本文選題：上頜快速擴(kuò)弓 + 鼻上頜復(fù)合體��； 參考：《貴州醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:利用CBCT和Dolphin軟件研究生長發(fā)育期上頜橫向?qū)挾炔蛔慊颊呓?jīng)上頜快速擴(kuò)弓治療后短期內(nèi)鼻上頜骨復(fù)合體及上氣道形態(tài)的改變,并進(jìn)一步分析兩者變化協(xié)調(diào)性,從而為正畸臨床制定合理、可行的矯治計劃提供重要參考依據(jù)。方法:選擇2014年12月至2016年9月于貴陽市口腔醫(yī)院正畸科就診的上頜橫向?qū)挾劝l(fā)育不足生長發(fā)育期錯患者30例,男性8例,女性22例,平均年齡(13.14±1.45)歲。所有患者均采用Hyrax擴(kuò)弓器進(jìn)行上頜快速擴(kuò)弓矯治,矯治前(T0)后(T1)均拍攝錐體束計算機(jī)斷層掃描(CBCT),用Dolphin軟件進(jìn)行圖像處理、三維重建、定點(diǎn)及分析,在影像冠狀面測量矯治前后上頜雙側(cè)尖牙、前磨牙及磨牙的牙根和牙冠的距離變化;上頜骨寬度、前后鼻腔及鼻底頜骨寬度變化;在正中矢狀面上確定氣道分段平面,并測量后鼻棘平面、第二頸椎平面及第三頸椎平面氣道的矢狀徑、冠狀徑、橫截面積及各段氣道高度和容積等項(xiàng)目。使用SPSS(Version19.0,SPSS,Chicago,USA)軟件進(jìn)行數(shù)據(jù)處理,應(yīng)用配對t檢驗(yàn)進(jìn)行分析,通過比較T0和T1的數(shù)據(jù),評價上頜快速擴(kuò)弓對鼻上頜復(fù)合體及上氣道形態(tài)的影響。結(jié)果:生長發(fā)育期患者經(jīng)上頜快速擴(kuò)弓治療后,牙性及骨性的冠向測量指標(biāo)均有顯著變化。鼻外側(cè)寬度增加(2.13±1.80)mm,上頜骨寬度增加(4.12±2.15)mm,矯治前后差異有統(tǒng)計學(xué)意義(P0.05)。擴(kuò)弓后硬腭平面氣道冠狀徑增加(3.30±2.56)mm,面積增加(75.37±53.92)mm,矯治前后差異具有統(tǒng)計學(xué)意義(P0.05),而矢狀徑無明顯變化;鼻咽部氣道表面積增加(33.57±57.10)mm2,容積增加(1009.59±1350.91)mm3,矯治前后差異具有統(tǒng)計學(xué)意義(P0.05)。腭咽及舌咽氣道表面積及容積無明顯變化。各段氣道高度無明顯變化。結(jié)論:生長發(fā)育期上頜橫向?qū)挾炔蛔慊颊呓?jīng)上頜快速擴(kuò)弓矯治后,在短期內(nèi)能有效擴(kuò)大鼻上頜復(fù)合體寬度,增大鼻咽氣道容積,但對上氣道口咽段及喉咽段影響較小。
[Abstract]:Objective: to study the morphologic changes of nasal and maxillary complex and upper airway in patients with maxillary transverse width deficiency after rapid maxillary arch expansion in a short period of time by using CBCT and Dolphin software, and to further analyze the coordination between the two changes. So as to establish a reasonable and feasible orthodontic clinical treatment plan to provide an important reference. Methods: from December 2014 to September 2016, 30 patients (8 males and 22 females, mean age of 13.14 鹵1.45) were selected from orthodontic department of Guiyang Stomatology Hospital. All the patients were treated with Hyrax extender for maxillary rapid bowing. Before and after the correction, all the patients were photographed with Cone beam computed tomography (Dolphin) software for image processing, 3D reconstruction, fixed point and analysis. The distance between root and crown of maxillary bilateral canines, premolars and molars, the width of maxillary bone, the width of nasal cavity and nasal floor were measured on the coronal plane before and after orthodontic treatment, and the segmental plane of airway was determined on the median sagittal plane. The sagittal diameter, coronal diameter, cross-sectional area and airway height and volume of the posterior nasal spine plane, the second cervical spine plane and the third cervical plane airway were measured. The data were processed with SPSSV version 19.0 and analyzed by paired t-test. By comparing the data of T _ 0 and T _ 1, the effect of rapid maxillary arch expansion on the morphology of nasal and maxillary complex and upper airway was evaluated. Results: after rapid maxillary arch expansion, the coronal measurements of tooth and bone were significantly changed in patients with growth and development. The lateral nasal width increased 2.13 鹵1.80 mm, and the maxillary width increased 4.12 鹵2.15 mm. The difference was statistically significant before and after treatment (P 0.05). The coronal diameter and area of the airway were increased by 3.30 鹵2.56mm and 75.37 鹵53.92mm. the difference before and after treatment was statistically significant (P 0.05), but the sagittal diameter did not change, the surface area of nasopharynx airway increased by 33.57 鹵57.10mm2, the volume increased by 1009.59 鹵1350.91mm3, the difference before and after treatment was statistically significant. The surface area and volume of palatopharynx and glossopharyngeal tract did not change significantly. There was no significant change in airway height in each section. Conclusion: after rapid maxillary expansion in patients with insufficient transverse maxillary width during growth and development period, the width of nasomaxillary complex can be effectively enlarged and the volume of nasopharynx airway can be increased in a short time, but the effect on the oropharyngeal segment and larynx segment of upper airway is relatively small.
【學(xué)位授予單位】：貴州醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R783.5

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