腺樣體肥大伴口呼吸對牙頜面發(fā)育的初步研究

朱亞玲 楊政堯 吳佩佩

[摘要]目的：通過頭影測量研究不同程度的腺樣體肥大與不同的呼吸方式對牙頜發(fā)育的影響。方法：選取年齡在11～14歲的尋求正畸治療的患者共90例，其中存在不同程度腺樣體肥大者60例為實(shí)驗(yàn)組，無口呼吸及腺樣體肥大者30例為對照組。根據(jù)A/N比值將90例分為三組，每組30例。實(shí)驗(yàn)組：A組：0.60≤A/N<0.71；B組：A/N≥0.71，其B組又可分為兩組，B1為腺樣體肥大伴鼻呼吸者；B2為腺樣體肥大伴口呼吸者。對照組即C組：A/N<0.60。本實(shí)驗(yàn)采用幾何畫板5.06圖像處理軟件測量腺樣體大小和牙頜面各項(xiàng)指標(biāo)。結(jié)果：治療后，C組與A組相比：ANS-Me/N-Me、∠SNA、∠SNB、NPg-SN、U1-NA、LI-NB、Y軸、UI-SN測量項(xiàng)目均有統(tǒng)計(jì)學(xué)差異（P<0.05），與B組相比：GoGn-SN、NP-FH測量項(xiàng)目均有統(tǒng)計(jì)學(xué)差異（P<0.05），C組分別與A組和B組比較，MP-FH、LI-MP角增大，與B組統(tǒng)計(jì)學(xué)差異更顯著（P<0.05）。LI-MP、NP-FH測量項(xiàng)目均有統(tǒng)計(jì)學(xué)意義（P<0.05），其中GoGn-SN增大、NPg-SN、Y軸減小，其差異更顯著（P<0.05）。U1-NA、LI-NB、GoGn-SN、FH-MP、LI-MP測量項(xiàng)目均有統(tǒng)計(jì)學(xué)意義（P<0.05），其中NPg-SN、U1-L1、NP-FH呈負(fù)相關(guān)（P<0.05）。結(jié)論：通過頭影測量分析得到重度腺樣體肥大伴口呼吸患者表現(xiàn)為下頜骨后縮，下頜逆時(shí)針旋轉(zhuǎn)及前牙開牙合且口呼吸，對咬合關(guān)系有影響。

[關(guān)鍵詞]腺樣體肥大；牙頜面發(fā)育；口呼吸；牙牙合關(guān)系；頭顱側(cè)位片

[中圖分類號]R782.2 [文獻(xiàn)標(biāo)志碼]A [文章編號]1008-6455（2018）11-0126-04

Abstract： Objective Cephalometric study of the effects of different degrees of adenoidal hypertrophy and different breathing patterns on dental and maxillofacial development. Methods 60 cases of adenoid hypertrophy aged 11-14 years were selected as experimental group， and 30 cases of no oral breathing and adenoid hypertrophy were used as control group. It is divided into 3 groups according to the A/N ratio of 30 cases in each group. Experimental group： group A：0.60≤A/N?0.71； group B： A/N≥0.71， and the B group was divided into 2 groups， B1 was adenoid hypertrophy with nasal breathing； B2 was adenoid hypertrophy with oral breathing. The control group： group C：A/N?0.60； The experiment using the Geometry Sketchpad 5.06 image processing software were used to measure the size of the adenoids and the indexes of the maxillofacial region. Results Group C is compared with A：ANS-Me/N-Me，∠SNA，∠SNB，NPg-SN，U1-NA，LI-NB，Y axis and UI-SN were statistically different （P<0.05）. Compared with the B group， there were statistical differences （P<0.05）. In the 3 groups， the differences in MP-FH and LI-MP angles were more significant （P<0.05）.LI-MP and NP-FH measurement items were statistically different （P<0.05）. Among them， GoGn-SN increased， NPg-SN and Y axis decreased， and the difference was more significant （P<0.05）. Compared with A and B， the angle of MP-FH，LI-MP in control group C increased， and the statistical difference in group B was more significant（P<0.05）， of which NPg-SN，U1-L1and NP-FH were negatively correlated （P<0.05）. Conclusion Cephalometric analysis showed that severe adenoidal hypertrophy with oral respiration showed mandibular retraction， anticlockwise mandibular rotation and anterior teeth opening， and oral respiration had an effect on occlusal relationship.