活动平面导板矫治对成人安氏Ⅱ类深覆患者髁突位置的影响  

Changes of condylar position in joint fossa of Angle classⅡdeep overbite malocclusion adult patients treated by removable bite plate

作　　者：张曦颖[1] 刘娜[1] 王照五[1] 王宇琛[1] 徐璐璐[1] ZHANG Xiying LIU Na WANG Zhaowu WANG Yuchen XU Lulu(Department of Stomatology, Chinese PLA General Hospital, Beijing 100853, China)

机构地区：[1]解放军总医院口腔正畸科,北京100853

出　　处：《解放军医学院学报》2017年第9期831-833,838,共4页Academic Journal of Chinese PLA Medical School

基　　金：科技部国际科技合作项目(2015-TSYS-2028);解放军总医院临床科研扶持基金(2013FC-TSYS-2007)~~

摘　　要：目的比较平面导板打开咬合对成人安氏Ⅱ类深覆患者髁突在关节窝中位置的影响。方法选择有正畸治疗需求的18~32岁安氏Ⅱ类错患者30例。矫治前行锥形束CT(cone beam CT,CBCT)扫描,对原始影像进行3D重建,利用QR-NNT软件测量重建后3D影像的关节前、上、后间隙,运用Pullinger分析法计算髁突在关节窝中的位置。矫治过程中,利用上颌活动式平面导板打开安氏Ⅱ类深覆患者前牙咬合,待前牙咬合打开、后牙建立稳定咬合接触后再次行CBCT,对矫治前后测量值进行统计学分析。结果平面导板打开咬合后,安氏Ⅱ类错患者关节前间隙减小[(2.16±0.13)mm vs(2.03±0.19)mm,P<0.000 1],关节上间隙增大[(2.81±0.32)mm vs(3.30±0.33)mm,P<0.000 1],后间隙增大[(2.68±0.41)mm vs(2.97±0.42)mm,P=0.000 3]。结论正畸治疗上颌活动式平面导板打开安氏Ⅱ类患者前牙咬合后,安氏Ⅱ类患者髁突在关节窝内有前移的趋势。Objective To compare the changes of condylar position in joint fossa of Angle classⅡdeep overbite malocclusion adult patients treated by removable bite plate. Methods Thirty adult patients aged 18-32 years with Angle classⅡmalocclusion treated in our hospital were included in this study. CBCT examination was performed, and three-dimensional（3D） images were reconstructed, QR-NNT programs were used to measure anterior, superior and posterior joint spaces. Then the position of condyle in the glenoid fossa was calculated by Pullinger analysis methods. Removal maxillary bite plate was used to raise the anterior teeth bite of the Angle classⅡmalocclusion patients. After raising the anterior teeth bite and establishing posterior teeth stable occlusion, all patients were scanned by CBCT again. Data, including joint space and condylar position before and after treatment, were compared by statistical software. Results After raising the anterior teeth bite, the anterior joint space decreased [（2.16±0.13） mm vs（2.03±0.19） mm, P〈0.000 1）], the superior joint space [（2.81±0.32） mm vs（3.30±0.33） mm, P〈0.000 1）] and posterior joint space [（2.68±0.41） mm vs（2.97±0.42） mm, P=0.000 3）] increased significantly. Conclusion After raising the anterior teeth bite of the Angle classⅡmalocclusion by removale bite plane, the condylar position in the fossa has the trend of moving forward.

关 键 词：髁突位置 锥形束CT 安氏Ⅱ类错[牙合] 上颌活动式平面导板 

分 类 号：R783.5[医药卫生—口腔医学]