压低辅弓与摇椅弓压低下颌切牙矫治安氏Ⅱ类1分类深覆牙合的临床效果比较  

Comparison of Intrusion Effect on the Mandibular Incisors Between Intrusive Auxiliary Arch and Rocking Chair Arch for Angle’s ClassⅡDivision 1 Deep Overbite

作　　者：王闪[1,2] 张月兰 WANG Shan;ZHANG Yuelan(Department of Orthodontics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Orthodontics,Xuchang Central Hospital Affiliated to Henan University of Science and Technology,Xuchang 461000,China)

机构地区：[1]郑州大学第一附属医院口腔正畸科,河南郑州450052 [2]河南科技大学附属许昌市中心医院口腔正畸科,河南许昌461000

出　　处：《河南医学研究》2021年第19期3468-3472,共5页Henan Medical Research

基　　金：河南省卫健委重点项目(201502014);河南省科技厅科技攻关项目(162102310552)。

摘　　要：目的比较压低辅弓与摇椅弓压低下颌切牙矫治安氏Ⅱ类1分类深覆牙合的临床效果。方法选取2017年1月至2019年12月于河南科技大学附属许昌市中心医院口腔正畸科治疗的60例安氏Ⅱ类1分类深覆牙合患者,根据打开咬合的方法分为A组和B组,各30例。对A组应用压低辅弓压低下颌切牙,对B组应用摇椅弓压低下颌切牙。患者矫治前后均拍摄口腔锥体束计算机断层扫描(CBCT)和头颅侧位片。比较两组咬合打开时间,使用CBCT自带的Exocad影像分析软件测量两组矫治前后下颌切牙切点到下颌平面(MP)的垂直距离(L-MP)、下颌切牙牙体长轴与MP相交的后上夹角(L/MP)、下颌切牙长度、下颌第一磨牙近中颊尖到MP的垂直距离(L6-MP)、MP与眼耳平面(FH)的前下夹角(MP-FH)以及矫治前后变化量。结果A组从开始粘接托槽放置钢丝到咬合打开的时间与B组比较,差异无统计学意义(Z=1.320,P=0.188),A组从开始放置辅弓到咬合打开的时间短于B组从更换摇椅弓丝到咬合打开的时间(Z=4.510,P<0.001)。与矫治前相比,矫治后两组L-MP均减小,A组矫治前后差值大于B组(P<0.05)。矫治后B组L/MP较矫治前增大,A组矫治前后差值小于B组(P<0.05)。与矫治前相比,矫治后两组下颌切牙长度均缩短(P<0.05),两组矫治前后差值比较,差异无统计学意义(P>0.05)。矫治后A组L6-MP较矫治前增加,A组矫治前后差值大于B组(P<0.05)。矫治后A组MP-FH较矫治前增大,A组矫治前后差值大于B组(P<0.05)。结论在矫治安氏Ⅱ类1分类深覆牙合中,压低辅弓和摇椅弓均可有效压低下颌切牙,两者均出现不同程度的牙根吸收,但两者打开咬合的机制不同,且压低辅弓在对下颌切牙的压低效力和转矩控制方面优于摇椅弓。Objective To compare the intrusion effect on the mandibular incisors between intrusive auxiliary arch and rocking chair arch for Angle’s ClassⅡdivision 1 deep overbite.Methods A total of 60 patients with Angle’s ClassⅡdivision 1 deep overbite treated in the Department of Orthodontics in Xuchang Central Hospital Affiliated to Henan University of Science and Technology from January 2017 to December 2019 were divided into group A(30 cases)and group B(30 cases)according to the method of occlusal opening.Intrusive auxiliary arch was applied to group A,while rocking chair arch was applied to group B.The oral cone beam computed tomography(CBCT)and lateral cephalogram were taken before and after treatment.The occlusal opening time of the two groups was compared,and the Exocad image analysis software included in the CBCT was used to measure the vertical distance(L-MP)from the cutting point of mandibular incisor to mandibular plane(MP),upper back angle between the long axis of mandibular incisor and MP(L/MP),mandibular incisor length,vertical distance from the mesiobuccal tip of the mandibular first molar to MP(L6-MP),mandibular plane-frankfurt horizontal plane angle(MP-FH)and changes before and after treatment.Results There was no statistical difference in the time from the beginning of bonding bracket and placing steel wire to occlusal opening between group A and group B(Z=1.320,P=0.188).The time from placing auxiliary arch to occlusal opening in group A was shorter than that from replacing rocking chair arch to occlusal opening in group B(Z=4.510,P<0.001).The L-MP in the two groups decreased after treatment compared with those before treatment,and the L-MP difference before and after treatment in group A was greater than that in group B(P<0.05).After treatment,the L/MP in group B increased compared with that before treatment,and the L/MP difference before and after treatment in group A was smaller than that in group B(P<0.05).The mandibular incisor length in the two groups decreased after treatment compared with

关 键 词：安氏Ⅱ类1分类 深覆牙合 压低辅弓 摇椅弓 下颌切牙压低 

分 类 号：R783.5[医药卫生—口腔医学]