前方牵引治疗不同骨龄骨性安氏Ⅲ类错的研究  

The effects of maxillary protraction in the treatment of skeletal class Ⅲ malocclusion of different skeletal maturation groups

作　　者：魏福兰[1] 王春玲[1] 刘东旭[1] 寇波[1] 

机构地区：[1]济南山东大学口腔医院正畸科,250012

出　　处：《实用口腔医学杂志》2006年第4期538-541,共4页Journal of Practical Stomatology

摘　　要：目的：评价前牵引治疗不同骨龄组骨性安氏Ⅲ类错[牙合]患者的硬组织变化，并探讨骨龄与前牵引效果之间的关系。方法：选取75例上颌后缩的骨性安氏Ⅲ类错[牙合]患者，均采用前方牵引联合快速扩弓治疗。在治疗前后拍摄头颅侧位片，并且根据治疗前头颅侧位片上颈椎成熟程度将其分为3组：生长加速期组（颈椎成熟度Ⅰ～Ⅱ期），生长峰值期组（颈椎成熟度Ⅲ期），生长减速期组（颈椎成熟度Ⅳ～Ⅵ期）。结果：生长加速期及生长峰值期2组间患者的上颌骨前移量没有明显差异；生长减速期患者上颌骨前移量减小，但其牙槽反应增加；3组间下颌向下后旋转、面下1／3高度增加、磨牙萌出量没有明显差异。结论：骨性安氏Ⅲ类错[牙合]患者诊断和治疗设计时应重视骨龄的评价。Objective： To investigate hard tissue changes produced by maxillary protraction in patients with skeletal Class Ⅲ malocclusion at different bone age, and to determine the relationship between the effect of maxillary protraction and bone age. Methods ：75 subjects of skeletal Class Ⅲ malocclusion with retruded maxilla were treated by maxillary protraction and rapid maxillary expansion for 6 months. Cephalometric radiographs were taken before and after treatment. The bone age of individual patients was assessed using cephalometric radiographs at the initiation of treatment on the basis of cervical vertebrace maturation indicatoes （CVMI）. Patients were divided into three groups：Prepubertal growth peak group （CVMI Ⅰ -Ⅱ ,8.2 -11.3 years old）, pubertal growth peak group （CVMI Ⅲ, 10.2 - 12.3 yeasr old）, and postpubertal growth peak group （ CVMI Ⅳ - Ⅵ, 11.5 - 14.5 years old）. Results： （ 1 ） There was no difference in the maxillary advancement after maxillary protraction between the prepubertal growth peak and the pubertal growth peak groups ; （2） in the postpubertal growth peak group, there was a decrease in maxillary skeletal advancement, whereas the dentoalveolar advancement was increased; （3） the posteroinferior rotation of mandible, the increase of lower facial height, and the eruption of maxillary molars showed no correlation with bone age. Conclusion：The importance of performing a biologic evaluation of bone age in the diagnosis and treatment planning of skeletal Class Ⅲ malocclusions in individual patients must be emphasized.

关 键 词：前方牵引 骨龄 骨性安氏Ⅲ类错[牙合] 颈椎成熟度 

分 类 号：R783.5[医药卫生—口腔医学]