改良固定反式TBA联合前牵矫治AngleIII类前牙反对TMJ影响的比较性研究  

The TMJ investigation of the modified fixed reverse Twin-block combine maxillary protraction appliance in treatment of AngleIII skeletal anterior crossbite

作　　者：刘红[1] 段银钟[2] 杨振华[2] 张海军[1] 宋卫东[1] 杨勃[1] 

机构地区：[1]兰州军区兰州总医院口腔科,甘肃兰州730050 [2]第四军医大学口腔医学院正畸科

出　　处：《中国美容医学》2006年第7期841-843,共3页Chinese Journal of Aesthetic Medicine

摘　　要：目的:应用改良固定反式双阻板矫治器(Twin-blockappliance,TBA)联合前牵治疗15例AngleIII类轻、中度骨性前牙反,进行颞颌关节方面研究,以期从颞颌关节适应性改建来探讨其作用机制。方法:测量分析治疗前后颞下颌关节中位断层片变化情况,并与前牵引组及反式TBA组进行比较。结果:未发现一例患者出现TMD症状。联合组治疗前后线性百分比分别为24.67%和11.62%,N/M值治疗前后分别为1.82和1.07,A值及P值变化均较明显,关节前间隙增大,后间隙减小。联合组及反式TBA组髁突发生明显后下移位,前牵引组变化较小。结论:适当持续性矫治力不会对颞颌关节产生不利影响。联合组全天作用引起颞颌关节适应性改建,前牙反锁结的快速解除并结合将前伸的髁突、下颌诱导后退,有利于恢复和建立后牙正常的ICP,真正实现牙位、肌位、关节位的协调一致,此对于矫治前牙反牙合、防止复发具有重要意义。ObjectiVe This study was to investigate the TMJ of the modified fixed reverse TBA combine maxillary protraction on treatment of early Angle Ⅲ skeletal anterior crossbite. Methods The appliance was used on 15 growing subjects with early Anglelll skeletal malocclusion and investigated the change in X-ray cephalometry pre- and post- treatment. Sametime compared with maxillary protraction and modified fixed reverse TBA. Results No one appeared TMD. The linear percent were 24.67% and 11.62% and the N/ M were 1.82 and 1.07 in pre- and post- treatment separately, A and P changes could be achieved in combined group. There were downward-backward direction of condylar dislocation in combined group and reverse TBA group and no significant difference in maxillary protraction group. Conclusion Suitable continuous orthodontic force does not lead to TMD. Combine group can led to the reconstruction of TMJt hose alter were important in treatment of anterior crossbite and prevention of relapse.

关 键 词：改良固定反式TBA 前牵引 AngleⅢ类错[牙合] 骨性前牙反[牙合] 颞颌关节 

分 类 号：R783.5[医药卫生—口腔医学]