无托槽隐形矫治器与钟摆矫治器对骨性Ⅱ类错[牙合]畸形矫治的临床对比研究  

A comparative study on clinical treatment of skeletal ClassⅡmalocclusion with invisible bracket free appliance and pendulum appliance

作　　者：高雪 张栋梁[2] 尹伟娇 段少宇 GAO Xue;ZHANG Dongliang;YIN Weijiao;DUAN Shaoyu(Department of Stomatology,Electric Power Teaching Hospital,Capital Medical University,Beijing 100073,China;Department of Orthodontics,Beijing Stomatological Hospital,Capital Medical University,Beijing 100006,China)

机构地区：[1]首都医科大学电力教学医院口腔科,北京100073 [2]首都医科大学附属北京口腔医院正畸科,北京100006

出　　处：《新疆医科大学学报》2022年第9期985-991,共7页Journal of Xinjiang Medical University

基　　金：北京市科技计划项目(Z151100004015155)。

摘　　要：目的探讨无托槽隐形矫治器与钟摆矫治器对骨性Ⅱ类错[牙合]畸形矫治过程中牙体移动精准控制效果。方法选取首都医科大学电力教学医院2017年5月至2020年5月接诊的107例骨性Ⅱ类错[牙合]畸形患者。根据矫治器类型分为无托槽隐形矫治器组(44例)和钟摆矫治器组(63例),分别佩戴无托槽隐形矫治器和钟摆矫治器进行矫治。对比两组患者的矫治疗程、治疗前后上颌第一磨牙位移距离的差值、治疗前后上颌骨与下颌骨的骨性改变情况,并统计两组患者对矫治效果的满意度。结果无托槽隐形矫治器组与钟摆矫治器组患者的矫治疗程经比较差异无统计学意义(P>0.05)。两组患者上颌第一磨牙(U6)矫治前后患者牙冠与牙根坐标的差值((ΔX_(g)、ΔY_(g)、ΔZ_(g))、(ΔX_(r)、ΔY_(r)、ΔZ_(r))差异无统计学意义(P>0.05),上牙槽座点以及鼻根点之间构成的角(SNA)、下牙槽座点以及鼻根点之间构成的角(SNB)、腭平面的倾斜角(SN-PP)、上颌平面角(PP-FH)、下颌第一磨牙(L6)的长轴与MP平面之间的交角(L6-long axis-MP)、PP平面与[牙合]平面之间的交角(PP-FOP)、SN平面与[牙合]平面的交角(SN-FOP)、后面高(S-Go)、后面高与前面高之比(S-Go/N-Me)的差值差异无统计学意义(P>0.05)。钟摆矫治器组患者前下面高与前面高比值(LFH/TFH)的差值,UI-SN差值大于无托槽隐形矫治器组,L6近中颊的尖点与MP平面之间垂直距离[L6-MP(LPDH)]的差值大于无托槽隐形矫治器组(P均<0.05)。两组患者对正畸效果的满意度均为100.00%。结论无托槽隐形矫治器与钟摆矫治器矫治骨性Ⅱ类错[牙合]畸形的效果均较好,患者满意度高。相比于钟摆矫治器,无托槽隐形矫治器更好地改善了患者磨牙远移后牙齿垂直方向的变化,且不容易丢失前牙支抗而导致前牙唇倾,对牙体移动精准控制效果更好。Objective To investigate the comparison betweenbracketless invisible appliance and pendulum appliance inprecise control of tooth movement during the orthodontic treatment of skeletal class II malocclusion.Methods 107 patients with skeletal ClassⅡmalocclusion were selected from the hospital from May 2017 to may 2020.According to the type of appliance,thepatients were divided into non bracket invisible appliance group(44 cases)and pendulum appliance group(63 cases).Compare the treatment course of the patients in two groups of,the difference ofdisplacement distance ofmaxillary first molar before and after the treatment,the bone changes ofmaxilla and the mandible before and after the treatment,and count the satisfaction of the two groups of the patients with the treatment effect.Results There was no significant difference in the treatment course between the invisible appliance group without bracket and the pendulum appliance group(P>0.05).There was no significant difference between(ΔX_(g)、ΔY_(g)、ΔZ_(g))、(ΔX_(r)、ΔY_(r)、ΔZ_(r))inthetwogroups(P>0.05),and there was no significant difference between SNA,SNB,SN-PP,PP-FH,L6 long axis MP,PP FOP,SN-FOP,S-GO,S-GO/N-Me(P>0.05).The difference of LFH/TFH was less than that in non bracket invisible appliance group,and the difference of L6-MP(LPDH)was greater than that in non bracket invisible appliance group(all P<0.05).The satisfaction of the patients in both groups with orthodontic effect was 100.00%.Conclusion The effect of non bracket invisible appliance and pendulum appliance in the treatment of skeletal Class II malocclusion is better,and thesatisfaction ofthe patient is high.Compared with the pendulum appliance,the invisible appliance without bracket can better improve the change ofvertical direction ofteeth after the molar is moved far,and it is not easy to lose the anterior anchorage and lead tolip inclination of the anterior teeth,which has a better effect onaccuratingthe control of tooth movement.

关 键 词：骨性Ⅱ类错[牙合]畸形 无托槽隐形矫治器 钟摆矫治器 牙体移动 精准控制 

分 类 号：R828.8[医药卫生—临床医学]