远移下颌磨牙矫治骨性Ⅲ类错（牙合）畸形的临床研究  

Distal movement of the mandibular dentition in the treatment of patients with Class Ⅲ skeletal pattern

作　　者：牟兰[1] 徐庚池[1] 韩耀辉[1] 葛振林[1] 

机构地区：[1]兰州大学口腔医学院正畸科,730030

出　　处：《中华口腔医学杂志》2015年第6期373-377,共5页Chinese Journal of Stomatology

摘　　要：目的 研究拔除下颌第三磨牙后用种植体支抗远移下颌磨牙,矫治恒牙期骨性Ⅲ类错（牙合）畸形的临床疗效.方法 选择15例恒牙期骨性Ⅲ类错（牙合）畸形患者,平均（24.0±5.8）岁.患者凹面型、前牙反（牙合）、第一磨牙近中关系,拔除下颌第三磨牙后,应用种植体支抗推下颌磨牙向远中移动,并结合MBT直丝弓矫治技术进行非手术掩饰性矫治.对矫治前后头颅侧位X线片进行头影测量分析.结果 矫治后所有患者第一磨牙、尖牙关系达到中性,前牙区反（牙合）解除,软组织侧貌得到改善;且与矫治前相比,矫治后ANB角增加1.65°±1.04°,Wits值增加（4.39±1.93） mm,上下齿槽座角（AB-NP角）增加3.20°±1.61°,Sn-Pg＇审美线距差增加（1.13±0.99） mm,矫治前后差异有统计学意义（P＜0.05）.结论 减数下颌第三磨牙,应用种植体支抗推下颌磨牙远移,结合直丝弓固定矫治技术矫治恒牙期骨性Ⅲ类错（牙合）畸形,可取得理想的咬合关系,并使软组织侧貌得到改善.Objective To evaluate the outcome of patients with skeletal Class Ⅲ malocclusion treated with extraction of mandibular third molars and distalization of molars using implant anchorage combined with MBT appliance.Methods Fifteen patients（mean age 24.0 ± 5.8） with skeletal Class Ⅲ malocclusion were selected.The mandibular third molars were extracted and the mandibular molars were moved distally using implant combined with MBT appliance.Cephalometric analysis was carried out before and after treatment.Results After active treatment,ANB,Wits distance,AB-NP and the distance between upper and lower lip position to SnPg＇ increased by 1.65°± 1.04°,（4.39± 1.93） mm,3.20°± 1.61° and （1.13±0.99） mm,respectively.The differences were statistically significant（P 〈 0.05）.Conclusions The skeletal Class Ⅲ patients in the permanent dentition could be treated successfully with extraction of mandibular third molars and distalization of mandibular molars using implant anchorage combined with MBT appliance.The soft-tissue profile was improved.

关 键 词：错(牙合) 安氏Ⅲ类 牙移动 正畸支抗 微螺钉种植体 Malocclusion Angle Class Ⅲ 

分 类 号：R783.5[医药卫生—口腔医学]