正畸正颌联合矫治骨性Ⅲ类错牙合畸形疗效分析  

The Clinical Effect of Combined Orthodontics and Orthognathic Treatment on Skeletal ClassⅢMalocclusion

作　　者：朱菲 何冬梅[1] 郝静[1] 王天丛[1] ZHU Fei;HE Dong-mei;HAO Jing;WANG Tian-cong(Department of Orthodontics,Nanjing Stomatological Hospital,Medical School of Nanjing University,Nanjing 210008,Jiangsu,China)

机构地区：[1]南京大学医学院附属口腔医院(南京市口腔医院)口腔正畸科,江苏南京210008

出　　处：《中国美容医学》2021年第12期147-151,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:分析正畸正颌联合治疗骨性Ⅲ类错牙合畸形患者的临床效果。方法:选取笔者医院2016年1月-2018年3月收治的30例骨性Ⅲ类错牙合畸形患者为研究对象,均实施正畸正颌联合治疗。于治疗前后评估患者软硬组织改变及前牙区牙槽骨厚度,评价其生活质量。结果:患者术后面上、面中1/3比例协调,颏点良好,口唇闭合自然,颞下颌关节无压痛,运动无弹响;咀嚼、吞咽功能恢复良好。患者术后面凸角、鼻唇角高于术前,颏唇角低于术前,MP-SN、L1-SA低于术前,TLL'、TBs高于术前,术后DA、DSN、DUI、DUL'高于术前,差异均有统计学意义(P<0.05);矫治前后的U1-SA、TSn、TUL'、TPos比较,差异无统计学意义(P>0.05);矫治后,UW、UW-m、UA、UP-m、LW、LW-m、LP、LP-m低于术前,LA高于术前,差异均有统计学意义(P<0.05);矫治前后UA-m、UP、LA-M比较,差异无统计学意义(P>0.05)。患者正颌术后1个月OHRQOL总分及各维度评分均高于术前,差异有统计学意义(P<0.05);所有治疗结束后,OHRQOL总分及各维度评分降低,且低于术前、正颌术后1个月,差异有统计学意义(P<0.05)。结论:骨性Ⅲ类错牙合畸形患者接受正畸正颌治疗,面部比例协调,口颌功能提高,术后软硬组织皆得到改善;但矫治后会减小患者上下前牙区的牙槽骨厚度,故临床医师应在一定限度内控制牙齿移动,减少牙槽骨厚度缺失程度。Objective Analysis of the clinical effects of combined orthodontics and orthognathic treatment on patients with skeletal ClassⅢmalocclusion.Methods To select 30 cases of skeletal Class III malocclusion patients collected by the hospital from January 2016 to March 2018,all perform orthodontic and orthognathic combined treatment in the hospital.To evaluate the soft and hard tissue changes and the thickness of the alveolar bone in the anterior teeth before and after treatment,and to evaluate the quality of life.Results After the operation,the face and middle 1/3 ratio of the face is coordinated,the chin point is good,the lips are closed naturally,the temporomandibular joint has no tenderness,and the movement is no bounce.The chewing and swallowing functions are restored.The postoperative facial lobes and nasolabial angles were higher than those before surgery,the chin-labial angles were lower than before surgery,MP-SN and L1-SA were lower than before surgery,TLL'and TBs were higher than those before surgery,and DA,DSN,DUI and DUL'are higher than before operation,the difference is statistically significant(P<0.05).U1-SA,TSn,TUL',TPos before and after operation are compared(P>0.05).Postoperative UW,UW-m,UA,UP-m,LW,LW-m,LP,LP-m were lower than preoperatively,and LA was higher than preoperatively(P<0.05).Preoperative and postoperative UA-m,Comparison of UP and LA-M(P>0.05).The total OHRQOL score and the scores of each dimension were higher than that of the preoperative one month after orthognathic surgery(P<0.05),the total OHRQOL score and the scores of each dimension decreased after all treatments,and were lower than those before and after orthognathic surgery 1 month(P<0.05).Conclusion Patients with skeletal ClassⅢmalocclusion received orthodontic treatment,with coordinated facial proportions,improved oral and jaw function,and improved soft and hard tissues after surgery.However,the thickness of the alveolar bone in the upper and lower anterior teeth will be reduced after the operation Therefore,clinicians should

关 键 词：正畸正颌联合矫治 骨性Ⅲ类错牙合畸形 前牙区 牙槽骨厚度 

分 类 号：R783.5[医药卫生—口腔医学]