非阻塞性口呼吸错(牙合)畸形儿童的口腔综合治疗
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摘要
目的:探讨非阻塞性口呼吸习惯错(牙合)畸形儿童的综合治疗效果。方法:36例非阻塞性口呼吸习惯患儿,分为少年组(n=7)和幼儿组(n=29),两组患儿均采用机械屏阻+颌面肌功能训练+牙列治疗模式进行干预治疗,采用儿童睡眠质量(CSHQ)问卷调查表和呼吸习惯戒除情况评价2组患儿治疗前及治疗3个月时的睡眠质量,比较两组患儿唇肌紧张度、唇闭合情况、上颌牙弓宽度(UAW)、覆(牙合)(OB)、覆盖(OJ)、切牙倾斜度、咬(牙合)平面倾斜度、Y轴角及下颌平面角变化。结果:机械屏阻治疗后,70%患儿戒除口呼吸习惯,幼儿组未见复发,少年组约30%复发;肌功能训练后,部分患儿AW平均增加(1.35±0.23) mm(P=0.034),唇肌紧张度降低、唇闭合度增加,但幼儿组不能配合肌功能训练;切牙唇倾度平均减小(2.37±0.86)°(P=0.009),OJ平均减小(1.83±0.87)mm(P=0.023),OB未显示变化,Y轴角平均减小(3.21±1.13)°,差异有统计学意义。结论:机械屏阻+颌面肌功能训练+牙列治疗对儿童非阻塞性口呼吸习惯的戒除是有效的,早期治疗的效果更好。
Objective: To explore the comprehensive treatment effect on Children with malocclusion of non-obstructive oral respiratory habits. Methods: Six children with non-obstructive oral respiratory habits were divided into juvenile group(n=7) and early childhood group(n=29).Children in both groups were treated with the intervention treatment of mechanical barrier + maxillofacial function training + dentition treatment. Sleep quality of children in two groups was evaluated by(CSHQ) questionnaire and respiratory habit abstinence assessment before treatment and at 3 months of treatment.The lip muscle tension, lip closure, maxillary arch width(UAW), overbite(OB), overjet(OJ), incisor inclination, occlusal plane inclination, Y axis angle and mandibular plane angle were compared between the two groups. Results: After the mechanical barrier treatment, 70% of the patients got rid of oral respiratory habits. There was no recurrence in the early childhood group but around 30% of the juvenile group relapsed. After the maxillofacial function training, the average increase of AW in some children was(1.35±0.23)mm(P=0.034), the tension of lip muscle decreased and the degree of lip closure increased. However, the early childhood group was unable to cooperate with the maxillofacial function training. The average lip inclination of incisors decreased by(2.37±0.86)°(P=0.009), and the average decrease of OJ was 1.83±0.87 mm(P=0.023). OB showed no change. The angle of the Y axis decreased by 3.21±1.13, and the difference was statistically significant. Conclusion: Mechanical barrier+maxillofacial muscle function training+dentition treatment is effective for the withdrawal of non-obstructive oral respiratory habits in children, and the early treatment is better.
Objective: To explore the comprehensive treatment effect on Children with malocclusion of non-obstructive oral respiratory habits. Methods: Six children with non-obstructive oral respiratory habits were divided into juvenile group(n=7) and early childhood group(n=29).Children in both groups were treated with the intervention treatment of mechanical barrier + maxillofacial function training + dentition treatment. Sleep quality of children in two groups was evaluated by(CSHQ) questionnaire and respiratory habit abstinence assessment before treatment and at 3 months of treatment.The lip muscle tension, lip closure, maxillary arch width(UAW), overbite(OB), overjet(OJ), incisor inclination, occlusal plane inclination, Y axis angle and mandibular plane angle were compared between the two groups. Results: After the mechanical barrier treatment, 70% of the patients got rid of oral respiratory habits. There was no recurrence in the early childhood group but around 30% of the juvenile group relapsed. After the maxillofacial function training, the average increase of AW in some children was(1.35±0.23)mm(P=0.034), the tension of lip muscle decreased and the degree of lip closure increased. However, the early childhood group was unable to cooperate with the maxillofacial function training. The average lip inclination of incisors decreased by(2.37±0.86)°(P=0.009), and the average decrease of OJ was 1.83±0.87 mm(P=0.023). OB showed no change. The angle of the Y axis decreased by 3.21±1.13, and the difference was statistically significant. Conclusion: Mechanical barrier+maxillofacial muscle function training+dentition treatment is effective for the withdrawal of non-obstructive oral respiratory habits in children, and the early treatment is better.
引文
[1] 刘大波,钟建文,罗绍鹏,等.小儿阻塞性睡眠呼吸暂停综合征的临床及睡眠呼吸特征[J].中华儿科杂志,2003,41(1):31-34.
