亚历山大矫治技术两种拔牙模式矫治差异的研究  

The comparison of effects in different extraction patterns treated with Alexander discipline

作　　者：刘福良[1] 温馥嘉 魏松[1] 刘伟涛[1] 周彦恒[1] 

机构地区：[1]北京大学口腔医学院·口腔医院正畸科,北京100081

出　　处：《中华口腔正畸学杂志》2015年第3期127-131,共5页Chinese Journal of Orthodontics

摘　　要：目的 探讨亚历山大矫治技术下两种不同拔牙模式治疗后下颌牙列变化的差异.方法 选取采用亚历山大技术矫治完成的拔牙病例52例,分为拔除上下第一前磨牙组（A组）和拔除上颌第一前磨牙及下颌第二前磨牙组（B组）,测量矫治前后下颌数字模型的牙弓宽度、长度、Spee曲深度及前牙不齐指数,并通过头影测量获取下切牙唇倾度.采用配对及成组f检验分别对测量项目进行统计分析.结果 矫治后两组病例的尖牙间宽度稍增大,第一磨牙间宽度、牙弓长度、Spee曲深度、IRR均减小,差异有统计学意义（P＜0.05）.治疗后A组下前牙唇倾度显著减小（P＜0.05）,B组变化不显著（P＞0.05）.B组治疗前后第一磨牙间宽度、Spee曲深度减小量均比A组大,下前牙倾斜度减少量较A组小（P＜0.05）.两组尖牙间宽度、牙弓长度及IRR等变化量间无显著差异（P＞0.05）.结论 亚历山大矫治技术有利于维持原有牙弓宽度的大小.下颌减数第一前磨牙有利于维持磨牙间宽度及回收下前牙;减数下颌第二前磨牙则更有利于磨牙前移调整磨牙关系并维持下切牙唇倾度.Objective To investigate the differences of alterations of lower arch between two different extraction patterns treated with Alexander Discipline.Methods 52 extraction cases treated with Alexander Discipline were divided into group A （extraction of first premolars） and group B （extraction of upper first and lower second premolars）.Arch widths,lengths,curve of Spee and irregularity index （IRR） were measured in digital mandibular casts before and after treatment.IMPA was also measured in cephalograms.Paired t-test and group t-test were used for statistical analysis.Results The lower inter-canine width increased slightly,while lower inter-molar width,depth of curve of Spee and IRR decreased after treatment （P〈0.05）.After treatment,IMPA decreased in group A （P〈0.05）,but remained unchanged in group B （P〉0.05）.The decrease of inter-molar width and depth of curve of Spee were larger in group B,but IMPA was smaller than group A （P〈 0.05）.There were no significant differences of changes of lower inter-canine width and arch length as well as IRR between two groups after treatment （P〉0.05）.Conclusions Alexander Discipline is prevailing in maintaining the lower arch width.Extraction of the lower first premolars has advantages in maintaining lower inter-molar width as well as retracting lower incisors.Extraction of lower second premolars might be more appropriate in correcting the distal molar relationship and maintaining the angulation of lower incisors.

关 键 词：亚历山大矫治技术 拔牙矫治 数字化三维模型 头影测量 

分 类 号：R783.5[医药卫生—口腔医学]