骨性Ⅱ类均角深覆盖患者3种不同拔牙模式的颅面特征分析  

Analysis of craniofacial features of patients with skeletal ClassⅡaverage angle deepoverjet in three different tooth extraction modes

作　　者：苏红[1] 韩冰[2] 王秀婧[1] 许天民[2] Su Hong;Han Bing;Wang Xiujing;Xu Tianmin(First Clinical Division,Peking University School and Hospital of Stomatology&National Engineering Research Center for Oral Biomaterials and Digital Medical Devices&Beijing Key Laboratory of Digitol Stomatology&NHC Research Center of Engineering and Technology for Computerized Dentistry,Beijing 100034,China;Department of Orthodontics,Peking University School and Hospital of Stomatology&National Engineering Research Center for Oral Biomaterials and Digital Medical Devices&Beijing Key Laboratory of Digitol Stomatology&NHC Research Center of Engineering and Technology for Computerized Dentistry,Beijing 100081,China)

机构地区：[1]北京大学口腔医学院·口腔医院第一门诊部,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,北京100034 [2]北京大学口腔医学院·口腔医院正畸科,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,北京100081

出　　处：《中华口腔正畸学杂志》2022年第1期24-28,共5页Chinese Journal of Orthodontics

基　　金：国家自然科学基金(82001080,82071172,51972005)。

摘　　要：目的探索骨性Ⅱ类均角深覆盖患者3种主要拔牙模式治疗前颅颌面特征的差异和治疗结果的不同。方法本研究为回顾性队列研究。从北京大学口腔医院正畸科选择155例骨性Ⅱ类均角深覆盖治疗完成患者[男性64例,女性91例,年龄(12.9±2.5)岁],其中拔除两个上颌第一前磨牙(拔除2个上4组)15例,拔除4个第一前磨牙(拔除4个4组)45例,拔除上颌第一前磨牙及下颌第二前磨牙(拔除上4下5组)18例,对治疗前后头颅侧位片进行测量,比较3组样本的差异,同时利用各组特征对8例治疗完成患者进行拔牙模式判断,与临床医师进行比较。结果治疗前三组间差异主要体现在牙性指标和软组织指标,拔除2个上4组的治疗前前牙覆盖最大[(10.5±1.9)mm],与另外两组[拔除4个4组:(8.9±1.7)mm,拔除上4下5组:(8.9±2.1)mm]间都有统计学差异(P=0.013);拔除上4下5组磨牙远中关系[(-1.3±1.6)mm]最严重,与拔除4个4组磨牙关系[(0.2±1.8)mm]差异有统计学意义(P=0.016);拔2个上4组下唇突度[(2.8±3.0)mm]显著小于另外两组[拔除4个4组:(5.1±2.5)mm,拔除上4下5组:(3.8±3.0)mm],差异有统计学意义(P=0.013)。3组治疗后的差异只有磨牙关系,拔除2个上4组是远中关系,而另外两组是中性关系。对于新样本的拔牙模式判断与临床医师决策的符合率为75%。结论骨性Ⅱ类均角深覆盖患者,下颌的拔牙与否与覆盖和下唇突度有关,覆盖越小,下唇突度越大,越倾向于拔牙;而拔牙的位置选择主要与磨牙远中关系和下唇突度有关,磨牙远中关系越严重,下唇突度越小,越倾向于拔除下颌第二前磨牙,反之则拔除下颌第一前磨牙。Objective To explore the differences in pre-treatment cranio-maxillofacial features and treatment results of the three main tooth extraction pattern for patients with skeletal classⅡaverage deep overjet.Methods In this retropective cohort study,155 finished cases with skeletal classⅡmean-angle deep overjet were selected from the Department of Orthodontics,Peking University Hospital of Stomatology.Among them,15 cases with extraction of two maxillary first premolars,45 cases with extraction of 4 first premolars,and 18 cases with extraction of maxillary first premolars and mandibular second premolars were included in this study.Cephalograms were measured before and after treatment to compare the difference among three groups.Then,the characteristics of each group were used to judge the extraction mode of 8 new patients.Results The difference between the three groups before treatment is mainly reflected in the index of dentition and soft tissue.The OJ of the cases with extraction of two maxillary first premolars before treatment[(10.5±1.9)mm]is the largest,which is statistically different from the other two groups[the cases with extraction of 4 first premolars:(8.9±1.7)mm,the cases with extraction of maxillary first premolars and mandibular second premolars:(8.9±2.1 mm)].The distal molar relationship was the most severe in cases with extraction of maxillary first premolars and mandibular second premolars[(-1.3±1.6)mm],which is statistically different from 4 first premolars extraction group[(0.2±1.8)mm].The lower lip protrusion LL_EP of the groups with extraction of two maxillary first premolars[(2.8±3.0)mm]is significantly smaller than that in the other two groups[the cases with extraction of 4 first premolars:(5.1±2.5)mm,the cases with extraction of maxillary first premolars and mandibular second premolars:(3.8±3.0)mm],the differences were statistically significant.The only difference among the three groups after treatment is the molar relationship.The extraction mode for the new sample is 75%.Conclusion

关 键 词：骨性Ⅱ类 均角 深覆盖 拔牙模式 头影测量 

分 类 号：R783.5[医药卫生—口腔医学]