上颌前牵引中两种口内固位装置的临床对比研究  

Comparison of two types of intra-oral fixation devices in maxillary protraction

作　　者：谢永建[1] 麦理想[1] 卢新华[1] 

机构地区：[1]中山大学光华口腔医学院·附属口腔医院,广东省口腔医学重点实验室,广州510055

出　　处：《中华口腔医学研究杂志（电子版）》2015年第5期48-52,共5页Chinese Journal of Stomatological Research(Electronic Edition)

基　　金：广东省自然科学基金(S2013040013793);广东省医学科学技术研究基金(A2012207)

摘　　要：目的探讨快速扩弓与包绕牙合垫式口内固位装置结合上颌前牵引矫治的效果差异,为临床治疗提供理论依据和参考。方法选择23例骨性Ⅲ类上颌后缩患者,分为快速扩弓结合上颌前牵引组(13例)和包绕牙合垫结合上颌前牵引(10例)。对两组患者治疗前及前牵引后的头颅定位侧位片进行头影测量分析,并进行配对t检验;对两组患者治疗前、前牵引后的差值变化进行组间独立样本t检验。结果两组患者矫治后均出现SNA增大、ANB减小、下颌骨长度增加、Y-axis、MP/FH、MP/SN、PP/MP、U1-SN增大、前下面高、前面高、后面高增加。这些指标的变化差异有统计学意义。快速扩弓组患者前颅底长、上颌骨长度(Ptm-A)明显增加,下切牙明显舌倾。包绕牙合垫组患者后颅底长明显增加,面角明显减小,前面高明显增加。两组间对比:S-Ba、NPg-FH变化两组差异有统计学意义(P<0.05),其余测量值变化差异无统计学意义(P>0.05)。结论使用快速扩弓与包绕牙合垫加上颌前牵引矫治骨性Ⅲ类上颌后缩患者在临床上是确实可行的,可取得满意的疗效。Objective To investigate the difference of the treatment effect of the maxillary protraction therapy with rapid palatal expansion appliance or with wrapped bite？plate removable appliance as intra？oral fixation devices. Methods Twenty？three skeletal ClassⅢmaxillary retrusion patients were selected and treated with maxillary protraction,the intra？oral devices were rapid palatal expansion appliance in 13 patients and wrapped bite？plate removable appliance in 10 patients. Paired t？test was used to compare the lateral cephalometric radiographs before and after treatment;the difference before and after treatment of two groups was compared with t-test of independent samples in group. Results SNA,Co-Po, Y-axis,MP/FH,MP/SN,PP/MP,U1/SN,ANA？Me,N？Me,S？Go increased,ANB decreased significantly in both groups. In rapid palatal expansion group,S？N,Ptm-A increased significantly,the lower incisors tipped lingual significantly. In wrapped bite？plate group,S？Ba,N-Me increased,facial angle decreased significantly（P〈0.05）. The difference before and after maxillary protraction of two groups had no significant except S-Ba and NPg-FH（P〉0.05）. Conclusion Maxillary protraction combined with rapid palatal expansion or with wrapped bite？plate removable appliance was effective in the treatment of ClassⅢpatients with maxillary deficiency,the treatment effects had no significant difference in two groups.

关 键 词：快速扩弓 前方牵引 上颌后缩 

分 类 号：R783.5[医药卫生—口腔医学]