种植支抗辅助口内Ⅲ类牵引对单侧唇腭裂患儿骨性Ⅲ类错合畸形的效果  

Effects of class Ⅲ traction assisted by implant anchorage on unilateral cleft and palate patients in treatment of skeletal class Ⅲ malocclusion

作　　者：张栋杰 叶展怡 黎凡 龙宝军 Zhang Dongjie;Ye Zhanyi;Li Fan;Long Baojun(Department of Stomatoplasty,Women and Children Medical Center,Guangzhou 510120,China)

机构地区：[1]广州市妇女儿童医疗中心口腔正畸科,广州510120

出　　处：《中华医学美学美容杂志》2023年第6期482-487,共6页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：广东省医学科学技术研究基金项目(C2022110);广州市科技计划项目(2023A04J1241);广州市科技计划项目(2023A03J0912)。

摘　　要：目的头颅定位侧位片评估种植支抗辅助的口内Ⅲ类牵引和传统合垫基托式口外前方牵引,纠正单侧唇腭裂患儿因上颌骨发育不足而导致的骨性Ⅲ类错合的效果。方法2018年3月至2020年10月,广州市妇女儿童医疗中心口腔正畸科用随机数字表法将单侧完全性唇腭裂患儿54例[男24例,女30例,年龄8~12(11.09±1.35)岁]分为3组:传统合垫基托式口外前方牵引组(A组)、种植支抗辅助口内Ⅲ类牵引组(B组)、对照组,每组18例。在矫治开始前(T1)及结束后(T2)分别拍摄头颅定位侧位片,通过Dolphin软件进行颌骨、牙齿以及软组织测量,将头影指标进行组间比较。结果A组和B组牵引时间分别为(10.51±1.33)个月和(9.20±1.45)个月(P=0.146)。A组和B组A点平均前移4.08 mm和4.83 mm,ANB角(上牙槽座点A至鼻根点N连线与鼻根点至下牙槽座点B连线构成角)和Wits值(Ao点与Bo点间距离)与对照组比较,差异有统计学意义(均P<0.01),上颌骨前移在A组和B组间差异无统计学意义(P>0.05)。B组U6-VRmx平均增加0.46 mm,U1-pp平均增加0.63 mm,均明显小于A组(均P<0.001),提示种植支抗辅助的口内Ⅲ类牵引能减少磨牙前移和上颌切牙唇倾。结论种植支抗辅助的口内Ⅲ类牵引能明显减少磨牙前移和上颌切牙唇倾等不利的牙齿移动。Objective To evaluate and compare the outcomes of maxillary protraction treatment assisted by temporary anchorage devices(TADs)and removable biteplate in cleft lip and palate patients using cephalometric analysis.Methods Fifty-four cleft lip and palate patients were divided into 3 groups based on different maxillary protraction treatments:bitepalate removable appliance group(group A),maxillary protraction treatment assisted by TADs group(group B)and control group(group C).Lateral cephalograms were taken at the start and the end of maxillary protraction.Skeletal,dental and soft tissue changes were measured using Dolphin software and compared between groups.Results The average protraction time of groups A and B were(8.51±1.33)and(9.20±1.45)months(P=0.146),respectively.A point moved forward by 4.08 mm in group A and 4.83 mm in group B were noted,without significant differences between the two groups.Compared to group C,ANB and wits was highly improved after protraction in groups A and B.U6-VRmx increased by 0.46 mm and U1-pp increased by 0.63 mm in group B,both of which were significantly smaller than those of group A(both P<0.05),suggesting that maxillary protraction treatment assisted by TADs could reduce molar advancement and upper incisor protrusion.Conclusions Both maxillary protraction treatment assisted by TADs and removable biteplate could significantly improve skeletal classⅢmalocclusion in unilateral cleft and palate patients.Maxillary protraction treatment assisted by TADs could reduce molar advancement and upper incisor protrusion.

关 键 词：唇裂 腭裂 骨性Ⅲ类错合畸形 种植支抗 前方牵引 头影测量 

分 类 号：R782[医药卫生—口腔医学]