| Objective:Explore the correlation between different severities of adenoid hypertrophy and palatal morphology,and identify the differences in the process of diagnosing adenoid hypertrophy by comparing LCR,CCB,MSP,so as to provide references for the diagnosis and early intervention of clinical adenoid hypertrophy.Methods:A total of 88 patients were selected from the Department of Orthodontics,Stomatological Hospital of Shandong University from December 2017 to June 2020,with an average age of 10.08±2.06.Each patient was photographed with LCR and CBCT.CCB and MSP are synthesized by CBCT.According to the dentition,the patients were divided into mixed dentition group and permanent dentition group.According to the A/N ratio of lateral cephalograms,the two dentition groups were divided into three groups:control group a/A,moderate hypertrophy group b/B and severe hypertrophy group c/C.According to whether there is mouth breathing,the two dentition groups were divided into mouth breathing group d/D and nose breathing group e/E,respectively.The palate was reconstructed by Mimics 21.0 and 3-matic 13.0 software,and the basal arch width,volume,surface area,height and palatal index of the palate were measured.One-way ANOVA,independent sample Student’s t test and Pearson correlation analysis were used to analyze the differences of measurement among groups,and the correlation between adenoid hypertrophy degree and palatal morphology.The A,N,A/N,PAS,EPAS and other related ratios were measured on LCR,CCB and MSP of the same patient to evaluate the size of adenoid.The ICC was used for consistency test,and then ANOVA of compatibility group and paired Student’s t test were carried out to judge differences of different lateral radiographs.The level of significant difference was set to P<0.05.Results:1.There was no significant difference among groups a,b and c,but there were significant differences in anterior basal arch width,palatal volume and palatal surface area among A,B and C(P<0.05).2.In mixed dentition group,the anterior basal arch width in the mouth breathing group was significantly lower than that in the control group(P<0.01),and in permanent dentition group,compared with the control group,the anterior basal arch width and the surface area of palate in the mouth breathing group were significantly lower(P<0.05).3.In mixed dentition group,there was no significant correlation between all items and the A/N value(P>0.05),but in permanent dentition group,the anterior basal arch width was negatively correlated with the A/N ratio(P<0.05).4.The ICC of all the results of LCR,CCB and MSP was greater than 0.75.Except for N,there were significant differences in A,N,ratio 1,ratio 2,ratio 3,ratio 4,PAS and EPAS among them.There were significant differences in A,ratio 1-4 and PAS between LCR and CCB(P<0.05).There were significant differences in A/N,ratio 2-4 and EPAS between CCB and MSP(P<0.05).There were significant differences in all items between LCR and MSP(P<0.05).Conclusion:1.In mixed dentition period,the impact of adenoid hypertrophy on the palatal morphology is not obvious,and mouth breathing will cause decrease of anterior basal arch width;in initial permanent dentition period under 14 years old,adenoid hypertrophy and mouth breathing will lead to decrease of anterior basal arch width,palatal volume and surface area.2.In mixed dentition period and initial permanent dentition period under 14 years old,there is no significant correlation between adenoid hypertrophy degree and palatal morphology.Clinically,it is not sufficient to take adenoid size or palatal morphology as the basis for early adenoid intervention.3.The consistency of the evaluation of adenoid size in LCR,CCB and MSP is high,among which CCB has the highest consistency and is a relatively more reliable measurement method.4.There are significant differences in the evaluation of adenoid size by LCR,CCB and MSP,and the accuracy differences among them need to be further studied in the future. |
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