Nance弓支抗下双颌前突患者拔牙矫治后软组织变化及与硬组织关系的研究  

The study of soft tissue profile ehanges and the relationship with the hard tissue in the adult patients with bimaxillary prtrusion treated with premolar extraction and Nance arch

作　　者：李巍然[1] 周伟华[1] 高琳[1] 傅振[1] 罗漪[1] 

机构地区：[1]北京大学口腔医院·口腔医学院正畸科,100081

出　　处：《中华口腔正畸学杂志》2011年第4期181-186,共6页Chinese Journal of Orthodontics

摘　　要：目的 探讨传统支抗下双颌前突拔牙患者正畸治疗后软组织的变化及与硬组织变化的关系.方法 应用回顾性研究方法,对满足纳入标准的29例拔除四个第一双尖牙并应用Nance弓增加支抗的女性成人双颌前突患者进行治疗前后的手工X线头影测量分析.测量软硬组织项目35项,应用SPSS 15.0软件进行统计分析.治疗前后的变化用配对t检验,软组织变化的相关分析用Pearson相关分析.结果 软组织测量项目显示,经过正畸治疗患者的上、下唇突度、软组织A点及B点的突度减小,颏唇沟深度增加,差异有统计学意义（P＜0.01）；上、下唇基底厚度减小,上唇突厚度增大,下唇突厚度减小,差异有统计学意义（P＜0.01）.而上唇长度、软组织颏前点突度在正畸治疗前后差异无统计学意义.与上唇突度变化（ ΔUL-SL）相关的硬组织测量项目为ΔU1-SL（r=0.469,P＜0.01）；与下唇突度变化（△LL-SL）相关的硬组织测量为ΔSNA（r=0.436,P＜0.05）、ΔU1 -SL（r=0.374,P＜.05）、△L1-SL（r=0.478,P＜0.01）；上、下唇突度变化正相关.鼻唇角的变化与ΔU1-SL（r=-0.534,P＜0.01）、△UL-E（r=-0.394,P＜0.05）负相关,与△A’-SL（r=0.478,P＜0.05）、ΔULL（r=0.474,P＜0.05）及ΔA’-A（r=0.423,P＜0.05）正相关.颏唇沟深度（B’-E）与下切牙的内收（ΔL1-SL）及下唇突度变化（ΔLL-SL）正相关.上唇突度减小与上前牙内收的关系为1∶0.6（以审美平面评价）或1∶0.62（以蝶鞍点垂线评价）.下唇突度减小与下切牙内收关系是1∶1.13；而下唇变化与上前牙内收的关系则是1∶（0.83±0.21）（LL-SL/U1-SL）.结论 传统支抗控制下拔除四个双尖牙后双颌前突成人侧貌改善显著.面下部软硬组织间存在中度相关关系.Objective To investigate the changes of soft tissue profile and the relationship with hard tissue.Methods Twenty-nine adult female patients with bimaxillary protrusion who met the including criteria were included into this retrospective study.Nance arch was used in anchorage control and four first premolars were extracted for each patient.Lateral cephalographs of pre and post treatment were traced by hands,thirtyfive linear and angular measurements were analyzed by SPSS version 15.0.paired t test and Pearson correlation were used.Results The prominence of upper and lower lips,soft tissue A and B point was decreased significantly after orthodontic treatment.The thickness of upper lip increased and lower lip decreased after orthodontic treatment.The retraction of upper incisor was the only measurement positively correlated with upper lip retraction.（ r=0.469,P〈0.01） ;ΔSNA（r=0.436,P〈0.05） 、ΔU1-SL（r=0.374,P〈0.05）、ΔL1-SL（r=0.478,P〈0.01）was correlated with the lower lip retraction; the upper lip retractiom was positively correlated with lower lip retraction.The nasio-labial angle was negatively correlated with ΔU1-SL（r=-0.534,P〈0.01）、ΔUL-E（r=- 0.394,P〈0.05）,and positively correlated with ΔA＇-SL（r=0.478,P〈0.05）、ΔULL（r=0.474,P〈0.05） and ΔA＇-A（r=0.423,P〈0.05）.the depth of soft tissue B（B＇-E）was correlated with（ΔL1-SL）and （LL-SL）.The retraction of the upper lip to the retraction of upper incisor was 1 ∶ 0.6（to E line）or 1∶ 0.62（to S line）.The retraction of the lower lip to the retraction of lower incisor was 1 ∶1.13;The retraction of the lower lip to the retraction of upper incisor was 1 ∶ （0.83±0.21） （LL-SL/U1-SL）.Conclusions Soft tissue profile improved significantly after four first premolars extraction and the use of Nance arch.The changes of soft tissue profile was moderate correlated with hard tissue.

关 键 词：双颌前突 拔牙 支抗 软组织侧貌 

分 类 号：R783.5[医药卫生—口腔医学]