王越 俞万钧

[摘要] 目的 通過双垫矫治装置（Twin-Block）和肌激动器（Activator）的矫正，观察治疗前后及两种矫治装置的差异探讨其对患者上气道结构的作用。 方法 选取2016年1月1日至2018年12月30日在宁波大学附属人民医院口腔科门诊经过纳排标准筛选的骨性Ⅱ类青少年患者30例，其中15例戴用Twin-Block矫治器，15例戴用Activator矫治器，分析比较两组矫治前后上气道矢状径及舌骨位置的变化量及比较两组上气道矢状径和舌骨位置矫治改变量的组间比较。 结果 Twin-Block和Activator矫治器在矫治后腭咽段指标（Ve1-Ve2、P1-P2）、舌咽段指标（Pas1-Pas2）、舌骨矢状向指标（AH-CVP、AH-NP、AH-RGn）、垂直向指标（AH-MP、AH-Or）均较矫治前差异均有统计学意义（P<0.05），而两组鼻咽段指标（PNS-S、PNS-Aa、PNS-Ad1、PNS-Ad2）、喉咽段指标（Va1-Va2）、软腭长度及厚度（PNS-P1、Sp1-Sp2）、舌骨指标（AH-FH、AH-SN、AH-PNS）组内比较，差异无统计学意义（P>0.05）。两组矫治装置治疗效果的对比结果显示，Ve1-Ve2、Pas1-Pas2、AH-MP比较，差异有统计学意义（P<0.05），其余指标差异均无统计学意义（P>0.05）。 结论 Twin-Block和Activator矫治器均能使上气道矢状径及舌骨位置得到改变，提升了呼吸通气效率。双垫矫治装置相较肌激动器能更好地改善骨性Ⅱ类的腭咽段及舌咽段矢状径，为骨性Ⅱ类早期矫治的临床诊疗给予一定的帮助及指导。

[关键词] Twin-Block矫治器;Activator矫治器;骨性Ⅱ类;上气道;青少年

[中图分类号] R783.5          [文献标识码] B          [文章编号] 1673-9701（2021）36-0075-05

Research on effect of Twin-Block and Activator on upper airway structure in adolescents with skeletal class Ⅱ

WANG Yue1   YU Wanjun2

1.Department of Stomatology， the Affiliated People′s Hospital of Ningbo University， Ningbo   315100， China; 2.Department of Respiratory Medicine，the Affiliated People′s Hospital of Ningbo University， Ningbo   315100， China

[Abstract] Objective To observe the differences between Twin-Block and Activator before and after treatment so as to investigate their effects on the upper airway structure of patients through the correction of the two devices. Methods A total of 30 adolescent patients with skeletal type Ⅱ based on the inclusion criteria from the outpatient Department of Stomatology of the Affiliated People′s Hospital of Ningbo University from January 1， 2016 to December 30， 2018 were selected. Among them， 15 cases wore Twin-Block and 15 cases wore Activator. The changes of sagittal diameter of upper airway and hyoid position before and after correction were analyzed and compared respectively between the two groups. Results After treatment with Twin-Block and Activator， the indexes of velopharyngeal segment （Ve1-Ve2， P1-P2）， glossopharyngeal segment （Pas1-Pas2）， hyoid sagittal direction （AH-CVP， AH-NP， AH-RGn）， vertical direction （AH-MP， AH-Or） were more significantly increased than those before the rectification， with statistically significant differences （P<0.05）， while there were no significant differences in the indexes of nasopharyngeal segment （PNS-S， PNS-Aa， PNS-Ad1， PNS-Ad2）， hypopharyngeal segment （Va1-Va2）， soft palate length and thickness （PNS-P1， Sp1-Sp2）， hyoid index （AH-FH， AH-SN and AH-PNS）（P<0.05）. The results showed that there were significant differences in Ve1-Ve2， Pas1-Pas2， AH-MP between the two groups （P<0.05）， but no significant differences were showed in other indexes （P<0.05）. Conclusion Both Twin-Block and Activator can change the sagittal diameter of upper airway and hyoid bone position， thus improving the respiratory and ventilation efficiency. Compared with muscle activator， the double occlusal pad removable orthodontic appliances can better improve the sagittal diameter of velopharyngeal segment and glossopharyngeal segment of adolescents with skeletal class Ⅱ， providing certain help and guidance for clinical diagnosis and treatment of early orthodontic class Ⅱ.

[Key words] Twin-Block; Activator; Skeletal class Ⅱ; Upper airway; Adolescents

骨性Ⅱ类是错畸形中一种常见的错畸形。国内学者曾祥龙研究发现，骨性Ⅱ类恒牙初期患病率就达到26.62%[1]。国内外研究均证实骨性Ⅱ类错畸形中存在上气道结构性狭窄[1-3]。

近年来，针对骨性Ⅱ类患者上气道结构性狭窄的治疗方法，主要通过下颌的前伸使上气道增大。……