Twin-block和Ⅱ类牵引矫治青少年安氏Ⅱ类1分类错（牙合）下颌后缩患者颞下颌关节的变化  

Comparison of temporomandibular joint changes in adolescent Class Ⅱ devision 1 malocclusion patients with mandibular retrusion treated with Twin-block and Class Ⅱ elastics

作　　者：麦理想[1] 姚宇[1] 张晟[2] 王大为[1] 张志光[1] 

机构地区：[1]中山大学光华口腔医学院·附属口腔医院正畸科·广东省口腔医学重点实验室,广州510055 [2]广东省口腔医院·南方医科大学附属口腔医院正畸科

出　　处：《中华口腔医学杂志》2014年第7期394-398,共5页Chinese Journal of Stomatology

基　　金：基金项目：广东省自然科学基金（$2013040013793）;广东省医学科研基金（A2012207）

摘　　要：目的 比较Twin-block和Ⅱ类牵引对青少年安氏Ⅱ类1分类错（牙合）下颌后缩患者髁突形态的影响,探讨二者颞下颌关节改建机制的异同,为此类患者的治疗提供依据.方法 选取60例替牙列晚期至恒牙列早期的安氏Ⅱ类1分类错（牙合）下颌后缩患者,利用计算机产生的随机数字随机分为Twin-block组、Ⅱ类牵引组与对照治疗组（采用固定矫治且过程中不采用Ⅱ类牵引或固定功能矫治措施）,每组各20例.治疗前后所有患者均拍摄锥形束CT,比较各组髁突形态及关节间隙的治疗前后差异及组间差异.结果 治疗后3组髁突短轴与髁突上部高度的总体差异有统计学意义（P＜0.05）,Twin-block组[（8.51±1.48）和（7.39±1.42） mm]和Ⅱ类牵引组[（8.44±1.03）和（7.24±0.89）mm]均显著大于对照治疗组[（7.47±1.27）和（6.47±1.56） mm]（P＜0.05）,而Twin-block组与Ⅱ类牵引组的组间差异均无统计学意义（P＞0.05）.治疗后Twin-block组和Ⅱ类牵引组髁突短轴、髁突上部高度显著大于治疗前（P＜0.05）.其余各组关于髁突、关节窝形态的测量项目治疗前后差异均无统计学意义（P＞0.05）.各组治疗前后关节间隙差异均无统计学意义（P＞0.05）,治疗前后关节间隙指数组间差异均无统计学意义（P＞0.05）.结论 Twin-block和Ⅱ类牵引均可使安氏Ⅱ类1分类错（牙合）下颌后缩的青少年患者髁突短轴和髁突上部高度增加,但二者对颞下颌关节的改建效果类似,治疗前后髁突与关节的位置关系并无显著变化.Objective To compare the temporomandibular joint changes in adolescent Class Ⅱ division 1 malocclusion patients with mandibular retrusion treated with Twin-block and Class Ⅱ elastics.Methods Sixty Class Ⅱ division 1 malocclusion patients with mandibular retrusion were divided into 3 groups （Twin-block group,Class Ⅱ elastic group and control group,20 patients in each group） randomly.Differences of condylar process morphology were compared using cone-beam CT（CBCT） before and after treatment.Results Condylar largest anteroposterior diameter and upper condylar height increased after treatment in both Twin-block groupand Class Ⅱ elastic group.The condylar largest anteroposterior diameter and upper condylar height were longer in both Twin-block group [（8.51 ± 1.48） and （7.39 ± 1.42） mm] and Class Ⅱ elastic group [（8.44± 1.03） and （7.24±0.89） mm] than those in the control group[（7.47± 1.27） and （6.47 ± 1.56） mm] （P〈0.05）.No significant difference was found in other measurements （P〉0.05）.Conclusions Condylar largest anteroposterior diameter and upper condylar height in Class Ⅱ division 1 malocclusion patients increased after treatment using Twin-block and Class Ⅱ elastics.There was no significant difference between two groups.

关 键 词：错(牙合) 安氏Ⅱ类 颞下颌关节 锥束计算机体层摄影术 正畸学 矫正 

分 类 号：R783.5[医药卫生—口腔医学]