骨性Ⅲ类错(牙合)畸形术前正畸拔牙与不拔牙的比较研究  

Pre-operative orthodontic treatment strategy of skeletal class Ⅲ malocclusion

作　　者：房兵[1] 毛丽霞[1] 林晓松[1] 吴勇[1] 冯贻苗[1] 娄新田[1] 夏蕴辉[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院

出　　处：《口腔正畸学》2007年第3期97-101,共5页Chinese Journal of Orthodontics

基　　金：上海市重点学科建设项目资助(Y0203);上海市科委资助项目(编号:05B224)

摘　　要：目的评价骨性安氏Ⅲ类畸形正颌术前正畸中上齿槽及牙的唇倾度的矫正,对正颌术后面型改善,以及正常前牙覆(牙合)覆盖建立的影响。方法通过回顾性研究对比安氏Ⅲ类错颌畸形双颌手术,术前正畸中上颌拔牙和非拔牙的两组患者,拔牙病例20例,非拔牙病例20例,头影测量研究两组患者治疗前后的牙长轴、鼻唇角、颌凸角等与面型有关的数据,评价拔牙和非拔牙术前正畸对安氏Ⅲ类错颌畸形面型矫正的影响。结果测量显示术前正畸中上颌拔牙矫正使鼻唇角明显增大,覆盖明显增大,代表面型的数据:鼻唇角、面角、颌凸角、颏前点到零子午线的距离、鼻下点到零子午线的距离两组变化有显著性差异,拔牙组对面型的调整更有效;牙长轴、覆骀覆盖、鼻唇角、面角、颌凸角、颏前点到零子午线的距离、鼻下点到零子午线的距离在拔牙组数据与正常均数比较无显著性差异。结论骨性安氏Ⅲ类错(牙合)畸形的正畸正颌联合治疗中,值得注意上颌前牙的代偿性唇倾,对其去代偿矫正是安氏Ⅲ类错颌畸形矫正中调整面型的主要因素。Objective Presurgical orthodontics treatment include reposition of the incisors in ＂ideal＂ positions, establishment of correct torque, and elimination of discrepancies of maxillary and mandibular. The aims of the present article was to compare facial profile change between maxillary premolar extraction and nonextraction de-compensation of orthodontics. Methods retrospective clinical trial, forty adults with Class Ⅲ malocclusions were examined who treated with bimaxillary orthognathic surgical procedure involving advancement of the maxilla and mandibular setback, 20 underwent presurgical orthodontics treatment with extraction, 20 underwent non-extraction protocal. Presurgical and posttreatment lateral cephalograms were analyzed, comparison of changes profile as well as the extraction presurgical orthodontics and nonextraction presurgical orthodontic protocol in class III malocclusion. Results There were significant differences between the extraction and nonextraction groups including naso-labila angle , overjet, facial angle, angle of convexity, 0-Meridian to Pog, 0-Meridian to Sn＇, long axis of upper incisor. No significant differences were found after treatment between the extraction group and norms. Conclusions The indications for maxillary premolar extraction in Class Ⅲ presurgical orthodontic treatment is necessary. In the sagittal plane, upper anterior teeth dental compensations should be removed which is very important to the correct the concave profile with class Ⅲ malocclusion.

关 键 词：骨性Ⅲ类错[牙合] 术前正畸 正颌手术 

分 类 号：R783.5[医药卫生—口腔医学]