterior teeth for lip profile improvement. The aim of the study is to compare the changes in regional pharyngeal airway space (PAS) after orthodontic treatment with Class II malocclusion and to identify the correlations between questionnaire results and PAS dimensions after orthodontic treatment. In this retrospective cohort study, 79 consecutive patients were divided into normodivergent nonextraction, normodivergent extraction, and hyperdivergent extraction groups. Serial lateral cephalograms were used to evaluate the patients' PASs and hyoid bone positions. The Pittsburgh Sleep Quality Index and STOP-Bang questionnaire were used for sleep quality evaluation and obstructive sleep apnea (OSA) risk assessment, respectively, after treatment. The greatest airway reduction was observed in hyperdivergent extraction group. However, the changes in PAS and hyoid positions did not differ significantly among three groups. According to questionnaire results, all three groups had high sleep quality and low risk of OSA, with no significant intergroup differences. Moreover, pretreatment-to-posttreatment changes in PAS were not correlated with sleep quality or risk of OSA. Orthodontic retraction with premolar extractions nither exhibit significant reduction in airway dimensions nor increase their risk of OSA.
正畸治疗中常采用拔除前磨牙的方式来缓解牙列拥挤,并内收前牙以改善唇突度。本研究旨在比较安氏Ⅱ类错牙合患者正畸治疗前后咽腔气道(PAS)区域的变化,并探讨正畸治疗前后问卷结果与 PAS 维度之间的相关性。在这项回顾性队列研究中,79 例连续患者被分为正常分散非拔牙组、正常分散拔牙组和高分散拔牙组。采用侧位头颅侧位片评估患者的 PAS 和舌骨位置。匹兹堡睡眠质量指数和 STOP-Bang 问卷分别用于治疗后的睡眠质量评估和阻塞性睡眠呼吸暂停(OSA)风险评估。最大气道缩小发生在高分散拔牙组。然而,三组之间的 PAS 和舌骨位置变化差异无统计学意义。根据问卷结果,三组睡眠质量均较高,发生 OSA 的风险均较低,组间差异无统计学意义。此外,PAS 的治疗前后变化与睡眠质量或 OSA 风险无相关性。正畸治疗中采用拔除前磨牙的方式既不会显著减小气道尺寸,也不会增加 OSA 的风险。