扩弓联合肌功能训练对口呼吸患儿舌位置的影响

王文婷; 黄俊强; 林巧珍; 刘小凤; 曹军; 戴娟

doi:10.13201/j.issn.2096-7993.2023.08.009

扩弓联合肌功能训练对口呼吸患儿舌位置的影响

- 深圳大学总医院口腔科深圳大学口腔医学研究所(广东深圳，518055)
基金项目:
广东省医学科学技术研究基金(No：20201125225840234)；深圳市高校稳定支持计划面上项目(No：20220808170713001)

详细信息

通讯作者: 戴娟，E-mail：daijrabbit@hotmail.com

中图分类号: R783.5

收稿日期: 2023-05-26

刊出日期: 2023-08-03

Effect of maxillary expansion combined with orofacial myofunctional therapy on the position of the tongue of children with mouth breathing

- Department of Stomatology, General Hospital of Shenzhen University, Institute of Stomatology, Shenzhen University, Shenzhen, 518055, China

More Information

Corresponding author: DAI Juan, E-mail: daijrabbit@hotmail.com

Received Date: 26 May 2023

Publish Date: 03 August 2023

摘要

摘要: 目的研究骨性Ⅱ类错伴口呼吸患儿行上颌扩弓联合口面肌功能训练后舌体位置的变化。方法选取30例上气道通畅的骨性Ⅱ类错畸形患儿，根据呼吸方式分为口呼吸组(15例)和鼻呼吸组(15例)，分别拍摄鼻呼吸组治疗前锥形束CT(cone-beam CT，CBCT)、口呼吸组上颌扩弓联合口面肌功能治疗前、后的CBCT，使用Invivo5软件对舌体位置进行测量。采用SPSS 27.0软件对鼻呼吸组和口呼吸组数据进行独立样本t检验。对口呼吸组治疗前、后数据进行配对样本t检验。结果口呼吸组和鼻呼吸组骨性Ⅱ类错患儿，舌体距离上腭的位置存在明显的差异(P＜0.05)。口呼吸组通过上颌扩弓联合口面肌功能训练后，舌背与上腭之间的距离减小，治疗前后差异有统计学意义(P＜0.05)。结论骨性Ⅱ类错伴口呼吸患儿常存在低舌位，通过上颌扩弓联合口面肌功能训练，有助于改善舌体位置。
- 上颌扩弓 /
- 口面肌功能治疗 /
- " type="keywords.keywordCn" href="javascript:void(0);"> 骨性Ⅱ类错 /
- 舌体位置
Abstract: Objective This study aimed to investigate the change of the position of the tongue before and after combined treatment of maxillary expansion and orofacial myofunctional therapy in children with mouth-breathing and skeletal class Ⅱmalocclusion.Methods A total of 30 children with skeletal class Ⅱ malocclusion and unobstructed upper airway were selected. The 30 children were divided into mouth-breathing group(n=15) and nasal-breathing group(n=15) and CBCT was taken. The images were measured by Invivo5 software. The measurement results of the tongue position of the two groups were analyzed by independent samples t-test. 15 mouth-breathing children with skeletal class Ⅱ malocclusion were selected for maxillary expansion and orofacial myofunctional therapy. CBCT was taken before and after treatment, the measurements were analyzed by paired sample t test with SPSS 27.0 software package.Results The measurement of the tongue position of the mouth-breathing and nasal-breathing groups were compared, the differences were statistically significant(P < 0.05). The measurement of the tongue position showed significant difference after the combined treatment of maxillary expansion and orofacial myofunctional therapy in children with mouth-breathing and skeletal class Ⅱmalocclusion(P < 0.05).Conclusion Skeletal class Ⅱ malocclusion children with mouth-breathing have low tongue posture. The combined treatment of maxillary expansion and orofacial myofunctional therapy can change the position of the tongue.
- maxillary expansion /
- orofacial myofunctional therapy /
- skeletal class Ⅱ malocclusion /
- the position of the tongue

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图 1 口呼吸组治疗前CBCT舌体位置图

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图 2 口呼吸组治疗后CBCT舌体位置图

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图 3 鼻呼吸组舌体位置测量方法

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图 4 口呼吸组舌体位置测量方法

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表 1 口面肌功能训练方法

练习内容	练习时间及频率	具体内容
N点训练	每次10 s，5次1组，每天3组	将舌尖抵在上中切牙后5 mm或发英文字母“N”结束时舌尖的位置，维持10 s，保持小张口，唇肌放松。
唇肌训练(吹纸训练)	每次10 s，5次1组，每天3组	保持抿住双唇10 s，尽量不要露出唇红。面前放一张纸巾，用力发“泼”音，用发“泼”音的气流力量将纸吹起。
呼吸训练(左右鼻孔交替呼吸)	每次10 s，5次1组，每天3组	闭上嘴，伸出双手食指，右手食指压住右侧鼻孔，用左侧鼻孔深吸气。憋住10 s，换左手食指压住左侧鼻孔，用右侧鼻孔将气呼出，之后交换鼻孔。
弹舌训练	每组20次，每天3组	将舌吸到上腭，迅速离开上腭发出类似马蹄“哒哒”声。训练舌前部和中部肌肉，帮助舌上抬。
吞咽训练(咧嘴弹舌吞咽训练)	每组15次，每天3组	大笑状，后牙轻咬，嘴唇离开牙齿，弹舌发出响声(口底部不发声，下巴不动，牙齿保持咬合)后吞咽。

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表 2 鼻呼吸组和口呼吸组舌体位置比较 mm，X±S

测量项目	鼻呼吸组(15例)	口呼吸组(15例)	P
T1	0.00±0.00	5.70±3.49	0.010
T2	0.00±0.00	7.59±4.70	0.011
T3	0.00±0.00	6.59±4.30	0.013
T4	0.00±0.00	5.99±3.30	0.007
T5	0.00±0.00	4.50±3.15	0.017
T6	0.06±0.00	2.47±2.11	0.035
T7	0.04±0.00	1.51±1.24	0.031

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表 3 矫治前后舌体位置比较 mm，X±S

测量项目	治疗前(D1)	治疗后(D2)	D1-D2	P
T1	5.71±3.49	0.68±1.05	5.03±3.49	0.021
T2	7.59±4.70	0.80±1.28	4.79±5.15	0.023
T3	4.59±4.30	0.83±1.30	5.74±4.51	0.024
T4	5.99±3.29	1.01±1.60	4.98±3.54	0.019
T5	4.50±3.15	1.10±1.79	3.40±3.35	0.045
T6	2.48±2.11	0.24±0.52	2.21±2.05	0.046
T7	1.50±1.23	0.00±0.00	0.00±0.00	0.031

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