Angle Orthod. 2024 Jul 1;94(4):432-440. doi: 10.2319/112223-774.1.
To evaluate changes of the upper airway and oral cavity volumes in patients with skeletal Class III malocclusion undergoing bimaxillary orthognathic surgery, and to analyze the correlation between postoperative upper airway decrease and the amount of jaw movement and oral cavity volume reduction.
Thirty patients (16 males and 14 females) undergoing bimaxillary surgery were included. Three-dimensional reconstruction of the upper airway and oral cavity were performed using preoperative (T0) and postoperative (T1) (6 months) cone-beam computed tomography scans.
The volume, sagittal area and minimum cross-sectional area of the upper airway were diminished (P < .001). The decrease in volume and minimum cross-sectional area in the oropharyngeal region of the upper airway were weakly correlated with B-point posterior movement (P < .05). Total oral cavity volume was decreased, with maxillary oral volume increasing and mandibular oral volume decreasing (P < .001). Upper airway decrease was highly correlated with total oral volume reduction and mandibular oral volume reduction, with the most significant correlation being with total oral volume reduction (P < .001).
Class III bimaxillary surgery reduced the volume, sagittal area, and minimum cross-sectional area of the upper airway as well as oral cavity volume. Upper airway changes were weakly correlated with anterior-posterior mandibular movement but significantly correlated with oral cavity volume changes. Thus, oral cavity volume reduction is a crucial factor of upper airway decrease in patients with skeletal Class III malocclusion undergoing bimaxillary orthognathic surgery.
评估骨性 III 类错颌患者接受双颌正颌手术后上气道和口腔容积的变化,并分析术后上气道减小与颌骨移动量和口腔容积减小的相关性。
纳入 30 例(男 16 例,女 14 例)接受双颌手术的患者。使用术前(T0)和术后(T1,术后 6 个月)锥形束 CT 对上气道和口腔进行三维重建。
上气道容积、矢状面积和最小横截面积减小(P<.001)。上气道口咽区容积和最小横截面积的减小与 B 点后移呈弱相关(P<.05)。总口腔容积减小,上颌口腔容积增加,下颌口腔容积减小(P<.001)。上气道减小与总口腔容积减小和下颌口腔容积减小高度相关,与总口腔容积减小的相关性最显著(P<.001)。
III 类双颌手术减少了上气道和口腔容积。上气道的变化与下颌前后移动呈弱相关,但与口腔容积的变化显著相关。因此,口腔容积的减小是骨性 III 类错颌患者接受双颌正颌手术后上气道减小的一个关键因素。