种植体支抗整体远中移动下颌牙列治疗骨性Ⅲ类错的疗效评价  

Evaluation of the correction of the skeletal class Ⅲ malocclusion by distalization of the whole mandible dentition with micro-implant anchorage

作　　者：范少轻[1] 周彦恒[2] 

机构地区：[1]北京大学口腔医学院·口腔医院,第一门诊部,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,北京100034 [2]北京大学口腔医学院·口腔医院,正畸科口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,北京100081

出　　处：《北京大学学报（医学版）》2017年第3期531-539,共9页Journal of Peking University:Health Sciences

摘　　要：目的:研究使用种植体支抗整体远中移动下颌牙列治疗骨性Ⅲ类错畸形的疗效。方法:选择轻到中度骨性Ⅲ类错患者20例,男性8例,女性12例,年龄16~38岁,平均(21.5±5.6)岁。采用直丝弓矫治技术,使用下颌外斜线区种植体支抗整体远中移动下颌牙列。患者在治疗前后拍摄X线头颅定位侧位片,对共计26个软硬组织测量项目进行测量分析。结果:矫治结束后患者磨牙关系均达到中性关系,侧貌改善。治疗后ANB角增大(0.80±1.02)°,P<0.05,Wits值增大(1.67±1.74)mm,P<0.05;L1-NB距离减小(2.64±1.50)mm,P<0.05;下颌第一磨牙近中颊尖远中移动(3.26±1.95)mm,P<0.05;下颌第一磨牙近中根尖远中移动(0.79±1.27)mm,P<0.05;下颌第二磨牙近中颊尖远中移动(3.06±1.80)mm,P<0.05。下颌牙齿与下颌平面的夹角:L1/MP角度减小(6.37±8.53)°,L5/MP角度减小(10.59±8.50)°,L6/MP角度减小(11.48±7.22)°,L7/MP角度减小(15.72±7.16)°,差异均有统计学意义(P<0.05);下唇和审美平面距离减小(1.70±1.59)mm,P<0.05。结论:种植体支抗整体远中移动下颌牙列能够有效治疗恒牙期骨性Ⅲ类错,侧貌改善良好;下颌牙齿发生有控制的倾斜移动。Objective: To evaluate the clinical effect of distalizing mandibular dentition with microimplant in patients with skeletal classⅢmalocclusion. Methods: In the study,20 patients with skeletal class Ⅲmalocclusion were selected. They are consist of 8 males and 12 female with an age range from 16 to 38 years old and an average age of( 21. 5 ± 5. 6) years. They were treated with straight wire technique and the implant were inserted into the mandibular external oblique line to distlize the lower dentition to a class Ⅰmolar relationships. Cephalometrics films were taken before and after treatment. The changes of hard tissue and soft tissue were analyzed by evaluating 26 measurement measurements. Results: ClassⅠmolar relationships were achieved,and the profile were improved after treatment. ANB increased by( 0. 80 ± 1. 02) °,Wits increased by( 1. 67 ± 1. 74) mm,after treatment( P < 0. 05). The lower dentition were significantly retracted after treatment with L1-NB distance decreased by( 2. 64 ± 1. 50) mm,P <0. 05; the mesial buccal cusp and mesial root of the lower first molars were retracted by( 3. 26 ± 1. 95)mm and( 0. 79 ± 1. 27) mm respectively( P < 0. 05); the mesial buccal cusp of the lower second molars were retracted by( 3. 06 ± 1. 80) mm( P < 0. 05). After treatment,mandibular teeth got up-righted distally. From incisors to molar,L1/MP,L5/MP,L6/MP,L7/MP angle decreased by( 6. 37 ± 8. 53) °,( 10. 59 ± 8. 50) °,( 11. 48 ± 7. 22) °,( 15. 72 ± 7. 16) °on average respectively( P < 0. 05),all of those changes had the statically significant effects. Soft tissue change after treatment,the distance from lower lip to esthetic plane were decreased by( 1. 70 ± 1. 59) mm on average( P < 0. 05). Conclusion:Distalizing mandibular dentition with micro-implant can get an satisfying result in patients with skeletal class Ⅲmalocclusion,the lower teeth were retracted by controlled tipping movement.

关 键 词：错[牙合] 骨性Ⅲ类 种植体支抗 头影测量 

分 类 号：R783.5[医药卫生—口腔医学]