Cone beam CT를 이용한 안면골격형태에 따른 상기도 공간 분석

Pharyngeal airway analysis of different craniofacial morphology using cone-beam computed tomography (CBCT)

상기도 공간은 3차원 입체 구조물로서 두부규격방사선사진 등으로 분석하기에는 평가의 한계가 존재하였다. 본 연구는 최근 방사선 피폭량 등의 감소로 그 활용도가 높아진 cone beam CT (CBCT)를 이용하여 안면골격형태에 따른 상기도 공간의 면적, 전후방 폭경 및 측방 폭경을 측정하고 그 관련성을 알아보았다. 102명을 대상으로 CBCT (VCT, Vatech, Seoul, Korea)를 촬영하였으며, FH plane에 평행하면서 aa point (the most anterior point on the anterior arch of atlas), CV<SUB>2ia</SUB>, CV<SUB>3ia</SUB> point (most infero-anterior point on the body of the second &amp; third cervical vertebra)를 지나는 평면을 기준으로 설정하였다. 각 항목의 계측치는 one-way ANOVA를 이용하여 통계처리하고 Duncan test로 사후검정하였다. 연구 결과, 안면 골격형태에 따른 측방 폭경에는 유의한 차이가 없었다. Group 2 (Class II) 집단은 aa plane, CV<SUB>2</SUB> plane, CV<SUB>3</SUB> plane에 의해 형성된 상기도 공간의 단면적이 좁았으며, 전후방 폭경도 Group 3 (Class III)에 비해 유의성 있게 좁았다. 수직 안면골격형태와 정상 안면골격 형태간의 유의성 있는 차이는 없었으나, aa plane에서 형성된 상기도 공간의 전후방 폭경은 Group 1V (Class I vertical)가 Group 1N (Class I normal)에 비해 유의성 있게 좁은 것으로 나타났다. (p ＜ 0.05).

Objective: CBCT has become popular for orthodontic diagnosis and treatment planning in recent times. The 3D pharyngeal airway space needs to be analysed using a 3D diagnostic tool. The aim of this study was to analyse the pharyngeal airway of different craniofacial morphology using CBCT. <br>Methods: The sample compromised 102 subjects divided into 3 groups (Class I, II, III) and 6 subgroups according to normal or vertical craniofacial patterns. All samples had CBCT (VCT, Vatech, Seoul, Korea) taken for orthodontic treatment. The pharyngeal airway was assessed according to the reference planes: aa plane (the most anterior point on the anterior arch of atlas), CV<SUB>2</SUB> plane, and CV<SUB>3</SUB> plane (most infero-anterior point on the body of the second &amp; third cervical vertebra). The intergroup comparison was performed with one-way ANOVA and duncan test as a second step.<br>Results:</br> The results showed the pharyngeal airway and anteroposterior width of group 2 (Class II) in aa plane, CV<SUB>2 </SUB>plane, CV<SUB>3</SUB> plane were significant narrower than in group 3 (Class III). There was no significant difference between vertical and normal craniofacial patterns except for the anteroposterior pharyngeal width of Group 1 (Class I) in aa plane.<br>Conclusions: Subjects with Class II patterns have a significantly narrower pharyngeal airway than those with Class III. However there was no difference in pharyngeal airway between vertical and normal craniofacial morphology. (Korean J Orthod 2009;39(3):136-145)