种植体支抗后牵引上颌骨颅颌面结构变化的动物实验研究  

Dentofacial changes after maxilla retraction with zygomatic implant anchorage-a rhesus monkey study

作　　者：张晓蓉[1,2] 曾祥龙[1] 徐芸[2] 

机构地区：[1]北京大学口腔医学院·口腔医院止畸科,100081 [2]昆明医学院附属口腔医院正畸科,650031

出　　处：《中华口腔正畸学杂志》2009年第1期9-12,共4页Chinese Journal of Orthodontics

基　　金：基金项目：云南省科技厅联合专项基金项目（2007C206R）

摘　　要：目的评价种植体支抗后牵引上颌骨对颅颌面的矫形作用。方法生长发育期恒河猴4只，3只用于研究（1只牵引1．5月、2只牵引3月），1只作为对照；采用颧骨微钛板种植体支抗后牵引上颌骨，铸造固位夹板粘接于上颌第一恒磨牙、第二乳磨牙及切牙上，牵引力值每侧1．47N（150克），方向与（牙合）平面平行；对实验前后X线头影测量进行对比分析。结果实验动物A点后移，1．5月组1mm，3月组平均2．5mm；SNA减小，1．5月组1°，3月组平均3．5°。1．5月组前牙覆盖减小3．5mm，其中骨效应大于牙齿效应（2．5：1）；磨牙关系改变为3mm，骨效应大于牙齿效应（5：1）；上颌效应大于下颌效应（2．5：1）。3月组平均前牙覆盖减小6．25mm，其中骨效应大于牙齿效应（1．8：1）；磨牙关系改变为5mm，骨效应大于牙齿效应（4：1）；上颌的作用大于下颌（5．7：1）。结论颧骨微钛板种植体能够提供稳定的支抗后牵引上颌骨，不仅抑制上颌骨向前生长，而且使上颌骨向远中移动，同时伴有逆时针方向的旋转。Objective To study the dentofacial changes caused by retractive force with zygomatic implant to the maxilla of rhesus monkeys. Methods 4 young male rhesuses were employed, 3 experimented （l for 1. 5 month and 2 for 3 months）, and 1 as control. Titanium miniplates were fixed on the bilateral zygomatic bones as an anchorage, the maxillary cast splint was anchored in cisors, second deciduous molars and firsr molars. A retractive force of 150g was exerted on each side with a direction parallel to an occlusal plane. Cephalometric comparison was analysed between the beginning and the end of experiment. Results A point was moved backward as measured by A-OLP distance, which was decreased by 1 mm（1. 5M） and 2. 5 mm（3M）. SNA angle was decreased by 1 degree （1. 5M） and 3. 5 degree （3M）. These morphological changes in mutual relationships of maxillofacial skeleton and inter-maxillary arch were demonstrated with the overjet decreased by 3.5 mm（1. 5M） and average 6. 25 mm（3M） with the ratio of skeletal to dental effects 2.5 ： 1 （1. 5M） and 1. 8 ： 1 （3M）; the molar occlusal changes were found to develop 5 mm distalization with the ratio of skeletal to dental effects 5 ： 1 （1.5M） and 4 ： 1 （3M）; maxillary effects stronger than mandibular effects in the ratio of 2.5 to 1 （1.5M） and 5.7 to 1 （3M）. Conclusions Zygomatic implant can be utilized as an anchorage not only to inhibit maxilla from growing forward but also to retract maxilla distally with some counterclockwise rotation.

关 键 词：种植体支抗 上颌骨 后牵引 动物实验 

分 类 号：R783.5[医药卫生—口腔医学] R782.22[医药卫生—临床医学]