对比微种植体支抗和改良横腭杆配合PASS矫治器在儿童安氏Ⅰ~Ⅱ类错(牙合)高角拔牙矫治中的应用  

Comparison treatment of micro-implant anchorage and vertical holding arch combined with PASS appliance in children with high angle tooth extraction of Ⅰ-Ⅱ malocclusion

作　　者：冯哲[1] 田炳欣[1] 马涛[2] 孙立婷[1] FENG Zhe;TIAN Bing-xin;MA Tao;SUN Li-ting(Department of Stomatology,Second Affiliated Hospital of Xingtai Medical College,Xingtai 054000,Hebei,China;Department of Stomatology,Xingtai Medical College,Xingtai 054000,Hebei,China)

机构地区：[1]邢台医学高等专科学校第二附属医院口腔科,河北邢台054000 [2]邢台医学高等专科学校口腔系,河北邢台054000

出　　处：《生物医学工程与临床》2022年第4期459-464,共6页Biomedical Engineering and Clinical Medicine

基　　金：河北省重点研发计划基金资助项目(19277792D)。

摘　　要：目的 探讨基于锥体束CT(CBCT)的三维重建技术对比微种植体支抗和改良横腭杆配合生理性支抗Spee氏弓矫治系统(PASS)矫治器在儿童安氏Ⅰ~Ⅱ类错(牙合)高角拔牙矫治中的控制效果。方法 选择安氏Ⅰ~Ⅱ类高角拔牙患儿140例,其中男性77例,女性63例;年龄11~15岁,平均年龄13.75岁。按随机数字表法分为试验组和对照组,每组70例。试验组采用微种植体支抗配合PASS矫治器进行矫治,对照组采用改良横腭杆配合PASS矫治器。拍摄头颅侧位片和口腔颌面CBCT,对CBCT数据进行三维重建,比较两组矫治方式对颊舌向倾斜度、牙弓宽度、垂直向的控制效果。结果 两组患者治疗前后骨性指标前颅底平面-上齿槽座点角(SNA)、前颅底平面-下齿槽座点角(SNB)、上齿槽座点-鼻根点-下齿槽座点角(ANB)、下颌平面-前颅底平面角(MP-SN)变化差异无统计学意义(P> 0.05)。矫治后试验组牙性指标中切牙长轴与下颌平面的交角(L1-MP)、下中切牙长轴与下齿槽座点-鼻根点连线交角(L1-NA)、上中切牙长轴与上齿槽座点-鼻根点连线交角(U1-NA)较矫治前明显降低[(92.47±2.47)°vs(96.73±3.13)°、(32.28±3.08)°vs (35.23±3.24)°、(25.19±3.17)°vs (29.16±3.36)°。P <0.05],而对照组牙性指标变化差异无统计学意义(P> 0.05)。矫治后试验组后牙支抗控制指标上颌第一磨牙近中颊尖点到PP平面的距离(U6-PP)、上颌第一磨牙近中颊尖点到PM平面的距离(U6-PM)变化差异无统计学意义(P> 0.05),而对照组矫治后明显降低[(100.83±5.18)°vs (97.62±4.89)°、(93.68±4.83)°vs (90.29±4.17)°。P <0.05]。经矫治后试验组、对照组牙弓宽度各指标均有不同程度变化,其中试验组上颌尖牙牙尖之间宽度(U33)明显高于对照组[(35.95±2.02) mm vs (34.38±2.12) mm],而上颌双侧第二前磨牙中央窝之间距离(U55)、下颌双侧第二前磨牙中央之间距离(L55)明显低于对照组[(38.74±2.09) mm vs (40.10±2.Objective To compare control effect between micro-implant anchorage and vertical holding arch combined with physiologic anchorage Spee’s-wire system(PASS) appliance based on three-dimensional(3D) reconstruction of pyramid cone beam CT(CBCT) in the treatment of children with high angle tooth extraction of Ⅰ-Ⅱ malocclusion. Method A total of 40 children with high angle tooth extraction of Ⅰ-Ⅱ malocclusion were enrolled, which included 77 males and 63 females, aged 11-15years old with mean age of 13.75 years old. All of them were randomly divided into experimental group( n = 70, performed micro-implant anchorage combined with PASS appliance) and control group( n = 70, performed vertical holding arch combined with PASS appliance). The lateral cephalogram and oral and maxillofacial CBCT were scanned, and 3D reconstruction of CBCT data was used to compare control effects of buccolingual inclination, dental arch width and vertical direction between 2 groups. Results There was no significant difference in changes of bone indexes[sella nasion subspinale(SNA), sella nasion supramental(SNB), subspinale nasion supramental(ANB), mandibular plane and sella nasion angle(MP-SN)]before and after treatment between 2 groups(P > 0.05). After treatment, the lower incisor and mandibular plane(L1-MP), lower incisor and nasion subspinale(L1-NA) and upper incisor and nasion subspinale(U1-NA) of experimental group were significantly lower than before treatment[(92.47 ± 2.47)° vs(96.73 ± 3.13)°,(32.28 ± 3.08)° vs(35.23 ± 3.24)°,(25.19 ± 3.17)° vs(29.16 ±3.36)°. P < 0.05], while there was no significant difference in dental indexes of control group(P > 0.05). After treatment, there was no significant difference in changes of U6-PP and U6-PM of experimental group(P > 0.05), while control group significantly decreased than before treatment[(100.83 ± 5.18)° vs(97.62 ± 4.89)°,(93.68 ± 4.83)° vs(90.29 ± 4.17)°. P < 0.05]. After treatment, each index of dental arch width changed to varying degrees in 2 groups, the U3

关 键 词：微种植体支抗 改良横腭杆 生理性支抗矫治技术 锥形束CT(CBCT) 颊舌向倾斜度 牙弓宽度 

分 类 号：R783.5[医药卫生—口腔医学]