早期骨性Ⅲ类错前方牵引矫治中扩弓效果的比较  

Effect of maxillary protraction with or without rapid palatal expansion in treating early skeletal Class Ⅲ malocclusion

作　　者：马文盛[1] 卢海燕[1] 董福生[2] 胡骁颖[1] 栗兴超[2] 

机构地区：[1]河北医科大学口腔医院正畸科,河北石家庄050017 [2]河北医科大学口腔医院颌面外科,河北石家庄050017

出　　处：《华西口腔医学杂志》2009年第2期178-182,共5页West China Journal of Stomatology

基　　金：河北省科学技术研究与发展指导计划资助项目(627611011)

摘　　要：目的研究快速扩弓前方牵引与单纯前方牵引矫治早期骨性Ⅲ类错临床疗效的异同。方法选择31例替牙期骨性Ⅲ类错患者分为A、B组,A组15例采用快速扩弓前方牵引矫治,B组16例采用单纯前方牵引矫治。2组患者矫治前后分别拍摄头颅定位侧位片,选择23个测量项目,比较矫治前后的变化,并用Pancherz分析法进行分析。结果A组疗程平均10.14个月,B组平均9.77个月(P>0.05)。Pancherz分析结果表明,A、B组上颌基骨分别前移2.99mm和3.33mm;A组下颌基骨后移0.07mm,B组下颌基骨前移0.80mm;A、B组前牙覆盖分别增加4.51mm和6.37mm,磨牙关系改善分别为4.97mm和4.73mm。以上项目除前牙覆盖的变化2组间有统计学差异外(P<0.05),其余项目无统计学差异(P>0.05),均达到满意的临床效果。A组下颌磨牙在下颌基骨中前移了1.18mm,B组下颌磨牙在下颌基骨中后移了1.20mm(P<0.05)。从2组矫治前后治疗变化量的比较来看,矫治后2组上颌前牙的唇倾度均有增加,但B组较A组增加更多(P<0.05)。结论对早期骨性Ⅲ类错采用前方牵引矫治,无论快速扩弓与否,均可获得满意的临床疗效。Objective To evaluate the effectiveness of treatment with maxillary protraction with or without rapid palatal expansion（RPE） for skeletal Class Ⅲ malocclusion in mixed dentition. Methods A total of 31 children with Class Ⅲ malocclusion in mixed dentition were selected, and 15 （group A） received maxillary protraction treatment with RPE, the other 16（group B） received maxillary protraction without RPE. Cephalometric films were taken before and after treatment, and traditional and Pancherz analysis were used. Results The average duration of treatment was 10.14 months in group A and 9.77 months in group B respectively （P〉0.05）. According to Pancherz analysis, maxillary basal bone moved forwards by 2.99 mm in group A and 3.33 mm in group B respectively（P〉0.05）, mandibular basal bone moved backwards by 0.07 mm in group A, while forwards by 0.80 mm in group B （P〉0.05）, the overjet increased by 4.51 mm in group A and 6.37 mm in group B respectively（P〈0.05）, and the molar relationship improved by 4.97 mm in group A and 4.73 mm in group B respectively （P〉05）. The effects were clinically satisfactory in the both groups. Lower molar moved forwards by 1.18 mm in basal bone in group A, while backwards by 1.20 mm in group B （P〈0.05）. Traditional ecphalometric analysis showed no statistic differences between the two groups except that upper incisior showed greater procline in group B than in group A （P〈0.05）. Conclusion The study shows that maxillary protraction treatment, with or without RPE, is clinically satisfactory to correct early skeletal Class Ⅲ malocclusion.

关 键 词：骨性Ⅲ类错[牙合] 前方牵引 快速扩弓 早期矫治 

分 类 号：R783.5[医药卫生—口腔医学]