不同矢状向骨性错(牙合)畸形患者的头颈姿势比较研究OACSTPCD

Objective To investigate the differences in head and neck posture in patients with different sagittally oriented osseous malocclusions,aiming to provide guid-ance for clinical diagnosis and treatment.Methods The clinical and imaging data of 454 patients with sagittally osse-ous malocclusion who attended the orthodontic department of West China Hospital of Stomatology,Sichuan University be-tween October 2022 to April 2023 were selected for retrospective analysis.The patients were categorized according to ANB for sagittally osseous malocclusion,and the parameters of head and neck posture(Ba-C3ia,C2ap-C4ip,CVT-OPT,CVT-NSL,CVT-RL,OPT-MP,OPT-FH,OPT-NSL,OPT-RL,and NSL-C2')were compared among the patients.Ad-ditionally,differences in head and neck posture indices were compared after stratifying patients according to their sex(male and female)and age(adult and adolescent),the correlation between the parameters of head and neck posture ad-justed for sex and age and different sagittally osseous malocclusion was analyzed by multiple linear regression.Results In the 454 patients,there were 212 patients(46.7％)with osseous class Ⅰ malocclusion,170 patients(37.4％)with osse-ous class Ⅱ malocclusion,and 72 patients(15.9％)with osseous class Ⅲ malocclusion.Comparison of the age and gender distribution of the patients showed no difference of statistically significant(all P＞0.05).The CVT-NSL,OPT-NSL and NSL-C2'of patients with osseous class Ⅱ malocclusion were significantly higher than those of patients with osseous classⅠ and Ⅲ malocclusions.The OPT-RL of patients with osseous class Ⅲ malocclusion was significantly higher than that of patients with osseous class Ⅰ malocclusion.In female patients,the Ba-C3ia and C2ap-C4ip of osseous class Ⅱ maloc-clusion were also higher than those of osseous class Ⅰ malocclusion(P＜0.05).The differences in parameters of head and neck postures in adult patients were consistent with the overall situation;whereas in adolescent patients,CVT-NSL,OPT-FH and OPT-NSL were higher in osseous class Ⅱ malocclusion than in osseous class Ⅰ,and CVT-NSL,CVT-RL,OPT-MP and OPT-RL in osseous class Ⅲ malocclusion were significantly greater than those of class Ⅰ patients(P＜0.05).More differences in parameters of head and neck postures were witnessed in adolescent female patients than in ad-olescent male patients.Multiple linear regression analyses after adjusting for age and sex confounders showed that com-pared to osseous class Ⅰ malocclusions,Ba-C3ia(B=1.164,P=0.011,95％CI:0.276-2.053),C2ap-C4ip(B=1.339,P=0.007,95％CI:0.364-2.314),CVT-NSL(B=4.154,P＜0.001,95％CI:2.717-5.591),OPT-NSL(B=4.059,P＜0.001,95％CI:2.454-5.664)and NSL-C2'(B=3.773,P＜0.001,95％CI:1.977-5.568)were positively correlat-ed with osseous class Ⅱmalocclusion;CVT-RL(B=3.172,P＜0.001,95％CI:1.313-5.031)and OPT-RL(B=3.003,P=0.004,95％CI:0.978-5.029)were positively correlated with osseous class Ⅲ malocclusions.Conclusion The head and neck postures of patients with osseous class Ⅱ malocclusions were significantly more anterior than those of pa-tients with osseous class Ⅰ and Ⅲ malocclusions,especially in adult female patients.The head and neck postures of un-derage patients with osseous class Ⅲ malocclusions were more anterior than those with osseous class Ⅰ malocclusions.Early orthodontic treatment of osseous class Ⅱ and Ⅲ malocclusions may improve the abnormal head and neck postures.