腺样体肥大伴口呼吸对牙颌面发育的初步研究

朱亚玲 杨政尧 吴佩佩

[摘要]目的：通过头影测量研究不同程度的腺样体肥大与不同的呼吸方式对牙颌发育的影响。方法：选取年龄在11～14岁的寻求正畸治疗的患者共90例，其中存在不同程度腺样体肥大者60例为实验组，无口呼吸及腺样体肥大者30例为对照组。根据A/N比值将90例分为三组，每组30例。实验组：A组：0.60≤A/N<0.71；B组：A/N≥0.71，其B组又可分为两组，B1为腺样体肥大伴鼻呼吸者；B2为腺样体肥大伴口呼吸者。对照组即C组：A/N<0.60。本實验采用几何画板5.06图像处理软件测量腺样体大小和牙颌面各项指标。结果：治疗后，C组与A组相比：ANS-Me/N-Me、∠SNA、∠SNB、NPg-SN、U1-NA、LI-NB、Y轴、UI-SN测量项目均有统计学差异（P<0.05），与B组相比：GoGn-SN、NP-FH测量项目均有统计学差异（P<0.05），C组分别与A组和B组比较，MP-FH、LI-MP角增大，与B组统计学差异更显著（P<0.05）。LI-MP、NP-FH测量项目均有统计学意义（P<0.05），其中GoGn-SN增大、NPg-SN、Y轴减小，其差异更显著（P<0.05）。U1-NA、LI-NB、GoGn-SN、FH-MP、LI-MP测量项目均有统计学意义（P<0.05），其中NPg-SN、U1-L1、NP-FH呈负相关（P<0.05）。结论：通过头影测量分析得到重度腺样体肥大伴口呼吸患者表现为下颌骨后缩，下颌逆时针旋转及前牙开牙合且口呼吸，对咬合关系有影响。

[关键词]腺样体肥大；牙颌面发育；口呼吸；牙牙合关系；头颅侧位片

[中图分类号]R782.2 [文献标志码]A [文章编号]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.