摘要
目的对比分析定制可调式和架定位式两种下颌前伸式矫治器(mandibular advancement device,MAD)治疗阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS),患者的睡眠状况、下颌骨位置、上气道大小、舌骨位置及主观评分。方法采用前瞻性研究,纳入80例轻中度成人OSAHS患者,随机分为A组:定制可调式MAD,B组:架定位式MAD,每组40例。对比分析两组治疗前、治疗6个月后的主、客观指标是否具有差异性。结果A、B两种矫治器治疗OSAHS患者的治疗前、治疗6个月后除了睡眠监测指标眼动期、浅睡期数据差异无统计学意义,其余指标变化均具有统计学差异,其中下齿槽座点-鼻根点垂距(B-N′)A组由(5.53±1.66)mm减小至(4.93±1.75)mm,P<0.001;B组由(5.99±1.45)mm减小至(5.27±1.39)mm,P<0.001。颏前点-鼻根点垂距(Pog-N′)A组由(19.33±3.26)mm减小至(18.08±1.54)mm,P=0.021;B组由(20.11±2.14)mm减小至(18.40±1.54)mm,P<0.001。下颌第一磨牙点-腭平面垂距(Lm-PP)A组由(27.00±1.49)mm减小至(26.36±1.78)mm,P<0.001;B组由(27.93±1.44)mm减小至(27.33±1.64)mm,P<0.001。下颌切牙点-腭平面垂距(Li-PP)A组由(23.93±1.97)mm增大至(24.83±1.72)mm,P<0.001;B组由(24.49±2.84)mm增大至(25.22±2.79)mm,P<0.001。舌骨-颈椎前平面垂距(H-VL)A组由(30.59±2.07)mm增大至(31.11±2.29)mm,P<0.001;B组由(29.47±2.47)mm增大至(30.19±2.30)mm,P<0.001。组间对比治疗后所有睡眠主、客观指标差异均无统计学意义。结论两种MAD治疗后均具有显著疗效,患者睡眠质量均大幅改善;下颌骨位置均前移;舌骨矢状向位置稍前移。组间治疗6个月后所有观察指标差异并不明显。
ObjectiveThe objective of this study was to conduct a comparative analysis of two kinds of mandibular advancement devices(MADs),specifically customized adjustable oral appliances and articulator positioning oral appliances,in terms of sleep status,mandibular position,upper airway size,hyoid position,and subjective score of Obstructive Sleep Apnea-hypopnea Syndrome(OSAHS)patients treated with MAD.MethodsA prospective study was conducted involving 80 adult patients diagnosed with mild to moderate OSAHS.Patients were randomly assigned to Group A(customized adjustable MAD)and Group B(articulator positioning MAD),with 40 cases in each group.Subjective and objective indexes were compared before treatment and six months after treatment between the two groups.ResultsNo significant difference was observed in the sleep monitoring index of eye movement and light sleep before and six months after treatment.However,significant differences were noted in the other indicators.The vertical distance from the inferior alveolar base to nasal root(B-N′)decreased from(5.53±1.66)mm to(4.93±1.75)mm in Group A(P<0.001)and from(5.99±1.45)mm to(5.27±1.39)mm in Group B(P<0.001).The distance from the anterior mental point to the nasal root point(Pog-N′)decreased from(19.33±3.26)mm to(18.08±1.54)mm in Group A(P=0.021)and from(20.11±2.14)mm to(18.40±1.54)mm in Group B(P<0.001).The vertical distance from the mandibular molar point to the palatal plane(Lm-PP)decreased from(27.00±1.49)mm to(26.36±1.78)mm in Group A(P<0.001)and from(27.93±1.44)mm to(27.33±1.64)mm in Group B(P<0.001).The vertical distance of the mandibular incisor to the palatal plane(Li-PP)increased from(23.93±1.97)mm to(24.83±1.72)mm in Group A(P<0.001)and from(24.49±2.84)mm to(25.22±2.79)mm in Group B(P<0.001).Hyoid-cervical vertical distance(H-VL)increased from(30.59±2.07)mm to(31.11±2.29)mm in Group A(P<0.001)and from(29.47±2.47)mm to(30.19±2.30)mm in Group B(P<0.001).There were no significant differences in any of the objective and subjective indicator
作者
路健
周玮
高莹卉
刘霖
封净
杨乐
马婷
王少
张佐
Lu Jian;Zhou Wei;Gao Yinghui;Liu Lin;Feng Jing;Yang Le;Ma Ting;Wang Shao;Zhang Zuo(School of Stomatology,Ningxia Medical University,Yinchuan 750003,China;Department of Respiratory,People's Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China;Sleep Center of Peking University International Hospital,Beijing 102206,China;Department of Respiratory and Critical Medicine,Second Medical Center,PLA General Hospital,Beijing 100853,China;Department of Stomatology,People's Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China;Nanliangtaizi Health Center,Helan County,Yinchuan City,Yinchuan 750200,China)
出处
《中华口腔正畸学杂志》
2024年第2期78-84,共7页
Chinese Journal of Orthodontics
基金
宁夏重点研发基金项目(2022BEG02031)。
