以超音波觀察矯正治療之前牙後退對吞嚥時 舌頭運動的影響

Ultrasound investigation of the influence on tongue movement during swallowing after anterior teeth retraction

陳怡君(Yi-chun Chen)

指導教授 ： 蔡吉陽 ； 彭建綸

臺北醫學大學/口腔學院/牙醫學系碩博士班/碩士(2006年)

摘要

本研究的目的是希望去評估接受拔牙治療之矯正患者,在前牙後退完成之後,舌頭吞嚥模式以及舌頭長度與厚度是否會改變。此研究使用B模式＋M模式口腔超音波防震掃描技術,對舌頭做動態與靜態客觀的測量，並檢測前牙後退、舌頭吞嚥模式以及舌頭長度與厚度之間的相關性。選擇13位符合條件的志願者為受測對象（男性4位，女性9位，平均年齡21歲3個月），分別在前牙退後之前後各取一次測顱x光片及超音波吞嚥之影像資料;而後以測顱x光片描繪取得前牙空間、距離、角度的改變量，再以電腦輔助分析超音波吞嚥影像，得到舌頭吞嚥各分期的時間振幅之改變以及舌體長度及厚度的改變量。用無母數分析法之t檢定去分析各變項前後之差異，再以Pearon correlation analysis 去求得各變項之間的相關性。 結果顯示：在矯正治療前牙後退完成之後，動態觀察方面，舌頭吞嚥各分期的持續時間與振幅，前後比較皆沒有改變，但舌頭休息位置，有向下移動的趨勢; 而在靜態觀察方面，舌體前後徑長度會減少，但舌體厚度並沒有改變。相關性方面顯示，舌頭休息位置的改變和垂直方向的振幅改變成高度正相關，也就是舌頭休息位置愈低位，舌頭吞嚥Ⅱa期（早期運送期）、Ⅲa期（早期終止期）及整體吞嚥之振幅也會隨之增大。而舌頭吞嚥時間的改變，和所有變項皆無相關性。 由本研究可知，雖然矯正治療將前牙後退會使口腔前後空間減少，但舌頭本身會去適應牙弓及齒列的變化，所以治療後舌頭吞嚥功能不會有改變。

關鍵字

前牙後退 ； 舌頭吞嚥 ； 超音波

並列摘要

The purpose of this study was to evaluate the changes on tongue movement during swallowing with ultrasound technique, while anterior teeth were posited backward by orthodontic therapy.The subject material consisted of four men and nine women, with a mean age of 21.3 years old. The subjects were undergoing orthodontic treatment with extraction, and there were at least 3mm space left on each side between lateral incisors and canines. The cephalometric radiography and ultrasound image of swallowing were recorded just before and after anterior teeth retraction. All the changes and correlation between the variable of anterior portion and the variable of tongue movement during swallowing were all discussed. The result showed that there were no significant change on duration and magnitude during swallowing after anterior retraction. It is also found the rest position of tongue is highly positive related to the magnitude of phase Ⅱa and phase Ⅲa. It demonstrated that anterior teeth retraction would not affect tongue movement during swallowing .

並列關鍵字

anterior retraction ； swallow, tongue ； ultrasound

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