基于颈椎骨龄定量分期法的安氏Ⅱ类Ⅰ分类错畸形患者最佳矫形时机的探讨  

The investigation of the optimal treatment timing for class II division I malocclusion based on quantitative cervical vertebral maturation

作　　者：胡丽[1] 林久祥[2] 陈莉莉[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院口腔医学中心,湖北武汉430022 [2]北京大学口腔医学院口腔正畸科,北京100081

出　　处：《临床口腔医学杂志》2013年第3期131-134,共4页Journal of Clinical Stomatology

基　　金：国家自然科学基金:(30801314);湖北省自然科学基金:(2008CBD088)

摘　　要：目的:基于颈椎骨龄定量分期法(Quantitative Cervical Vertebral Maturation,QCVM),探讨上颌发育正常的安氏II类I分类错牙合畸形患者的最佳矫形治疗时机。方法:随机选择在武汉协和医院口腔正畸科就诊的上颌发育正常、表现为安氏II类I分类错牙合畸形的患者,根据颈椎骨龄定量分期法(QCVM),双盲法将患者分为四期:QCVM第I期(加速期)、QCVM第II期(高峰期)、QCVM第III期(减速期)、QCVM第IV期(结束期),每期30例共120例患者入选。年龄8.2～16.1岁(平均年龄12.9岁,其中男62例,女58例)。分别利用Twin-block功能矫治器导下颌向前,改善颌骨畸形,疗程约7个月。治疗前后均拍摄X线头颅侧位片,对各参数指标进行测量分析比较。结果:颈椎骨龄不同时期的患者,矫治后面型均有不同程度的改善,在QCVM I期、II期和III期,SNB、ANB、Ar-Gn等骨骼测量参数治疗前后有显著性变化(P<0.05),治疗前后参数变化绝对值的顺序依次为:QCVM II期>QCVM III期>QCVM I期>QCVM IV期。而L1-NB、U1-L1等角度测量参数在QCVM IV期变化较明显(P<0.05)。结论:颈椎骨龄定量分期法能准确评估在不同的骨龄发育阶段下颌骨的生长发育潜力,在预测下颌骨矫形治疗的最佳时机方面有较好的指导意义。Objectlve：To investigate the optimal treatment timing for class Ⅱ division I malocclusion according to Quantitative Cervical Vertebral Maturation （QCVM）. Method： 120 cases with Class II division Ⅰ malocclusion （8.2-16.1 years） with normal maxilla and retruded mandible were selected and the patients were divided into four groups according to QCVM Ⅰ-Ⅳ. For each group,mandibular protraction was achieved with Twin-block functional appliance for 7 months. Cephalometric analysis was done between pre-treatment and post-treatment. Result： During QCVM Ⅰ, Ⅱ, Ⅲ, the skeletal parameters such as SNB,ANB,Ar-Gn were significant changed before and post treatment （P 〈0.05）. The order of the parameters variation in different QCVM groups is QCVM Ⅱ〉QCVM Ⅰ〉QCVM Ⅲ〉QCVM Ⅳ. In QCVM stage IV, most of the angular parameters such as L1-NB,U1-L1 were changed significantly （P 〈0.05）. Conclusion： QCVM is practical to forecast the optimal treatment timing of mandibular protraction.

关 键 词：颈椎骨龄定量分期法 手腕骨龄 Twin—block功能矫治器 安氏Ⅱ类Ⅰ分类错胎 

分 类 号：R783.5[医药卫生—口腔医学]