[2] 徐洁,张亚梅,向莉.阻塞性睡眠呼吸暂停低通气综合征对儿童肺功能的影响[C].中华医学会呼吸病学分会2014全国肺功能学术会议,2014.
[3] RAVINDRA N,SUNIL K主编,邹冰爽主译.现代口腔正畸学[M].人民卫生出版社,2011.
[4] 刘艳萍,黄广文,马敏,等.2-5岁儿童睡眠状况流病学调查及其影响因素分析[J].中国临床康复,2006(30):69-73.
[5] 孙莞绮,陈文娟,姜艳蕊,等.学龄儿童睡眠卫生习惯与睡眠质量的相关性[J].中华预防医学杂志,2012,46(8):713-717.
[6] 傅民魁.口腔正畸学[M].北京:人民卫生出版社,2013.
[7] BAHIJA B K,SUNDEEP H,SHAM S B,et al.nce of mouth breathing on the dentofacial growth of children:a cephalometric study[J].Journal of International Oral Health,2014,(6):50-55.
[8] FARIA P T,AC D O R,MATSUMOTO M A,et al.Dentofacial morphology of mouth breathing children[J].Brazilian Dental Journal,2002,13(2):129.
[9] 朱敏.张口呼吸的诊断与治疗[J].中国临床医生,2013,(7):476-477.
[10]赵婷婷,邓丽嘉,贺红.儿童错((牙合))畸形伴OSAHS诊疗理念——多学科合作[J].中国实用口腔科杂志,2017,(2):70-72.
[11]ROSSI R C,ROSSI N J,ROSSI N J C,et al.Dentofacial characteristics of oral breathers in different ages:a retrospective case-control study[J].Progress in Orthodontics,2015,(1):23.
[12]BAKOR S F,ENLOW D H,PONTES P,et al.Craniofacial growth variations in nasal-breathing,oral-breathing,and tracheotomized children.[J].American Journal of Orthodontics & Dentofacial Orthopedics,2011,(4):486-92.
[13]严冬,车晓霞.口呼吸对颅面生长发育影响的研究进展[J].北京口腔医学,2016(2):113-115.
[14]MOSS M L,SALENTIJN L.The primary role of functional matrices in facial growth[J].American Journal of Orthodontics,1969,55(6):566-577.
[15]李小兵.儿童错(牙合)畸形早期矫治的必要性和方法[J].中国实用口腔科杂志,2013(12):709-717.
[2] 徐洁,张亚梅,向莉.阻塞性睡眠呼吸暂停低通气综合征对儿童肺功能的影响[C].中华医学会呼吸病学分会2014全国肺功能学术会议,2014.
[3] RAVINDRA N,SUNIL K主编,邹冰爽主译.现代口腔正畸学[M].人民卫生出版社,2011.
[4] 刘艳萍,黄广文,马敏,等.2-5岁儿童睡眠状况流病学调查及其影响因素分析[J].中国临床康复,2006(30):69-73.
[5] 孙莞绮,陈文娟,姜艳蕊,等.学龄儿童睡眠卫生习惯与睡眠质量的相关性[J].中华预防医学杂志,2012,46(8):713-717.
[6] 傅民魁.口腔正畸学[M].北京:人民卫生出版社,2013.
[7] BAHIJA B K,SUNDEEP H,SHAM S B,et al.nce of mouth breathing on the dentofacial growth of children:a cephalometric study[J].Journal of International Oral Health,2014,(6):50-55.
[8] FARIA P T,AC D O R,MATSUMOTO M A,et al.Dentofacial morphology of mouth breathing children[J].Brazilian Dental Journal,2002,13(2):129.
[9] 朱敏.张口呼吸的诊断与治疗[J].中国临床医生,2013,(7):476-477.
[10]赵婷婷,邓丽嘉,贺红.儿童错((牙合))畸形伴OSAHS诊疗理念——多学科合作[J].中国实用口腔科杂志,2017,(2):70-72.
[11]ROSSI R C,ROSSI N J,ROSSI N J C,et al.Dentofacial characteristics of oral breathers in different ages:a retrospective case-control study[J].Progress in Orthodontics,2015,(1):23.
[12]BAKOR S F,ENLOW D H,PONTES P,et al.Craniofacial growth variations in nasal-breathing,oral-breathing,and tracheotomized children.[J].American Journal of Orthodontics & Dentofacial Orthopedics,2011,(4):486-92.
[13]严冬,车晓霞.口呼吸对颅面生长发育影响的研究进展[J].北京口腔医学,2016(2):113-115.
[14]MOSS M L,SALENTIJN L.The primary role of functional matrices in facial growth[J].American Journal of Orthodontics,1969,55(6):566-577.
[15]李小兵.儿童错(牙合)畸形早期矫治的必要性和方法[J].中国实用口腔科杂志,2013(12):709-717.