青少年下颌后缩隐形前导矫治的疗效评价研究  

Evaluation of the mandibular advancement efficacy of clear appliance in correction of mandibular retrusion in adolescents

作　　者：孔蕾 刘新强[1] 郭学强 Kong Lei;Liu Xinqiang;Guo Xueqiang(Department of Orthodontics,The Affiliated Hospital of Qingdao University,Qingdao 266003,China;Department of Stomatology,Qingdao Women and Children's Hospital,Qingdao 266000,China)

机构地区：[1]青岛大学附属医院口腔正畸科,青岛266003 [2]青岛市妇女儿童医院口腔科,青岛266000

出　　处：《中华口腔正畸学杂志》2023年第3期154-159,共6页Chinese Journal of Orthodontics

摘　　要：目的评估隐形前导矫治器矫治青少年下颌后缩患者的疗效。方法回顾性选取2017年至2021年于青岛大学附属医院正畸科经隐形前导矫治完成的下颌后缩青少年患者30例,其中男性15例,女性15例,年龄(11.6±0.9)岁。应用Pancherz分析法评估治疗前后的头影测量参数,采用配对t检验比较矫治前后骨骼及牙齿的变化。结果治疗后,下颌骨颏前点前移(3.13±0.89)mm(P=0.029),长度增加(4.14±2.18)mm(P<0.001),下颌升支长增加(4.09±1.58)mm(P=0.018),下颌体长增加(4.25±2.87)mm(P=0.001),髁突位置后移(1.03±0.79)mm(P<0.001)。SNB增加(1.96±2.56)°(P<0.001),ANB减小(2.03±1.32)°(P<0.001),Wits值减小(2.90±1.72)mm(P<0.001)。上中切牙舌向倾斜(4.06±4.88)°(P<0.001);下中切牙唇向倾斜(1.23±0.40)°(P<0.001)。治疗后覆盖减小(4.31±1.43)mm(P<0.001),骨性效应占比58.7%,牙性效应占比41.3%;磨牙关系改善(3.87±0.78)mm(P<0.001),骨性效应占比65.4%、牙性效应占比34.6%。结论对于生长期骨性下颌后缩患者,隐形下颌前导能有效促进下颌生长发育,疗效以骨性效应为主。Objective To evaluate the mandibular advancement efficacy of clear appliance in adolescent mandibular retrusion.Methods Thirty adolescent patients with mandibular retrusion who underwent mandibular advancement correction in orthodontic department of the affiliated Hospital of Qingdao University from 2017 to 2021 were selected,including 15 males and 15 females(with an average of 11.6±0.9 years).Pancherz analysis was used to evaluate the cephalometric parameters before and after treatment,and paired t test was used to analyze the changes of bone and teeth.Results After treatment,Pogonion advanced by(3.13±0.89)mm(P=0.029);mandibular length increased by(4.14±2.18)mm(P<0.001);ramus length increased by(4.09±1.58)mm(P=0.018);mandibular body length increased by(4.25±2.87)mm(P=0.001);condylar position retruded by(1.03±0.79)mm(P<0.001);SNB increased by(1.96±2.56)°(P<0.001);ANB decreased by(2.03±1.32)°(P<0.001);Wits decreased by(2.90±1.72)mm(P<0.001);The inclination and angle of the upper central incisor were decreased(3.44±6.89)°(P=0.010)and(4.06±4.88)°(P<0.001),respectively;The inclination and angle of the lower central incisor increased(2.62±1.63)°(P=0.030)and(1.23±0.40)°(P<0.001),respectively.After treatment,the overjet decreased by(4.31±1.43)mm(P<0.001),in which skeletal factors accounted for 58.7%of the effect while dental accounted for 41.3%;Molar relationship improved by(3.87±0.78)mm(P<0.001)mm,and skeletal factor accountd for 65.4%of the effect and dental factor accounted for 34.6%.Conclusions For growing patients with skeletal mandibular retrusion,the invisible appliance can promote mandibular forward growth and development,and the curative effect of the malocclusion is mainly skeletal.

关 键 词：青少年 下颌后缩 PANCHERZ分析法 隐形下颌前导 

分 类 号：R783.5[医药卫生—口腔医学]