CICE-下颌前移器矫治安氏Ⅱ类错畸形最佳时机的探讨  

The investigation of the optimal treatment timing of CICE appliance for class Ⅱ malocclusion

作　　者：田雪[1] 韩俊[1] 丁丽芳[1] 郑文皓 袁小莉[1] 陈莉莉[1] TIAN Xue HAN Jun DING Lifang ZHENG Wenhao YUAN Xiaoli CHEN Lili.(Department of Stomatology, Union Hospital, Tongfi Medical College, Huazhong University of Science and Technology, Wuhan 430022, Chin)

机构地区：[1]华中科技大学同济医学院附属协和医院口腔医学中心,湖北武汉430022

出　　处：《口腔医学》2017年第3期227-232,共6页Stomatology

基　　金：国家自然科学基金青年基金资助项目(30801314);湖北省科技支撑计划项目(2015BAA031)

摘　　要：目的基于颈椎骨龄定量分期法,探讨应用CICE-下颌前移器治疗下颌骨发育不足的安氏Ⅱ类错畸形的最佳时机。方法随机选择2013年6月—2015年1月在武汉协和医院口腔医学中心正畸科就诊的上颌发育正常、下颌发育不足,表现为安氏Ⅱ类错畸形的患者。参照陈莉莉、林久祥等创建的颈椎骨龄定量分期法(QCVM),根据患者开始矫治时的骨龄阶段将患者分为3组:QCVMⅠ期(加速期)组、QCVMⅡ期(高峰期)组、QCVMⅢ期(减速期)组,每组20例共60例患者入选,男24例,女36例,平均年龄12.5岁。所有患者均为非拔牙矫治,固定矫治之前先采用由武汉协和医院口腔医学中心正畸科自行研制的CICE-下颌前移器进行功能矫治6个月,恢复上下颌骨正常的矢状关系后,再进行固定矫治。对治疗前后的头影测量X线片进行比较分析。结果颌骨矫形治疗6个月后,3组患者面型均有明显的改善,面部突度变小,侧貌变成直面型,颏唇肌紧张症状减轻,前牙建立基本正常的覆覆盖关系,磨牙达到或接近安氏Ⅰ类关系。治疗前后参数的变化值和牙、骨性变化比例共同提示我们下颌骨增长的速度与颈椎骨龄分期具有明显的相关性,QCVMⅡ期组>QCVMⅠ期组>QCVMⅢ期组。结论CICE-下颌前移器矫治下颌发育不足的安氏Ⅱ类错畸形,具有舒适、隐形、简洁、高效的效果,但是矫治时机的选择非常重要。Objective To investigate the optimal treatment timing of CICE appliance for the treatment of class Ⅱ malocclusion with mandibular growth deficiency according to Quantitative Cervical Vertebral Maturation （QCVM）. Methods 60 cases who were treated in the Department of Orthodontics, Oral and Medical Center, Wuhan Union Hospital, from June 2013 to January 2015 of Class Ⅱ mal- occlusion （an average age of 12.5 years old） with normal maxilla and retruded mandible were selected and the patients were divided in- to three groups Ⅰ （ acceleration phase） - Ⅱ （fastigium） - Ⅲ （ deceleration phase） according to QCVM. For each group, there were 20 pa- tients（24 male and 36 female in total） and mandibular protraction was achieved with CICE appliance for 6 months; then fixed ortho- dontic treatment was carried out when the mandible and maxillary returned to their normal sagittal relation. Cephalometric analysis was compared before and after treatment. Results After 6 months of CICE appliance therapy, harmany profile and remarkable advancement of the mandible were obtained in all of these cases. Class Ⅱ occlusions were changed to Class Ⅰ relationship. During QCVM Ⅱ , the skeletal parameters were changed more significantly than dental parameters before and after treatment. The order of the parameters vari- ation in different QCVM groups was QCVM Ⅱ 〉QCVM Ⅰ 〉QCVM Ⅲ. Conclusion CICE appliance for the treatment of class Ⅱ mal- occlusion is comfortable, invisible, concise, efficient, but the optimal treatment timing of mandibular protraction is also significant.

关 键 词：颈椎骨龄定量分期法 功能矫治器 安氏Ⅱ类错[牙合] 

分 类 号：R783.5[医药卫生—口腔医学]