The sample consisted of 17 patients with treated with MAD and 17 patients treated with MMA matched by weight, height, body mass index. Cone-beam computed tomography from before and after both treatments were used to measure total UA, superior/inferior oropharynx volume and surface area; and mandibular rotation.
Both groups showed a significant increase in the superior oropharynx volume after the treatments (p = 0.003) and the MMA group showed greater increase (p = 0.010). No statistical difference was identified in the MAD group considering the inferior volume, while the MMA group showed a significantly gain (p = 0.010) and greater volume (p = 0.024). Both groups showed anterior mandibular displacement. However, the mandibular rotation were statistically different between the groups (p < 0.001). While the MAD group showed a clockwise rotation pattern (-3.97 ± 1.07 and - 4.08 ± 1.30), the MMA group demonstrated a counterclockwise (2.40 ± 3.43 and 3.41 ± 2.79). In the MAD group, the mandibular linear anterior displacement was correlated with superior [p = 0.002 (r=-0.697)] and inferior [p = 0.004 (r = 0.658)] oropharynx volume, suggesting that greater amounts of mandibular advancement are correlated to a decrease in the superior oropharynx and an increase in the inferior oropharynx. In the MMA group, the superior oropharynx volume was correlated to mandibular anteroposterior [p = 0.029 (r=-0.530)] and vertical displacement [p = 0.047 (r = 0.488)], indicating greater amounts of mandibular advancement may lead to a lowest gain in the superior oropharynx volume, while a great mandibular superior displacement is correlated with improvements in this region.
The MAD therapy led to a clockwise mandibular rotation, increasing the dimensions of the superior oropharynx; while a counterclockwise rotation with greater increases in all UA regions were showed in the MMA treatment.
方法:样本包括17名接受MAD治疗的患者和17名接受MMA治疗的患者,高度,体重指数。两种治疗前后的锥形束计算机断层扫描用于测量总UA,上/下口咽体积和表面积;和下颌旋转。
结果:治疗后两组上口咽体积均显著增加(p=0.003),MMA组增加更大(p=0.010)。在MAD组中,考虑到下体积,没有发现统计学差异,而MMA组显示出显着的增加(p=0.010)和更大的体积(p=0.024)。两组均显示下颌前移位。然而,下颌旋转在组间有统计学差异(p<0.001)。而MAD组显示顺时针旋转模式(-3.97±1.07和-4.08±1.30),MMA组呈逆时针方向(2.40±3.43和3.41±2.79)。在MAD组中,下颌线性前移与上[p=0.002(r=-0.697)]和下[p=0.004(r=0.658)]口咽体积相关,提示下颌前移量增加与上口咽减少和下口咽增加有关.在MMA组中,上口咽体积与下颌前后[p=0.029(r=-0.530)]和垂直位移[p=0.047(r=0.488)]相关,表明更大量的下颌前移可能导致上口咽体积的最低增益,而下颌上位的大移位与该区域的改善有关。
结论:MAD治疗导致下颌顺时针旋转,增加上口咽的尺寸;而在MMA治疗中显示出所有UA区域增加更大的逆时针旋转。