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目的:观察正畸治疗和正颌手术后三叉神经分布区域温度感觉功能的变化。方法:选取20例平均年龄在20.9±1.74岁的骨性Ⅲ类错患者,进行温度觉的定量感觉检查(quantitative sensory tests,QST)。检查部位在双侧眶下孔(V2L、V2R)、双侧颏孔(V3L、V3R)和左手大鱼际。检测时间分别在正畸治疗前(T0)、正颌手术前(T1)、正颌手术后2个月(T2)和正颌手术后6个月(T3)。检查项目包括冷感阈值(cold detection threshold,CDT)、温感阈值(warm detection threshold,WDT)、冷痛阈值(cold pain threshold,CPT)和热痛阈值(hot pain threshold,HPT)4项指标。采用SPSS16.0软件包对数据进行统计学分析。结果:T1与T0相比,V2L(P=0.006)和V2R(P=0.017)的温感阈值降低(敏感性增高),V2L(P=0.028)的冷感阈值增加(敏感性降低),V2R(P=0.028)和V3R(P=0.017)的热痛阈值增加(敏感性降低)。T3与T0相比,V3L(P=0.024)的温感阈值增加(敏感性降低),V2R(P=0.036)、V3L(P=0.012)和V3R(P=0.044)的冷痛阈值降低(敏感性增高),V2L(P=0.009)、V2R(P=0.034)、V3L(P=0.032)和V3R(P=0.001)的热痛阈值增加(敏感性降低)。T2期的麻木症状在是T0期的93.3%,T3期的麻木症状在是T0期的20%。有无颏成形术对患者在T2期(P=0.303)和T3期(P=0.530)的感觉变化无影响。结论:正畸治疗和正颌手术均会影响三叉神经分布区域的温度感觉功能,各个阶段手部的感觉功能无改变。但大多数患者的温度感觉功能在半年后会部分恢复。
OBJECTIVE: To observe the changes of temperature sensory function in the distribution of trigeminal nerve after orthodontic treatment and orthognathic surgery. Methods: Twenty patients with skeletal class Ⅲ malocclusion were enrolled in this study. Their mean sensitivities tests (QST) were performed in 20.9 ± 1.74 years old. The site of the examination was bilateral infraorbital foramen (V2L, V2R), bilateral lingual foramina (V3L, V3R) and left-handed megalobrachia. The detection time was before T0, before the orthognathic surgery (T1), 2 months after the orthognathic surgery (T2) and 6 months after the orthognathic surgery (T3). The items included cold detection threshold (CDT), warm detection threshold (WDT), cold pain threshold (CPT) and hot pain threshold (HPT). SPSS16.0 software package for statistical analysis of the data. Results: Compared with T0, the thresholds of temperature sensitivities of V2L (P = 0.006) and V2R (P = 0.017) were decreased (sensitivities increased), the sensitivities of V2L (P = 0.028) (P = 0.028) and V3R (P = 0.017) increased (decreased sensitivity). T3 showed a decrease in the threshold for cold sensitivities of V3L (P = 0.024) (decreased sensitivity), V2R (P = 0.036), V3L (P = 0.012) and V3R (P = 0.044) (Increased sensitivity), V2L (P = 0.009), V2R (P = 0.034), V3L (P = 0.032) and V3R (P = 0.001). The numbness of T2 was 93.3% of T0, and the numbness of T3 was 20% of T0. The presence or absence of genioplasty had no effect on the patient’s sensory changes at T2 (P = 0.303) and T3 (P = 0.530). Conclusion: Both orthodontic treatment and orthognathic surgery can affect the temperature sensory function in the trigeminal nerve distribution area. The sensory function of the hand in each stage has no change. However, most patients’ temperature sensory function partially recovered after six months.