齒顎矯正對上呼吸道的影響系列之七：骨性一級咬合雙顎前突病人治療後上呼吸道空間的改變

Literature Review: Changes of Pharyngeal Airway Space Following Orthodontic Treatment of Class I Bimaxillary Protrusion

骨性一級咬合雙顎前突（Bimaxillary protrusion），常因較突的外觀而尋求矯正治療，主要是拔牙的方式達到顏面部的美觀或是改善咬合問題。大部分接受治療的病人是以美觀為第一考量，較少去考慮呼吸道空間改變的問題。上下顎牙齒的遠心移動是否會直接或間接造成其後方呼吸道空間的改變，近年來有越來越多研究觀察治療後呼吸道的改變、改變後軟組織的反應、以及這些改變是暫時性還是永久性都是值得探討的。之前3D立體影像尚未發展的時代是以2D測顱平面X光影像來測量呼吸道的改變，呼吸道為立體的型態，以平面上呼吸道長度、寬度的改變來測量評估呼吸道的改變量，可能無法全面考量，近來有許多呼吸道的測量使用3D重組來評估，更能觀察呼吸道的面像。但由於呼吸道的型態多變性目前並無呼吸道正常值的發表，所以僅能與受試者做治療前後的比較。本篇文獻回顧整理骨性一級咬合雙顎前突病人治療後其上呼吸道空間的改變。

Bimaxillary protrusion is characterized by protrusive and proclined upper and lower incisors. Since patients with bimaxillary protrusion generally have perfectly good occlusion, orthodontic treatment is often solely sought to correct the protrusive profile and less concern about the airway space change. Typical orthodontic treatment includes extraction of the bimaxillary premolars and anterior tooth retraction, with maximum anchorage. Recently, the relationship between maximum anchorage and tooth displacement is well recognized, retrospective upper airway analysis after retraction of the large incisors remains to be established. This article review previous studies about the pharyngeal airway changes after orthodontic treatment of class I bimaxillary protrusion.