一项关于有或无上颌前突的下颌后缩治疗骨性III类错牙合对睡眠相关呼吸参数影响的前瞻性队列研究。
A prospective cohort study on effects of mandibular setback with or without maxillary advancement for skeletal class III malocclusion on sleep-related respiratory parameters.
作者信息
Patharakorn Ratanaporn, Saengfai Nuntinee Nanthavanich, Chaweewannakorn Chaiyapol, Boonpratham Supatchai, Satravaha Yodhathai, Peanchitlertkajorn Supakit
机构信息
Department of Orthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
出版信息
Sleep Breath. 2025 Apr 30;29(2):174. doi: 10.1007/s11325-025-03347-7.
PURPOSE
This study aimed to investigate changes in sleep-related respiratory parameters before and after orthognathic surgery in patients with skeletal class III malocclusion.
METHODS
Adults with skeletal class III malocclusion and treated with isolated mandibular setback or bimaxillary surgery (maxillary advancement and mandibular setback) were recruited. Sleep-related respiratory parameters were obtained with type III sleep study. Epworth Sleepiness Scale (ESS) was also recorded. The pre- and post-operative (6 months) data were compared. Correlations between these changes and pre-operative characteristics were analyzed. Subjects were categorized into three groups based on changes in the respiratory event index (REI) and 3% oxygen desaturation index: Δ ≤ -2.5, -2.5 < Δ < 2.5, and Δ ≥ 2.5. Amounts of surgical movement and pre-surgical parameters were compared among the 3 groups.
RESULTS
Thirty patients with an average age of 25.4 ± 5.0 years were recruited. Eleven patients underwent isolated mandibular setbacks while nineteen received bimaxillary surgery. Pre- and post-operative sleep-related respiratory parameters were not significantly different in the total samples, and when analyzed separately according to surgical procedures. Pre-operative ESS were correlated with the changes in REI (p = 0.01), average blood oxygen levels (p = 0.01), and snoring percentage (p = 0.04). Additionally, this study found that patients with a significant decrease in REI (ΔREI ≤ -2.5) after surgery had significantly higher pre-operative REI (6.2 events/hour) compared to those with minor REI changes (2.6 events/hour).
CONCLUSION
There was no significant change in sleep-related respiratory parameters following mandibular setbacks with or without maxillary advancement in this study.
TRAIL REGISTERED
This study was retrospectively registered and approved on February 11, 2025, under registration number TCTR20250211002.
目的
本研究旨在调查骨骼Ⅲ类错牙合畸形患者正颌手术前后睡眠相关呼吸参数的变化。
方法
招募接受单纯下颌后缩或双颌手术（上颌前徙和下颌后缩）治疗的骨骼Ⅲ类错牙合畸形成年患者。通过Ⅲ型睡眠研究获取睡眠相关呼吸参数。还记录了爱泼华嗜睡量表（ESS）。比较术前和术后（6个月）的数据。分析这些变化与术前特征之间的相关性。根据呼吸事件指数（REI）和3%氧饱和度下降指数的变化将受试者分为三组：Δ≤-2.5、-2.5＜Δ＜2.5和Δ≥2.5。比较三组之间的手术移动量和术前参数。
结果
招募了30例平均年龄为25.4±5.0岁的患者。11例患者接受单纯下颌后缩，19例接受双颌手术。在总样本中，以及根据手术程序分别分析时，术前和术后睡眠相关呼吸参数无显著差异。术前ESS与REI变化（p=0.01）、平均血氧水平（p=0.01）和打鼾百分比（p=0.04）相关。此外，本研究发现，术后REI显著降低（ΔREI≤-2.5）的患者术前REI（6.2次/小时）显著高于REI变化较小的患者（2.6次/小时）。
结论
本研究中，无论是否进行上颌前徙，下颌后缩术后睡眠相关呼吸参数均无显著变化。
试验注册
本研究于2025年2月11日进行回顾性注册并获得批准，注册号为TCTR20250211002。
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