腭中部与颊侧种植支抗系统对成人双颌前突患者的临床效果对比评价  

Midpalatal dual-miniscrews and buccal interradicular miniscrews for anteroposterior and vertical anchorage control of bimaxillary protrusion:Cephalometric comparisons of treatment changes

作　　者：卫瑶 卢钰[1] WEI Yao;LU Yu(Department of Orthodontics,Foshan Stomatological Hospital,Guangdong Foshan 528000,China)

机构地区：[1]佛山科学技术学院附属口腔医院·佛山市口腔医院,广东佛山528000

出　　处：《临床口腔医学杂志》2021年第11期676-679,共4页Journal of Clinical Stomatology

摘　　要：目的:对比研究腭中部种植钉与颊侧牙根间种植钉矫治双颌前突患者的矢状向与垂直向的支抗控制疗效。方法:分析2017年6月~2020年6月佛山市口腔医院正畸科完成正畸治疗的53例成人双颌前突患者资料,根据上颌磨牙支抗加强方法分成两组,其中24例应用2枚腭中部种植钉结合改良腭弓内收前牙(腭侧支抗组),29例应用2枚颊侧牙根间种植钉内收前牙(颊侧支抗组)。两组患者均拔除上下颌第一前磨牙。比较两组治疗前后头颅侧位片的测量数据差值,明确两种不同部位的种植钉在矢状向与垂直向上所产生的骨性与牙性变化。结果:腭侧支抗组与颊侧支抗组的上颌前牙分别平均内收6.36 mm与6.71 mm,上颌第一磨牙分别近中移动1.28 mm与0.96 mm,两组矢状向支抗控制无显著差异(P>0.05)。腭侧支抗组上颌前牙与上颌第一磨牙分别被压低1.83 mm和1.30 mm,颊侧支抗组上颌前牙与上颌第一磨牙分别伸长0.87 mm和0.62 mm,腭侧支抗组的垂直向支抗控制优于颊侧支抗组,差异有统计学意义(P<0.001)。结论:两枚腭中部种植钉结合改良腭弓的支抗系统稳定性好,可作为一种正畸强支抗方法应用于双颌前突患者的矫治。Objective:To observe the cepholemetric restults of midpalatal dual-miniscrew anchorage system and buccal interradicular miniscrew anchorage in the treatment of bimaxillary protrusion and evaluate which anchorage system is better suited for both anteroposterior and vertical anchorage control of maxillary posterior teeth.Methods:Fifty-three subjects requiring maximum anchorage were divided into 2 groups according to maxillary posterior anchorage reinforcement, modified transpalatal arch supported by two midpalatal miniscrews(palatal group, n=24),two buccal interradicular miniscrews(buccal group, n=29).Bilateral maxillary first premolars were extracted in all patients.Pretreatment and posttreatment lateral cephalometric radiographs were analysed to compare skeletal and dental changes between the groups.Results:The mesial movement of the maxillary first molars in palatal group and buccal group was 1.28 and 0.96 mm respectively, maxillary incisor retraction was 6.36 and 6.71 mm respectively, which suggest that there were no significant anteroposterior anchorage control differences between the two anchorage groups.The maxillary molars were significantly intruded in the palatal group(1.30 mm),whereas they were extruded in the buccal group(0.62 mm).The maxillary incisors were significantly intruded in the palatal group(1.83 mm), whereas they were extruded in the buccal group(0.87 mm).The vertical anchorage control in the palatal group was superior to the buccal group.Conclusion:In both the anteroposterior and vertical directions, a modified transpalatal arch supported by 2 midpalatal miniscrews provided more stable anchorage, which can serve as an alternative method of maximal anchorage during orthodontic treatment of bimaxillary protrusion.

关 键 词：种植支抗 双颌前突 腭 头颅侧位片分析 

分 类 号：R783.5[医药卫生—口腔医学]