Jiang Tianlu, Qi Yizhe, Zhang Yueying, Du Yusen, Wu Qiuyue, Xiao Hua, He Kangping, Zheng Jiajing, Jin Zuolin, Li Feifei
State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China.
Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an Jiaotong University, Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, People's Republic of China.
BMC Oral Health. 2025 Jul 1;25(1):975. doi: 10.1186/s12903-025-06284-9.
This study aimed to analyze three-dimensional and sleep-breathing data of adolescent patients with Class II division 1 malocclusion and mandibular retrognathism to explore the effects of clear aligner mandibular advancement (MA) treatment on airway morphology and respiratory function.
Cone beam computed tomography data of 27 patients with mandibular retrognathism (average age, 12.25 ± 1.50 years; 11 male and 16 female patients) were prospectively collected at the beginning (T0) and end (T1; treatment duration, 11.36 ± 1.48 months) of the MA treatment. A three-dimensional model of the hyoid bone, soft palate, tongue, and upper airway was reconstructed using Dolphin 11.9 software. Multiple linear regression analyses were conducted to analyze the contribution of lateral and anteroposterior diameters to the volume and cross-sectional area of the airway. Sleep-breathing data collected from 22 patients using portable polysomnography were analyzed using the RemLogic software. Paired-sample t-tests were used to compare relevant morphological and respiratory function parameters before and after MA treatment.
After clear aligner MA treatment, the measurement of the angle of the soft palate was decreased, whereas the length of the soft palate, vertical distance of the hyoid bone, length and thickness of the tongue, and parameters of the upper airway and each segment increased, except for the anteroposterior diameter of the nasopharyngeal plane. The increase in the anteroposterior diameter contributed more to the increase in volume and cross-sectional area than that in the lateral diameter, except for the nasopharyngeal plane. Regarding respiratory function, the measurement of the apnea/hypopnea index (AHI) and supine AHI decreased, whereas the average blood oxygen saturation increased (all P < 0.05).
In this study, clear aligner MA treatment may be beneficial for the upper airway morphology and respiratory function as it might morphologically relax the soft palate and expand the upper airway volume, reduce the AHI, and increase the SpO in terms of respiratory function. These changes are beneficial to the growth and development of adolescent patients with Class II malocclusion and mandibular retrognathism.
本研究旨在分析安氏II类1分类错牙合伴下颌后缩青少年患者的三维及睡眠呼吸数据，以探讨透明矫治器下颌前导（MA）治疗对气道形态及呼吸功能的影响。
前瞻性收集27例下颌后缩患者（平均年龄12.25±1.50岁；男11例，女16例）在MA治疗开始时（T0）及结束时（T1；治疗时间11.36±1.48个月）的锥形束计算机断层扫描数据。使用Dolphin 11.9软件重建舌骨、软腭、舌及上气道的三维模型。进行多元线性回归分析，以分析左右径及前后径对气道容积及横截面积的贡献。使用便携式多导睡眠监测仪收集22例患者的睡眠呼吸数据，并使用RemLogic软件进行分析。采用配对样本t检验比较MA治疗前后的相关形态学及呼吸功能参数。
透明矫治器MA治疗后，软腭角度减小，而软腭长度、舌骨垂直距离、舌长度及厚度、上气道及各节段参数增加，但鼻咽平面的前后径除外。除鼻咽平面外，前后径的增加对容积及横截面积增加的贡献大于左右径。关于呼吸功能，呼吸暂停低通气指数（AHI）及仰卧位AHI降低，而平均血氧饱和度升高（均P<0.05）。
在本研究中，透明矫治器MA治疗可能有利于上气道形态及呼吸功能，因为它可能在形态上使软腭松弛并扩大上气道容积，降低AHI，并在呼吸功能方面提高SpO。这些变化有利于安氏II类错牙合伴下颌后缩青少年患者的生长发育。
