自攻型微螺钉矫治高角型双颌前突临床研究  

The clinical study on self-drilling microscrews for the treatment of high-angle bimaxillary protrusion

作　　者：谢雪梅 郑庆忠 XIE Xue-mei;ZHENG Qing-zhong(Department of Dentistry,Fengcheng Hospital,Fengxian District,Shanghai 201411,China)

机构地区：[1]上海市奉贤区奉城医院口腔科,上海201411

出　　处：《全科口腔医学电子杂志》2018年第28期40-43,共4页Electronic Journal of General Stomatology

摘　　要：目的探讨使用国产自攻型微螺钉种植支抗配合滑动直丝弓技术矫治高角型双颌前突临床应用研究。方法选择双颌前突患者40例,将患者随机分为A、B2组:A组为试验组20例,使用国产自攻型微螺钉种植体;B组为对照组20例,使用Nance弓-横腭杆-双磨牙带环联合支抗。均拔除4颗第一前磨牙后采用一步滑动法关闭拔牙间隙。评估矫正效果,测量以下各项指标:1、A-Sv(mm),2、B-Sv(mm),3、U6ASv(mm),4、L6A-Sv(mm),5、U6S-Sv(mm),6、L6S-Sv(mm),7、U1A-Sv(mm),8、L1ASv(mm),9、U1E-Sv(mm),10、L1E-Sv(mm),11、U6-PP(mm),12、MP-FH(°),13、Ls-E(mm),14、Li-E(mm),15、Cm-Sn-UL(°),16、上唇倾角(°),17、下唇倾角(°),18、颏唇沟角(°)。A、B两组的测量值进行统计学处理。结果微螺钉种植支抗稳定性高于Nance弓-横腭杆-双磨牙带环联合支抗,两组比较差异有统计学意义(P<0.05)。A组关闭间隙时间明显短于B组,差异有统计学意义(P<0.05)。治疗后A组U6A-Sv、U6S-Sv、L6A-Sv、L6S-Sv变化量明显低于B组,U1A-Sv、U1ESv、L1E-Sv、Ls-E变化量明显高于B组(均P<0.05);两组其他指标变化量无明显差异,均P>0.05,无统计学意义。结论两种支抗配合滑动直丝弓技术矫治高角型双颌前突,上下前牙均得到较大程度的内收,上下唇突度减小,软组织侧貌改善。但前者矫治时间较短,患者感觉较舒适。Objective To explore the clinical application of self-drilling microscrew implant anchorage and straightwireappliance in the treatment of high-angle bimaxillary protrusion.Methods Forty patients with bimaxillary protrusion were selected.The patients were randomly divided into A and Bgroups:Group A was a test group of 20 patients,and a home-made self-drilling microscrew implant was used.Group B was a control group of 20 patients and used a Nance-TPA-double molars band combined anchorage.After removing 4 first premolars,one-step sliding method was used to close the extraction gap.To evaluate the orthodontic effect,measure the following indicators:A-Sv(mm),B-Sv(mm),U6A-Sv(mm),L6A-Sv(mm),U6S-Sv(mm),L6S-Sv(mm),U1A-Sv(mm),L1A-Sv(mm),U1E-Sv(mm),L1E-Sv(mm),U6-PP(mm),MP-FH(°),Ls-E(mm),Li-E(mm),Cm-Sn-UL(°),upper lip inclination(°),lower lip inclination(°),chinand lip groove angle(°).Measurementsof two groupswere statistically processed.Results The stability of microscrew implant anchorage was higher than that of Nance-TPA-double molars band combined anchorage.There was significant difference between the two groups(P<0.05).The extraction gap closure time in group A was significantly shorter than that in group B,and the difference was statistically significant(P<0.05).After treatment,the changes of U6A-Sv,U6S-Sv,L6A-Sv,and L6S-Sv in group A were significantly lower than those in group B.The changes in U1A-Sv,U1E-Sv,L1E-Sv,and Ls-E were significantly higher than those in group B(All P<0.05);There was no significant difference in the other measurements between the two groups(P>0.05,no statistical significance).Conclusion Two kinds of anchorages are combined with sliding straightwireapplianceto treat high-angle bimaxillary protrusions.The upper and lower anterior teeth receive a greater degree of adduction.The upper and lower lip protrusion decreases,and the soft tissue profile improves.However,the former treatment time is shorter and the patient feels more comfortable.

关 键 词：种植体支抗 双颌前突 矫治 直丝弓 Nance弓-横腭杆-双磨牙带环联合支抗 

分 类 号：R783.5[医药卫生—口腔医学]