腭部微螺钉种植支抗在安氏Ⅱ类错牙合矫治中的应用  

Clinical Application of Microscrew Palatal Implant Anchorage in the Treatment of Angle Class Ⅱ Malocclusion

作　　者：李梅霞[1] 申秀梅[1] 王文玲[1] LI Mei-xia;SHEN Xiu-mei;WANG Wen-ling(Department of Stomatology,The Eye Hospital of Handan,The Third Hospital of Handan,Handan 056001,Hebei,China)

机构地区：[1]邯郸市眼科医院(邯郸市第三医院)口腔科,河北邯郸056001

出　　处：《中国美容医学》2017年第9期87-89,共3页Chinese Journal of Aesthetic Medicine

基　　金：邯郸市科技局计划项目(编号:1423108065-9)

摘　　要：目的:评价腭部微螺钉种植支抗+改良腭弓在安氏Ⅱ类错牙合畸形矫治中推上颌磨牙远移的临床效果。方法:30例安氏Ⅱ类错牙合患者,采用在上颌双侧第二前磨牙和第一磨牙间腭侧植入微螺钉种植支抗,配合改良腭弓推上颌磨牙远移,上下颌直丝弓固定矫治,改善磨牙关系,解除前牙拥挤和前突,矫治前后拍摄口腔全景片和头颅侧位片、取研究模型,进行头影测量和模型分析,并做统计学分析。矫治结束后对患者进行问卷调查,通过综合分析评价矫治效果。结果:30例患者均顺利完成矫治,推磨牙远移时间平均为4~6个月,磨牙远移量平均为(4.23±1.08)mm/侧,LU6-b(°)倾斜度平均为(0.13±1.16)°,RU6-b(°)倾斜度平均为(0.18±0.79)°,矫治时间平均为20个月,矫治后面型良好,咬合关系正常,头影测量分析UI-NA角度平均减少(10±2.04)°,UI-NA距离平均减少(3±0.78)mm,UI-SN角度平均减少(9.5±3.01)°,患者满意度100%。经t检验:SNA(°)、SNB(°)、ANB(°)、MP-SN、UL6-b(°)、UR6-b(°)治疗前后值无明显差异(P>0.05),UI-NA(°)、UI-NA、UI-SN(°)、U6-a治疗前后值差异明显(P<0.05)。结论:微螺钉种植支抗+改良腭弓推上颌磨牙远移是一种有效的矫治方法,不完全依赖于患者的依从性,磨牙整体远移,减少正常牙列中牙齿的拔除,患者满意度高,值得临床推广应用。Objective To evaluate the clinical application effect of microscrew palatal implant anchorage and modified transpalatal arch moved upper molar distally in the treatment of Angle ClassⅡmalocclusion.Methods A total of thirty patients received the cure that the palatal were implanted the microscrew implant anchorage in the maxillary bilateral between the second premolar and the first permanent molar,and the upper molar was moved distally by the modified palatal arch.The upper and lower jaws were used the straight wire appliance to improve molar relationship and solve the problem of crowding and protrusion of anterior teeth.The oral panorama,cephalometrical film,study model,and the questionnaire survey were measured to analyze the change before and after orthodontic treatment,and processed the statistical analysis based on that.Results All the thirty patients were completed the treatment successfully.The average move upper molar distally time was4-6months.The average amount of distal molar movement was(4.23±1.08)mm,and<LU6-b the average amount of molar inclination was(0.13±1.16)o,RU6-b(°)the average amount of molar inclination was(0.18±0.79)o.The patient showed goodfacial profile and dental relationships after20months of mean treatment time.The mean reduction of UI-NAangle by(10±2.04)°,UI-SN angle by(9.5±3.01)°,UI-NA by(3±0.78)mm.The satisfaction of patients was100%.After the ttext:SNA(°),SNB(°),ANB(°),MP-SN,UL6-b(°),UR6-b(°),there was no significant difference before and after(P>0.05),UI-NA(°),UI-SN(°),U6-a,there was obvious difference before and after(P<0.05).Conclusion The microscrew palatal implant anchorage and modified transpalatal arch moved upper molar distally can provide efficient anchor,without depending on patient cooperation.The whole molar distalization reduced the tooth extraction in the normal and gained the high degree of satisfaction.It is worthy of clinical applicantion.

关 键 词：微螺钉种植支抗 改良腭弓 安氏Ⅱ类错牙合 推上颌磨牙远移 

分 类 号：R783.5[医药卫生—口腔医学]