OSAS患者口腔矫治器下颌前移对上气道及周围结构形态变化影响的研究
【摘要】
目的：为治疗阻塞性睡眠呼吸暂停综合征（OSAS）的口腔矫治器设计、制作提供形态学依据，以提高口腔矫治器治疗OSAS患者的有效率。
方法：采用口腔矫治器下颌前移治疗OSAS的患者，在坚持戴用矫治器6个月后，通过主观有效率、客观有效率均为有效的X线头影测量片与治疗前X线头影测量片的比较，得出口腔矫治器致下颌骨前移后，上气道软组织、软腭、舌体、舌骨形态的变化及下颌骨前移的具体位置。
结果：下颌最适前移量与最大前移量的比值是62%，最适开口度与最大开口度的比值是19%。软腭后间隙扩大显著（P<0.01）；软腭长度明显减小（P<0.05），软腭与舌体接触长度缩短（P<0.001）。舌根后气道间隙明显增大（P<0.05），舌根部与颏后点间的距离显著小于治疗前（P<0.01）；但治疗前后舌体长度与厚度的变化均无显著性（P<0.05）。舌骨垂直向位置变化有显著性（P<0.05）。
结论：将下颌前移到对刃颌位后，前牙咬合打开2～3 mm，可以达到治疗OSAS的目的。下颌前移后可引起上气道及周围结构的变化，是治疗OSAS行之有效的途径之一。软腭的移动在口腔矫治器致下颌前移治疗OSAS中起到了重要作用。通过舌体前移达到治疗目的，舌体大小没有发生变化。舌骨向上移动的方向及距离是治疗OSAS成功的一个关键点。下颌前移治疗OSAS对气道上部发生阻塞效果较好，对下部发生阻塞效果较差。
【关键词】阻塞性睡眠呼吸暂停综合征；上气道；口腔矫治器；下颌骨前移；X线头影测量
The reflection of upper airway soft organization and around shape change of OSAS using DA(https://www.daowen.com)
ABSTRACT
Objective:To provide the morphology basis for designing and making the Dental Appliances（DA）of effective Obstructive Sleep Apnea Syndrome（OSAS）treatment and to raise the effective rate.
Methods:The patients were treated through Mandibualar Advancement（MAD）by DA.The Cephalometric Roentgenogram Measurement（CRM）was recognized effective after the treatment with using DA six months.When the mandibualar advanced（MA），the site of mandibualar bone and the change of the Upper airway（UA）soft tissue，soft palate，Hyoid bone（HB），hyoid body were determined.
Results:The ratio of the mandibular advanced of the fittest and the biggest was 62%and the aperture width and maximum aperture width ratio is 19%.The distance soft palate was enlarged（P＜0.01）and the lengthen was reduced（P＜0.05）.The contact lengthen soft palate with hyoid body was reduced（P＜0.001）.There was no significantly difference in the change of hyoid body lengthen and thickness between treatment before and after（P＜0.05）.
Conclusion:The change of the UA and the around organize as the mandibualar advance are effective for treating OSAS.The moving of soft palate plays a important role in mandibualar advancement using to treat OSAS.The hyoid body is no difference in the mandibualar advancement direction.Up-moving of hyoid body is important in treating OSAS.
Key words:obstructive sleep apnea syndrome（OSAS）；upper airway（UA）；dental Appliances（DA）；mandibular advancement（MA）；cephalometric roentgenogram measurement（CRM）