使用种植体支抗三种加力方式关闭拔牙间隙前后的头影测量分析  

Cephalometric analysis of three different loading methods in en-masse retraction using mini-implant anchorage

作　　者：张丽雯[1] 郭润智 王玥 徐宝华[1] 李巍然[2] Zhang Liwen;Guo Runzhi;Wang Yue;Xu Baohua;Li Weiran(Department of Orthodontics,Dental Medical Center,ChinatJapan Friendship Hospital,Beijing 100029,China;Department of Orthodontics.Peking University School and Hospital of Stomatology&National Center of Stomatology&.Natiomal Clinical Research Center for Oral Diseases&National Engineering Research Center for Oral Biomaterial and Digital Medical Devices,Beijing 100081,China)

机构地区：[1]中日友好医院口腔医学中心正畸科,北京100029 [2]北京大学口腔医学院·口腔医院正畸科·国家口腔医学中心,国家口腔疾病临床医学研究中心·口腔生物材料和数字诊疗装备国家工程研究中心,北京100081

出　　处：《中华口腔正畸学杂志》2022年第4期181-185,共5页Chinese Journal of Orthodontics

摘　　要：目的对比研究使用种植体支抗3种加力方式关闭拔牙间隙后.牙齿及颅颌面软硬组织的变化是否存在差异。方法本研究为前瞻性队列研究,选取45例成人上颌前突患者,均需拔除上颌双侧第一前磨牙并使用种植体支抗内收上前牙,将其随机分为3组,采用不同加力方式内收上前牙:A组采用短牵引钩和直接支抗,B组采用短牵引钩和间接支抗,C组采用长牵引钩和直接支抗拍摄关闭拔牙间隙前后的头颅侧位片,采用配对样本1检验比较关闭拔牙间隙前后牙齿、颅颌面软硬组织的变化.并采用方差分析比较3组患者之间的差异。结果在关闭拔牙间隙阶段前后,3组患者上前牙切缘舌向移动量分别为:A组(5.99±1.06)mm,B组(5.6.1±1.06)mm,C组(5.71±0.95)mm,3组间的差异无统计学意义(P=0.624);而上前牙根尖舌向移动量分别为A组(1.51±0.71)mm,B组1.80(2.80.1.10)mm,C组(3.91±1.06)mm,C组大于其他两组(P<0.001)。A组在关闭拔牙间隙阶段前后胎平面顺时针旋转4.11°±2.27(P<0.001),上颌第一磨牙压低(2.74±0.50)mm(P<0.001),远中倾斜6.97°±2.45P<0.001);而其他两组在关闭拔牙间隙阶段前后其磨牙的垂直向位移(B组-0.70mm±1.47mm.P=0.086,C组0.17mm±0.85mm,P=0.445)和近远中倾斜角(B组-0.10(1.20,2.40)°,P=0.410,C组-0.73°±3.77°,P=0.464)的变化均无统计学意义。结论使用种植体支抗内收前牙时,不同加力方式均可获得理想的支抗效果。直接种值体支抗配合短牵引钩加力后,磨牙可能压低、冠远中倾斜,[牙合]平面顺时针旋转:使用长牵引钩可获得更多前牙控根移动。Objective To compare the skeletal.dental.and soft tissue changes before and after en-masse retraction using different loading methods with mini-implant anchorage.Methods Forty-five patients with maxillary protrusion were recruited.The treatment plan involved the extraction of the bilateral maxillary first premolars and anterior retraction by mini-implant anchorage in upper arch.The patients were randomly assigned to three groups:direct anchorage with short power arm,indirect anchorage with short power arm.direct anchorage with long power arm.Paired sample t tests were performed to examine the treatment changes in lateral cephalograms between before and after space closure in each group.AN()VA were performed to compare the treatment changes between groups.ResultsThe incisal edges of anterior teeth moved lingually by(5.99±1.06)mm in group A.(5.64±1.06)mm in group B.and(5.71±0.95)mm in group C.and no statistical differences were found in the three groups(P=0.624).The roots of the anterior teeth lingually moved(1.51±0.71)mm in group A and 1.80(2.80.1.10)mm in group B.Both were shorter than the distance of group C.which was(3.91±1.06)mm(P<0.001).In group A.the occlusal plane rotated clockwise by 4.11°±2.27°(P<0.001).and the molars intruded by(2.74±0.50)mm(P<0.001)and distally inclined by 6.97°±2.45°(P<0.001).The other two groups showed no statistical significant changes neither vertical(-0.70 mm±1.47mm in group B.P=0.086.0.17mm±0.85 mm in group C(P=0.445),norsagittal(-0.10(1.20.2.40)°ingroupB.P=0.410.-0.73°±3.77in group C(P=0.464).Conclusions Different loading methods using mini-implant anchorage can provide successful anchorage.Using direct anchorage with short power arm.the molars were intruded.distally moved and the occlusal plane rotated clockwise.The direct anchorage with long power arm could help achieve a better lingual root torque control.

关 键 词：种植体支抗 加力方式 头影测量 牙齿移动 

分 类 号：R783.6[医药卫生—口腔医学]