伴上颌拥挤的成人骨性反正畸矫治的临床研究  

Orthodontic treatment to skeletal crossbite cases with maxillary overcrowding

作　　者：宁芳[1] 段银钟[1] 徐迈[1] 赵彦涛[1] 

机构地区：[1]第四军医大学口腔医学院,陕西西安710032

出　　处：《临床口腔医学杂志》2006年第10期592-594,共3页Journal of Clinical Stomatology

基　　金：国家科技攻关计划基金资助项目(2004BA720A25)

摘　　要：目的:评价采用拔除上下颌4个前磨牙矫治伴上颌拥挤的骨性反病例的临床效果,为临床矫治该类骨性反牙合提供一种新思路。方法:选取17～30岁伴上颌拥挤的骨性反牙合病例13例,拔除上、下颌4个第一或第二前磨牙,应用标准方丝弓固定矫治技术,分析治疗前后X线头颅侧位片各项指标变化。结果:所有病例在矫治结束后磨牙尖牙均达到Ⅰ类关系,覆牙合覆盖正常。患者硬组织改变没有显著性(p≥0.05)。L1-MP角平均减小8.4°,U1-L1角平均增大11.7°,L1-NB角平均减小10.1°,L1-NB距平均减小5.2mm,差异均有显著性(p<0.01)。软组织侧貌改善明显,Li-E距、Li-H距、Li-RL2距平均减小量分别为3.3mm、3.3mm和4.5mm,差异均有显著性(p<0.01)。结论:采用拔除4个前磨牙的方法矫治伴上颌拥挤的骨性反牙合病例是一种可尝试的矫治方法,矫治后咬合关系良好,侧貌变为直面型。Objective： To evaluate the clinical effect of the orthodontic treatment to skeletal crossbite cases with maxillary overcrowding and provide a new way for the treatment of skeletal crossbite cases.Method： Thirteen skeletal crossbite cases with maxillary overcrowding were studied. With age range from 17 years old to 30 years old. In these cases, first or second premolars in each quadrant were extracted. The standard edgewise technique was adopted. Lateral cephalometric radiographs were taken before and after treatment for analysis. Result： At the end of the treatment, normal overjet and overbite were established with a Class I canine and molar relationship. There appeared to be no significant skeletal changes with treatment （P≥0.05）. L1-MP angle decreased by 8.4°, U1-L1 angle increased by 11.7°, L1-NB angle decreased by 10.1°, L1-NB distance decreased by 5.2mm. Statistically significant differences were found in these changes （P〈0.01）. The softtissue profile improved significantly. Li-E distance,Li-H distance and Li-RL2 distance decreased by 3.3mm,3.3mm and 4.5mm respectively. Statistically significant differences were found in these changes （P〈0.01）. Conclusion： The bimaxillary four premolars extraction for skeletal crossbite cases with maxillary overcrowding may be a viable treatment option. All the patients finished with good occlusion and a straight profile.

关 键 词：骨性反[牙合] 拥挤伴反[牙合] 临床矫治 拔牙 

分 类 号：R783.5[医药卫生—口腔医学]