前方牵引联合快速扩弓矫治骨性Ⅲ类错(牙合)的面部软组织变化  

Maxillary Protraction and Rapid Palatal Expansion on the Facial Soft Tissue Changes for Class Ⅲ Skeletal Malocclusion Patients

作　　者：李洁 漆昱君 张小君 刘冬巧 李继宏 张玲阁 LI Jie;QI Yujun;ZHANG Xiaojun;LIU Dongqiao;LI Jihong;ZHANG Lingge(Department of Orthodontics,Zhengzhou Stomatological Hospital,Zhengzhou Henan 450000,China;Department of Stomatology,Hospital of Northwestern Polytechnical University,Xi’an Shaanxi 710072,China;Department of Nursing,Zhengzhou Stomatological Hospital,Zhengzhou Henan 450000,China;Department of Oral and Maxillofacial Surgery,Zhengzhou Stomatological Hospital,Zhengzhou Henan 450000,China)

机构地区：[1]郑州市口腔医院正畸科,河南郑州450000 [2]西北工业大学医院口腔科,陕西西安710072 [3]郑州市口腔医院护理部,河南郑州450000 [4]郑州市口腔医院口腔颌面外科,河南郑州450000

出　　处：《临床研究》2023年第2期38-41,共4页Clinical Research

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20191152)。

摘　　要：目的 分析前方牵引加快速扩弓对骨性Ⅲ类错(牙合)开展矫治后面部软组织的改变情况。方法 选择2020年8月至2022年8月郑州市口腔医院收入上颌发育不足引起骨性Ⅲ类错(牙合)共40例患者开展研究,均处在生长发育的高峰阶段或者高峰前期,通过前方牵引加快速扩弓进行矫治,在开始矫治前、结束矫治后分别测量鼻顶点到Y轴距离、上唇凸厚、上唇凸距、上唇基角、下唇凸距、上唇突点到Y轴之间距离、上唇凹点到Y轴之间距离、颏厚度、颏唇角、H角、软组织下面高、下唇基角、软组织面角、鼻唇角以及软组织颏前点到Y轴距离,以评定面部软组织的改变情况。结果 矫治后,所有患者的软组织面角、下唇基角和矫治前相比减小,差异有统计学意义(P<0.05);上唇基角、鼻顶点到Y轴距离、软组织下面高和矫治前相比增加,差异有统计学意义(P<0.05)。矫治后,所有患者的鼻唇角和矫治前相比减小,差异有统计学意义(P<0.05);上唇凸厚、上唇凸距、上唇凹点到Y轴之间距离以及上唇突点到Y轴之间距离和矫治前相比增加,差异有统计学意义(P<0.05);下唇凸距、下唇凹点到Y轴之间距离和矫治前相比差异无统计学意义(P>0.05)。矫治后,所有患者的颏厚度、颏唇角以及H角和矫治前相比增加,差异有统计学意义(P<0.05);软组织颏前点到Y轴距离和矫治前相比减小,差异有统计学意义(P<0.05)。结论 前方牵引加快速扩弓对骨性Ⅲ类错(牙合)开展矫治后患者面部软组织有明显改变,主要表现为上唇明显前移、颏部往下移位,颏唇关系改善以及侧貌突度明显增加。Objective To analyze the impacts of maxillary protraction and rapid palatal expansion on the facial soft tissue changes for class Ⅲ skeletal malocclusion patients. Methods A total of 40 maxillary deficiency patients with class Ⅲ skeletal malocclusion treated from August 2020 to August 2022 in Zhengzhou Stomatological Hospital were selected. At the peak or prepeak growth development stage, maxillary protraction and rapid palatal expansion were performed. The facial soft tissue changes were appraised through the nasal apex to Y-axis distance, upper lip convex thickness, upper lip convex distance, upper lip basal angle, lower lip convex distance, upper lip protruding point to Y-axis distance, upper lip pit to Y-axis distance, mentolabial thickness, mentolabial angle, H angle, soft tissue inferior height, lower lip basal angle, soft tissue face angle, nasolabial angle,and soft tissue pogonion to Y-axis distance. Results After correction, the soft tissue face angle and lower lip basal angle were significantly lower than before(P<0.05);the upper lip basal angle, the nasal apex to Y-axis distance, and soft tissue inferior height were significantly higher than before(P<0.05);after correction, the nasolabial angle was significantly smaller than before(P<0.05);the upper lip convex thickness, upper lip convex distance, upper lip pit to Y-axis distance, upper lip protruding point to Y-axis distance were significantly higher than before(P<0.05);the lower lip convex distance, lower lip pit to Y-axis distance after correction were not significantly different than before correction(P>0.05);after correction, the mentolabial thickness, mentolabial angle, and H angle were significantly higher than before(P<0.05);the soft tissue mentolabial pogonion to Y-axis distance was significantly smaller than before(P<0.05). Conclusion The maxillary protraction and rapid palatal expansion produce a great influence on the facial soft tissues for class Ⅲ skeletal malocclusion patients, especially with the antedisplacement of the upper lip,

关 键 词：前方牵引 快速扩弓 骨性Ⅲ类错(牙合) 面部软组织 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]