Department of Orthodontics, Faculty of Dentistry, Alexandria University, Champollion St, P. O. Box: 21521, Alexandria, Alexandria, Egypt.
BMC Oral Health. 2023 Nov 8;23(1):841. doi: 10.1186/s12903-023-03613-8.
The primary objective of the study was to evaluate the effects of SEC III (Splints, Class III Elastics, and Chin cup) protocol on the upper airway dimensions using lateral cephalometric radiographs. The secondary objectives were to evaluate the skeletal and dental effects of the SEC III protocol using lateral cephalometric radiographs.
The pre- and post-treatment lateral cephalometric radiographs of 24 patients treated using the SEC III protocol were used to address the aim of the study. Children in the pre-pubertal (CS-1 or CS-2) or circumpubertal (CS-3 or CS-4) skeletal maturation stage and having class III dentoskeletal malocclusion were included in the study. Patients with a history of previous orthodontic treatment, maxillofacial surgery or trauma, tonsillectomy, adenoidectomy, or craniofacial malformations were excluded. The pre-treatment and post-treatment lateral cephalometric radiographs were traced, then airway measurements, skeletal measurements, and dental measurements were performed. The results were analysed using paired samples t-test or Wilcoxon signed rank test according to the data normality.
Data of 6 males and 18 females were analysed (Mean age = 11.21 ± 1.02 years). Duration of active treatment was 5.75 ± 1.03 months. Treatment using SEC III protocol resulted in a significant increase in ANB angle (2.92 ± 1.50 degrees, p < 0.001) and Wits appraisal (3.31 ± 1.99 mm) (p < 0.001). The increase in the mandibular plane angle (0.75 ± 1.42 degrees, p = 0.02) and the maxillary length (2.29 ± 2.69 mm, p < 0.001) was statistically significant. Contrarily, the mandibular length did not change significantly (p = 0.10). The maxillary incisors were significantly proclined (4.38 ± 4.28 degrees; p < 0.001), while the mandibular incisors were significantly retroclined (-5.79 ± 6.21 degrees; p < 0.001) following treatment. The change in the nasopharyngeal airway and the retropalatal airway was not statistically significant. The middle and inferior pharyngeal space (retroglossal airway) significantly decreased by 1.33 ± 1.97 mm (p = 0.003) and 1.96 ± 2.48 mm (p = 0.001), respectively.
Early class III correction using SEC III protocol reduced the retroglossal airway dimensions but did not affect the nasopharyngeal and retropalatal airway dimensions. Correction of the class III dentoskeletal relationship was obtained through both skeletal and dental changes.
本研究的主要目的是使用侧位头颅侧位片评估 SEC III（夹板、III 类橡皮筋和颏托）方案对上气道尺寸的影响。次要目标是使用侧位头颅侧位片评估 SEC III 方案的骨骼和牙齿效果。
使用 24 名接受 SEC III 方案治疗的患者的治疗前后侧位头颅侧位片来解决研究目的。纳入研究的患者为处于骨骼成熟的青春期前（CS-1 或 CS-2）或青春期（CS-3 或 CS-4）阶段，且存在 III 类牙颌面骨骼畸形的儿童。排除有正畸治疗、颌面外科手术或外伤、扁桃体切除术、腺样体切除术或颅面畸形史的患者。对治疗前后的侧位头颅侧位片进行描记，然后进行气道测量、骨骼测量和牙齿测量。根据数据正态性，使用配对样本 t 检验或 Wilcoxon 符号秩检验分析结果。
分析了 6 名男性和 18 名女性的数据（平均年龄=11.21±1.02 岁）。主动治疗时间为 5.75±1.03 个月。使用 SEC III 方案治疗后，ANB 角（2.92±1.50 度，p<0.001）和 Wits 评价（3.31±1.99 毫米）（p<0.001）显著增加。下颌平面角（0.75±1.42 度，p=0.02）和上颌长度（2.29±2.69 毫米，p<0.001）的增加具有统计学意义。相反，下颌长度没有显著变化（p=0.10）。上颌切牙明显前倾（4.38±4.28 度；p<0.001），而下颌切牙明显后倾（-5.79±6.21 度；p<0.001）。鼻咽气道和腭后气道的变化没有统计学意义。中咽和下咽空间（舌后气道）分别显著减少 1.33±1.97 毫米（p=0.003）和 1.96±2.48 毫米（p=0.001）。
早期使用 SEC III 方案矫正 III 类错合畸形可减少舌后气道尺寸，但不影响鼻咽和腭后气道尺寸。III 类牙颌面骨骼关系的矫正通过骨骼和牙齿的变化来实现。
