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目的:应用锥形束CT(cone-beam computed tomography,CBCT)和Invivo5软件测量成人骨性Ⅲ类错口咽气道容积大小和舌骨位置,分析上、下颌骨的位置对气道的影响,为正畸临床评估口咽气道容积及舌骨位置提供理论依据。方法:随机筛选CBCT资料,按纳入标准和上、下颌骨矢状位置,将研究对象分为3组,筛选出60例骨性Ⅰ类错作为对照组;将成人骨性Ⅲ类错分为上颌后缩组和下颌前突组,每组60例。采用第三方软件Invivo5将CBCT扫描数据进行三维重建,建立三维坐标系,应用测量工具测量口咽气道及舌骨位置,采用SPSS19.0软件包对上述3组进行两两比较。结果:成人骨性Ⅲ类下颌前突组分别较上颌后缩组、骨性Ⅰ类组口咽气道容积大(P<0.05),但骨性Ⅲ类上颌后缩组与骨性Ⅰ类组口咽气道容积无显著差异(P>0.05);舌骨矢状向位置由前到后为骨性Ⅲ类下颌前突组、骨性Ⅲ类上颌后缩组、骨性Ⅰ类组(P<0.05);舌骨垂直向位置,骨性Ⅲ类下颌前突组显著高于上颌后缩组、骨性Ⅰ类组(P<0.05),但骨性Ⅲ类上颌后缩组与骨性Ⅰ类组无显著差异(P>0.05)。结论:成人不同骨性错畸形上气道三维特征不同,下颌骨矢状位置、长度较上颌骨对口咽气道容积、形态、走向、舌骨矢状位置影响更为显著。CBCT及Invivo5是评价上气道的实用工具,可为正畸临床评估骨性错患者上气道三维结构及舌骨位置、制订合理有效的治疗方案提供指导。
OBJECTIVE: To evaluate the influence of upper and lower jaw position on the airway volume, the volume of the pharyngeal airway and the location of the hyoid bone by using cone-beam computed tomography (CBCT) and Invivo5 software. To provide a theoretical basis for orthodontic clinical assessment of oropharyngeal airway volume and hyoid bone position. Methods: The CBCT data were randomly selected. According to the inclusion criteria and the sagittal position of upper and lower jaws, the subjects were divided into three groups and 60 cases of skeletal Class Ⅰ malocclusion were screened out as the control group. The adult skeletal Class Ⅲ malocclusion For the maxillary contraction group and mandibular protrusion group, 60 cases in each group. Third-party software Invivo5 was used to reconstruct the CBCT scan data to establish a three-dimensional coordinate system. The oropharyngeal airway and hyoid bone were measured with measuring tools. SPSS19.0 software package was used to compare the three groups. Results: Compared with maxillary retrusion group and skeletal class Ⅰ group, the oropharyngeal airway volume of adult skeletal class Ⅲ mandibular protrusion group was larger than that of maxillary retrusion group (P <0.05), but the skeletal Class Ⅲ maxillary retrusion group and skeletal Class Ⅰ group mouth There was no significant difference in pharyngeal airway volume between the two groups (P> 0.05). The sagittal position of hyoid was from the anteroposterior to the posterior group of skeletal class Ⅲ mandibular protrusion, skeletal class Ⅲ maxillary retrusion group and skeletal class Ⅰ group (P <0.05) ); Vertical position of the hyoid bone, type Ⅲ mandibular protrusion group was significantly higher than the maxillary retrusion group, skeletal class Ⅰ group (P <0.05), but the type Ⅲ maxillary retrusion group and skeletal class Ⅰ group No significant difference (P> 0.05). CONCLUSION: The three-dimensional characteristics of the upper airway in adults with different skeletal malformations are different. The sagittal position and length of the mandible are more significant than the maxilla to the oropharyngeal airway volume, shape, orientation and sagittal position. CBCT and Invivo5 are useful tools for the evaluation of the upper airway, which can guide the clinical evaluation of the three-dimensional structure of the upper airway and the position of the hyoid bone in orthodontic patients and to provide a reasonable and effective treatment plan.