骨性Ⅲ类错牙合患者应用微种植支抗的临床研究  

Clinical study of the effects of microimplant anchorage in patients with skeletal class Ⅲ malocclusion

作　　者：王臻[1,2] 戴静桃[1,2,3] 李平[1,2,3] 李安[3] 罗尚叠[1,2,3] 黄晓文[1,2,3] 

机构地区：[1]暨南大学医学院附属惠州口腔医院 [2]惠州市口腔医院正畸科,广东惠州516000 [3]暨南大学医学院

出　　处：《中国美容医学》2014年第13期1092-1098,共7页Chinese Journal of Aesthetic Medicine

基　　金：惠州市科技计划项目资助(2012Y112)

摘　　要：目的:比较应用微种植支抗与多曲方丝弓矫治骨性Ⅲ类错牙合患者软硬组织的变化,研究不同方法掩饰性治疗骨性Ⅲ类错牙合的临床矫治效果。方法:骨性III类错牙合患者16例,8例应用微种植支抗牵引下牙列整体远中移动;8例多曲方丝弓代偿性治疗反牙合,运用Winceph8.0软件对矫治前、后软硬组织垂直向、矢状向的变化进行测量,应用SPSS13.0软件对矫治前、后各测量项目进行两样本配对t检验。结果:16例患者均获得较理想的治疗效果,达到正常覆牙合、覆盖和尖窝关系。矫治前后两组的∠L1-MP、∠L6-MP、L1c-Y轴及L6c-Y轴均明显减小,差异具有统计学意义(P<0.05);两组的UL-EL距离均增大,变化差异均无统计学意义(P>0.05);两组的LL-EL、L1r-Y轴、L6r-Y轴距离均减小,其中微种植支抗组变化差异具有统计学意义(P<0.05),多曲方丝弓组变化差异无统计学意义(P>0.05);微种植支抗组L6-MP距离减小,常规支抗组L6-MP距离增大,两组的变化差异均无统计学意义。结论:种植支抗可使下颌磨牙达到远中整体移动,切牙主要为倾斜移动,较好控制后牙垂直高度;多曲方丝弓通过远中竖直下颌磨牙获得间隙,牙齿以倾斜移动为主,较难控制后牙垂直高度;两种矫治方法均能达到改善软组织侧貌的治疗目的,但微种植支抗容貌改善效果更好;临床应用中应根据具体情况选择好适应证。Objective Comparing the changes of soft and hard tissue in skeletal class Ⅲ malocclusion with microimplant anchorage and without microimplant,to investigate the clinical effects of two compensatory Class Ⅲ treatment modalities. Methods Sixteen cases with skeletal class Ⅲ were divided into two groups.Group A was treated by distalization of the lower full dentition using microimplant anchorage, while group B was treated with MEAW （multiloop edgewise archwire）. Pretreatment and posttreatment lateral cephalograms were taken,the soft and hard tissue measurements in the vertical and anteroposterior dimensions were analyzed using cephalometric analysis and the data was statistically analyzed using student t test by SPSS13.0. Results The angle of L1-MP,L6-MP and the length of L1c-Y,L6c-Y Z in both groups were decreased with statistical significance.The length of upper lip to E line in both groups was increased with no statistical significance. The length of lower lip to E line,L1r-Y,L6r-Y were decreased with statistical significance in group A,while with no statistical significance in group B.The length of L6-MP was decreased in group A, but was increased in group B. Conclusion In group A,the lower molars can be simultaneously distalized and the incisors move lingually, more easily to control the vertical height of mandible.The lower of aroup B aet clearance bv upriaht and distal movement of the lower posterior teeth,and the teeth move lingually,to control the vertical height of mandible with difficulty.Both methods could achieve the goal of improving the profiles,but microimplant anchorage could achieve more significantly change.

关 键 词：骨性Ⅲ类错(牙合) 微种植支抗 多曲方丝弓 软硬组织 

分 类 号：R783.5[医药卫生—口腔医学]