正畸优先模式与手术优先模式对骨性Ⅲ类患者疗效的差异性研究  

Differences in efficacy between orthodontic-first and surgery-first models for skeletal Class Ⅲ patients

作　　者：蔡观慧 管兆兰[1] 李根 王华[1] 张卫兵[1,2] CAI Guanhui;GUAN Zhaolan;LI Gen;WANG Hua;ZHANG Weibing(Department of Orthodontics,The Affiliated Stomatological Hospital of Nanjing Medical University,Jiangsu Province Key Laboratory of Oral Diseases,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine,Nanjing 210029,China)

机构地区：[1]南京医科大学附属口腔医院正畸科,江苏省口腔疾病研究重点实验室,江苏省口腔转化医学工程研究中心,江苏南京210029 [2]苏州大学附属独墅湖医院口腔科,江苏南京215000

出　　处：《口腔医学》2023年第4期317-321,共5页Stomatology

基　　金：国家自然科学基金(81870797);江苏省科教能力提升工程——江苏省研究型医院(YJXYYJSDW4);江苏省医学创新中心(CXZX202227)。

摘　　要：目的 比较手术优先与正畸优先对骨性Ⅲ类错牙合患者疗效的影响。方法 选择正畸-正颌联合治疗的骨性Ⅲ类错牙合患者24例,其中正畸优先组13例,手术优先组11例。收集患者治疗前后的锥形束CT(CBCT)影像学资料,并导入Dolphin Imaging软件,进行软硬组织头影测量分析。结果 正畸优先组与手术优先组都能够成功改善患者的覆盖及软组织侧貌,治疗前后软硬组织变化具有统计学差异(P<0.05)。两组治疗前后各项指标差值比较无统计学意义(P>0.05)。此外手术优先组平均治疗时间为(18.86±3.61)个月,显著小于正畸优先组(27.15±5.16)个月,具有统计学差异(P<0.001)。结论 手术优先组与正畸优先组治疗前后软硬组织变化值差异无统计学意义,治疗时间差异有统计学意义。Objective To compare the impact between a surgery-first strategy and an orthodontics-first approach on the result and course of therapy in patients with skeletal Class Ⅲ malocclusion.Methods The sample consisted of 24 patients with severe skeletal Class Ⅲ malocclusion,who needed orthognathic surgery.Eleven patients were treated with the surgery-first approach,and 13 patients were treated with the traditional orthodontic-surgical approach.Dolphin Imaging software was used to perform cephalometric analysis on the cone beam computed tomography(CBCT)data that were collected before and after treatment.Results In skeletal Class Ⅲ patients,the overjet and soft-tissue profile were successfully normalized in both of the two groups at high rates.Before and after the treatment,there was no statistically significant difference in indexes between the two groups(P>0.05).In terms of soft and hard tissue changes before and after treatment,there was a statistically significant difference between the orthodontic-first group and the surgery-first group(P<0.05).In addition,the overall treatment duration was much shorter in the surgery-first group((18.86±3.61)months)than in the orthodontic-first group((27.15±5.16)months),with a statistical difference(P<0.001).Conclusion There is no statisti-cally significant difference in soft and hard tissue changes between the surgery-first group and the orthodontic-first group,but there is a significant difference in treatment duration between two groups.

关 键 词：骨性Ⅲ类错牙合 手术优先 正畸-正颌联合治疗 

分 类 号：R783.5[医药卫生—口腔医学]