正畸正颌联合治疗骨性Ⅲ类错畸形的术前正畸去代偿情况的研究  

Study on Presurgical Orthodontics Decompensation in Skeletal Class Ⅲ Malocclusion with Orthodontic-surgical Treatment

作　　者：宋少华[1] 莫水学[1] 庞煊奈[1] 陈亚莉[1] 

机构地区：[1]广西医科大学口腔医院口腔正畸科,广西南宁530021

出　　处：《口腔医学研究》2013年第4期346-349,352,共5页Journal of Oral Science Research

基　　金：广西教育厅面上项目(编号:200810MS058)

摘　　要：目的:通过头影测量分析研究经正畸正颌联合治疗的骨性Ⅲ类错畸形在治疗前和经术前正畸后手术前骨性和牙性的垂直向、矢状向变化及牙齿去代偿情况,分析总结骨性Ⅲ类错畸形的术前正畸治疗特点。方法:回顾性研究正畸正颌联合治疗包括行完善的术前正畸的骨性Ⅲ类患者25例,治疗前根据临床检查、头影测量分析和模型分析等与正颌外科医生会诊制定治疗计划。经过术前正畸、正颌手术和术后正畸观察患者疗效。结果:大多数患者的术前正畸为非拔牙矫治,少数为拔上颌双尖牙和因龋坏等原因拔除其他部位的牙齿。经过术前正畸去代偿治疗,骨性方面垂直向和矢状向的关系均无变化。在牙性方面大多数上前牙代偿情况没有明显变化,而下前牙去代偿比较完善,有显著统计学意义(P<0.05)。结论:骨性Ⅲ类错畸形术前正畸可以去除大部分下颌前牙代偿,但是上前牙去代偿效果不明显。虽然患者对治疗效果满意,但术前正畸并未达到完全去代偿。能否完全去除代偿及有无必要完全去除代偿,仍值得进一步探讨和研究。Objective： To investigate the presurgical orthodontics decompensation of skeletal class Ⅲ patients treated with orthodontic-surgical treatment by the comparison of the skeletal and dental cephalometric values in both pretreatment and presurgical orthodontics stages.Methods： In this retrospective study,25 skeletal class Ⅲ patients treated with orthodontic-surgical treatment were selected from the Stomatology Hospital of Guangxi Medical University.The treatment planning was made by orthodontists and surgeons together based on the clinical evaluation,cephalometrics and cast analysis.The treatment process includes three stages：presurgical orthodontics,orthognathic operation and postsurgical orthodontics.The satisfactory treatment effect was obtained.A comparison of the skeletal and dental cephalometric values before and after the presurgical orthodontic decompensation was made.Results： The majority of the subjects treated with nonextraction in presurgical orthodontics,the minority treated with premolar extraction.After presurgical orthodontics,the skeletal relationships in sagittal and vertical were not changed.Presurgically,the lingual inclined mandibular incisors were decompensated statistically evident（P＆lt;0.05）.The labial inclined maxillary incisors were not significantly changed.Conclusion： The study showed the mandibular incisors were decompensated by the presurgical orthodontic treatment in skeletal class Ⅲ malocclusion,but the maxillary incisors have no obvious changes.Further studies and discussion about whether decompensation must be done or can be done thoroughly would be necessary.

关 键 词：骨性Ⅲ类错[牙合]畸形 正畸正颌联合治疗 术前正畸 去代偿 

分 类 号：R783.5[医药卫生—口腔医学]