齒顎矯正對上呼吸道的影響系列之五：活動性顎骨矯正裝置對上呼吸道空間的影響

Effects of Removable Orthopedic Appliance on Upper Airway Dimensions

活動性顎骨矯正裝置常用於治療尚具生長潛力且上下顎骨關係異常的病患，以期發揮生長修飾（growth modification）的效果。回顧文獻可發現不同類型的活動性顎骨矯正裝置，對於呼吸道有不等程度的影響。在骨性二級關係的患者使用低拉式頭套治療時，短期內可能壓迫其上呼吸道的空間；然而若使用讓下顎前置的機能矯正裝置時，則可能增加上呼吸道的空間，尤其是下顎較後縮或呼吸道較狹窄的病患。對於骨性三級關係且具有生長潛力的病患，使用面罩治療可能增加其上呼吸道的寬度，這對於罹患呼吸道阻塞的患者而言是有助益的。對於下顎後縮的睡眠呼吸中止症成人患者，睡眠時佩戴將下顎前置的改良式功能性矯正裝置，可能有助於增加其上呼吸道的空間而改善呼吸道阻塞症狀。本篇文獻回顧整理近年來有關使用活動性顎骨矯正裝置對呼吸道空間影響的研究報告。

Growth modification by using removable orthopedic appliances has been commonly used in growing patients to correct maxilla-mandibular jaw discrepancy. Previous studies reported the different effects of various orthopedic appliances on the airway dimension. Low-pull headgear therapy may induce a short-term decrease of the upper airway dimension in Class II patients. Face mask therapy seems to be associated with the increase of upper airway dimension in growing Class III patients. However, mandible protruding appliances can increase the upper airway dimension, especially in the Class II patients with mandible retrusion.