成人开[牙合]患者伴颞下颌关节紊乱正畸治疗后长期稳定性研究  

Study on long-term stability after orthodontic treatment in adult patients with apertognathia and temporomandibular joint disorder

作　　者：张栋 程洁[1] 李娟[1] ZHANG Dong;CHENG Jie;LI Juan(Hebei General Hospital, Shijiazhuang 050051,Hebei,China)

机构地区：[1]河北省人民医院,河北石家庄050051

出　　处：《现代中西医结合杂志》2020年第35期3916-3919,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省医学科学研究重点课题计划项目(20190356)。

摘　　要：目的研究伴颞下颌关节紊乱病的成人开[牙合]患者在正畸结束后面型、咬合及颞下颌关节的长期稳定性。方法收集2014年1月-2016年6月在河北省人民医院正畸治疗结束3年以上且资料齐全的11例成人开[牙合]患者资料,均用种植支抗辅助压低上后牙、上颌扩弓进行唇侧固定矫治。记录正畸治疗前、正畸治疗结束及末次随访时的X射线头影测量指标数据、覆[牙合]、覆盖及颞下颌关节弹响、疼痛情况和最大开口时上下切牙间的距离(开口度)。结果正畸治疗结束,关节角平均减少3.0°,下颌角平均减少2.8°,下颌上角平均减少2°,下颌下角平均增加0.7°,前颅底长平均增加0.7 mm,前面高平均减小3.2 mm,前面高和后面高比减小0.03,与治疗前比较差异均有统计学意义(P均<0.05);末次随访时各测量指标与正畸治疗结束比较差异均无统计学意义(P均>0.05)。正畸治疗结束时,覆盖平均减少了2.76 mm,与治疗前比较差异有统计学意义(P<0.05);覆[牙合]平均增加了1.66 mm,与治疗前比较差异无统计学意义(P>0.05);末次随访时,覆盖和覆[牙合]与治疗结束时比较差异均无统计学意义(P均>0.05)。治疗结束、末次随访时颞下颌关节症状无加重,开口度与治疗前比较差异均无统计学意义(P均>0.05)。结论成人开[牙合]伴颞下颌关节紊乱患者正畸治疗后能获得面型的改善及稳定的咬合关系,且对颞下颌关节没有长期不良影响。Objective It is to study the face shape,occlusion and long-term stability of the temporomandibular joint in adults with apertognathia and temporomandibular joint disorders.Methods The data of 11 adult patients who had completed orthodontic treatment for more than 3 years at Hebei General Hospital from January 2014 to June 2016 with complete data were collected.All the patients were treated with anchorage implant to assist in lowering upper posterior teeth and maxillary expansion for labial fixed correction.The X-ray cephalometric index data,overbite,coverage and the temporomandibular joint snapping,pain,and the distance between the upper and lower incisors at the maximum opening(opening degree)were recorded before the orthodontic treatment,at the end of the orthodontic treatment and the last follow-up.Results After orthodontic treatment,the joint angle was reduced by an average of 3.0°,the mandibular angle was reduced by an average of 2.8°,the upper mandibular angle was decreased by an average of 2°,the submandibular angle was increased by an average of 0.7°,the anterior skull base length was increased by 0.7 mm,and the front height was decreased by 3.2 mm,the ratio of front height and back height was decreased by 0.03,and the difference was statistically significant compared with that before treatment(all P<0.05);there was no statistically significant difference in the measurement indexes between the last follow-up and the end of orthodontic treatment(all P>0.05).At the end of orthodontic treatment,the coverage was reduced by an average of 2.76 mm,which was statistically significant compared with before treatment(P<0.05);the overbite was increased by an average of 1.66 mm,which was not statistically significant compared with before treatment(P>0.05).At the last follow-up,there was no statistically significant difference in coverage and overbite compared with the end of treatment(all P>0.05).At the end of treatment and at the last follow-up,no aggravation of the symptoms of temporomandibular joint was found,a

关 键 词：颞下颌关节 开[牙合] 成人 长期稳定性 正畸治疗 

分 类 号：R782.6[医药卫生—口腔医学]