减数下颌2个前磨牙矫治成人骨性反牙合的临床研究  

2 Lower premolar extraction in correction of adult skeletal cross-bite malocclusion

作　　者：宁芳[1] 段银钟 袁东辉[1] 

机构地区：[1]白求恩国际和平医院口腔科,石家庄050082 [2]第四军医大学口腔医院正畸科,西安710032

出　　处：《口腔医学》2013年第9期597-600,共4页Stomatology

基　　金：国家科技攻关计划基金(2004BA720A25)

摘　　要：目的评价采用减数下颌2个前磨牙矫治成人骨性反牙合病例的临床效果。方法选择18～30岁骨性反牙合临界病例18例,拔除下颌2个第一或第二前磨牙,分析治疗前后X线头颅侧位片各项指标的变化。结果所有病例在矫治结束后磨牙均变为完全Ⅲ类关系,尖牙为Ⅰ类关系,覆牙合覆盖正常。患者硬组织改变没有显著性(P≥0.05)。L1-MP角平均减小8.1°,U1-L1角平均增大7.7°,L1-NB角平均减小7.3°,L1-NB距平均减小4.8 mm,差异均有显著性(P<0.01)。软组织侧貌改善明显,Li-E距、Li-H距、Li-RL2距平均减小量分别为3.2、3.4和4.1 mm,差异均有显著性(P<0.01)。结论采用减数下颌2个前磨牙矫治成人骨性反牙合病例在临床上是一种较好的矫治方法,矫治后咬合关系良好,侧貌有向直面型发展的趋势。Objective To evaluate the clinical effect of the orthodontic treatment after extracting two mandibular premolars in adult skeletal cross-bite subjects. Methods Eighteen borderline adult skeletal cross-bite cases from 18 years old to 30 years old were stud- ied. In these cases, first or second mandibular premolars were extracted. Lateral cephalometric radiographs were taken before and after treatment for analysis of all indicators. Results At the end of the treatment, normal overjet and overbite were established in class Ill molar relationship and class I canine relationship. There appeared to be no significant hard tissue changes（P≥0.05）. L1-MP angles decreased by 8.1 °on average, U1-L1 angles increased by 7.7°on average, L1-NB angles decreased by 7.3°on average, L1-NB dis- tances decreased by 4.8 mm on average. Statistically significant differences were found in these changes（ P 〈 0. 01 ）. The soft-tissue profile improved significantly. Li-E distances, Li-H distances and Li-RL2 distances decreased by 3.2 mm,3.4 mm and 4.1 mm on av- erage respectively. Statistically significant differences were found in these changes（P 〈 0.01 ）. Conclusions Success in the treatment of adult skeletal cross-bite can be achieved clinically by extraction of 2 lower premolars. All the patients get good occlusion and straight profile tendency.

关 键 词：成人骨性反[牙合] 掩饰性拔牙矫治 软组织侧貌 

分 类 号：R783.5[医药卫生—口腔医学]