骨性Ⅲ类错(牙合)畸形患者拔牙正畸与非拔牙正畸治疗选择分析  

Selection of Extraction Orthodontic Therapy and Non-extraction Orthodontic Therapy for Patients with Skeletal Class Ⅲ Malocclusion

作　　者：武利州 杨利华 WU Lizhou;YANG Lihua(The Fifth People’s Hospital of Longgang District,Shenzhen 518110,China)

机构地区：[1]广东省深圳市龙岗区第五人民医院,广东深圳518110

出　　处：《中国医学创新》2020年第31期33-38,共6页Medical Innovation of China

摘　　要：目的:分析骨性Ⅲ类错(牙合)畸形患者拔牙正畸与非拔牙正畸治疗的选择因素。方法:选取2015年3月-2017年4月于本院行正畸正颌联合治疗的骨性Ⅲ类错(牙合)畸形患者64例的临床资料进行回顾性分析。根据术前正畸是否进行拔牙分为拔牙组(拔牙正畸)与非拔牙组(非拔牙正畸),各32例。比较术前正畸前后两组头颅侧位片测量分析数据。结果:术前正畸前,拔牙组N-Me、ANS-Me、∠SN-MP、∠ANB、∠NAPg、∠L1-NB、∠SN-OP、Ns-Mes、Sn-Mes、∠Ns-Sn-Pgs均高于非拔牙组,而U1-NA低于非拔牙组(P<0.05)。术前正畸后,拔牙组N-Me、ANS-Me、∠SN-MP、∠ANB、∠NAPg、∠SN-OP、Ns-Mes、Sn-Mes、∠Ns-Sn-Pgs、LL-E均高于非拔牙组,而L1-NB、U1-NA与UL-E均低于非拔牙组(P<0.05)。术前正畸前后,拔牙组U1-NA差值低于非拔牙组,而L1-NB、∠L1-NB、LL-E差值均高于非拔牙组(P<0.05)。结论:骨性Ⅲ类错(牙合)畸形患者中,面下1/3长者多选择拔牙正畸治疗,而面中1/3后缩者多选择非拔牙正畸,两种正畸方式均能到达良好的矫正效果,有利于患者侧貌修复。Objective:To analyze the selection factors of extraction orthodontic therapy and non-extraction orthodontic therapy for patients with skeletal class Ⅲ malocclusion.Method:The clinical data of 64 patients with skeletal class Ⅲ malocclusion treated with combined orthodontic and orthognathic treatment in our hospital from March 2015 to April 2017 were retrospectively analyzed.They were divided into the extraction group (extraction orthodontic therapy) and the non-extraction group (non-extraction orthodontic therapy),with 32 cases in each group.The data of lateral cephalometric radiographs before and after orthodontic treatment were compared.Result:Before preoperative orthodontic,the N-Me,ANS-Me,∠SN-MP,∠ANB,∠NAPg,∠L1-NB,∠SN-OP,Ns-Mes,Sn-Mes and ∠Ns-Sn-Pgs in the extraction group were higher than those in the non-extraction group while the U1-NA was lower than that in non-extraction group (P<0.05).After preoperative orthodontic,the N-Me,ANS-Me,∠SN-MP,∠ANB,∠NAPg,∠SN-OP,Ns-Mes,Sn-Mes,∠Ns-Sn-Pgs and LL-E in the extraction group were higher than those in the non-extraction group,while the L1-NB,U1-NA and UL-E were lower than those in non-extraction group (P<0.05).Before and after preoperative orthodontic,the difference of U1-NA in the extraction group was lower than that in the non-extraction group,while the differences of L1-NB,∠L1-NB and LL-E were higher than those in the non-extraction group (P<0.05).Conclusion:Among patients with skeletal class Ⅲ malocclusion,patients with 1/3 of below face long will mostly choose extraction orthodontic therapy,and patients with 1/3 of middle face retrusion will mostly choose non-extraction orthodontic therapy.Both orthodontic methods can achieve good correction effects,and are beneficial for lateral appearance of patients.

关 键 词：骨性Ⅲ类错(牙合) 术前正畸 正颌手术 

分 类 号：R783.5[医药卫生—口腔医学]