| Objective: Adenoid hypertrophy is a common disease in children.It has different effects on the growth and quality of life of children.In the treatment of adenoidal hypertrophy,traditional Chinese medicine is slow to take effect,while western medicine surgeries have certain risks and are not easily accepted by children and parents.In this study,we observed the changes of adenoids by early orthodontic treatment in children with anterior crossbite,compared the changes of adenoids size before and after early orthodontic treatment between children with moderate adenoid hypertrophy and children with normal adenoids,the changes of adenoids size before and after treatment by different early orthodontic methods,and the changes of nasopharynx airway and the mandibular plane angle after early orthodontic treatment.This will provide new ideas for the choice of early orthodontic treatment for children with adenoid hypertrophy.Materials and Methods: Three hundred and twenty-one patients who completed early orthodontic treatment in the Department of Orthodontics,Dalian Stomatology Hospital Affiliated of Dalian Medical University were selected.Among them,172 patients of skeletal class ? malocclusion were treated with maxillary protraction appliance,including 82 cases of normal adenoids(42 males,40 females,with an average age 9.02± 1.25),94 cases of adenoid hypertrophy(46 males,48 females,with an average age8.45 ± 1.33);145 patients of skeletal class ? malocclusion were treated with "2×4" correction technique,including 70 cases of normal adenoids(40 males,30 females,with an average age 8.94 ± 0.90),75 cases of adenoid hypertrophy(51 males,24 females,with an average age 8.88 ± 0.87).Lateral cephalograms where taken for all patients in the natural head position,and were traced and analyzed by Winceph 9.0 cephalometric software.All measurements including the thickness of the adenoids,the width of nasopharynx cavity,upper airway space and the mandibular plane angle were measured before and after orthodontic treatment.SPSS 23.0 statistical software was used to analyze the results,and t-test was used to compare the results within and between groups.Results: From the results we found that: 1.After maxillary protraction treatment in children of skeletal class ? anterior crossbite malocclusion(with or without adenoid hypertrophy),the thickness of adenoids decreased,the width of nasopharynx cavity increased,the A/N ratio decreased significantly(P < 0.01),the gap of nasopharynx airway,the gap of superior and posterior soft palate airway,the gap of posterior uvula tip airway,the minimum gap between soft palate and adenoids all increased significantly(P < 0.01),and the mandibular plane angle was increased significantly(P <0.01).After maxillary protraction treatment in children of skeletal class ? anterior crossbite malocclusion,the ratio of A/ N decreased more in patients with adenoid hypertrophy than in patients with normal adenoids.2.After "2×4" correction technique treatment in children of skeletal class ? anterior crossbite malocclusion(with or without adenoid hypertrophy),the width of nasopharynx cavity increased significantly(P <0.01).There was no statistically significant difference in the measurement indexes between the children of skeletal class ? anterior crossbite malocclusion with normal adenoids or adenoid hypertrophy.CONCLUSION: After using maxillary protraction treatment in skeletal class ?anterior crossbite malocclusion for children with moderate adenoid hypertrophy,the thickness of adenoids decreased,the mandibular plane angle and upper airway space increased except for the posterior airway space of epiglottis valley.After using "2×4" treatment technique in skeletal class ? anterior crossbite malocclusion for children with moderate adenoid hypertrophy,there was no statistical significance in the changes of each index.Therefore,it is suitable to use early anterior traction in the treatment ofskeletal Class ? anterior crossbite with moderate adenoid hypertrophy.At the same time,we should pay close attention to the clinical symptoms of patients,carry out multi-disciplinary diagnosis and treatment,so as to promote the development of maxilla,widen the upper airway,reduce the probability of adenoidectomy,and improve the quality of health and life of patients. |
PDF Full Text Request