改良前方牵引矫治器治疗骨性Ⅲ类错[牙合]伴拥挤的疗效评价  

Evaluation of a modified maxillary protraction appliance for the treatment of patients with skeletal ClassⅢmalocclusion associated with crowding

作　　者：刘晔[1] 葛晓磊 张士珑 覃缘 侯彦[1] 卢海燕[1] 马文盛[1] LIU Ye;GE Xiao-lei;ZHANG Shi-long;QIN Yuan;HOU Yan;LU Hai-yan;MA Wen-sheng(Department of Orthodontics,School and Hospital of Stomatology,Hebei Medical University,Hebei Key Laboratory of Stomatology,Hebei Clinical Research Center for Oral Diseases.Shijiazhuang 050017,Hebei Province;Department of Orthodontics,Suining Central Hospital.Suining 629000,Sichuan Province,China)

机构地区：[1]河北医科大学口腔医学院·口腔医院正畸科,河北省口腔医学重点实验室,河北省口腔疾病临床医学研究中心,河北石家庄050017 [2]遂宁市中心医院口腔医学中心,四川遂宁629000

出　　处：《上海口腔医学》2024年第2期180-185,共6页Shanghai Journal of Stomatology

基　　金：河北省医学科学研究重点课题计划(20180609);河北医科大学口腔医院自主培育计划(kq201934)。

摘　　要：目的:评价改良前方牵引矫治器治疗骨性Ⅲ类错[牙合]伴拥挤的疗效。方法:将40例骨性Ⅲ类错[牙合]患者,按磨牙关系分为2组,每组20例,试验组磨牙中性或远中关系,应用改良前方牵引矫治器;对照组磨牙近中关系,应用传统前方牵引矫治器。2组患者治疗前后分别拍摄头颅侧位片进行比较,采用SPSS 22.0软件包对数据进行统计学分析。结果:2组患者治疗前后角度测量中,SNA、ANB、SN-MP、U4-SN显著增加(P<0.01),SNB显著减小(P<0.01);SN-OL在试验组治疗前后变化有显著差异(P<0.05)。2组患者治疗前后矢状向测量指标中,除对照组上颌牙弓长度外,其余指标均有显著改变(P<0.05);垂直向测量指标中,U1-PP、L1-MP、U4-SN、U6-SN、ANS-Me显著增加(P<0.05);U4-PP、U6-PP在对照组治疗前后的变化有显著差异(P<0.05)。2组患者治疗前后头影测量值变化量与对照组相比,试验组治疗后上颌牙弓长度显著增加,U6位置更偏远中,磨牙关系变化更小(P<0.01)。结论:改良前方牵引矫治器对磨牙中性或远中关系的骨性Ⅲ类错[牙合]伴拥挤患者具有良好的前方牵引和推磨牙向远中的效果。PURPOSE:To investigate the efficacy of a modified maxillary protraction appliance in patients of skeletal ClassⅢwith crowding.METHODS:Forty patients with skeletal ClassⅢmalocclusion were divided into two groups,with 20 patients in each group.The experimental group had molar in a neutral or distal relationship and applied a modified maxillary protraction appliance,while the control group had molar mesial relationship and applied a conventional maxillary protraction appliance.Lateral cephalometric radiographs were taken before and after treatment in both groups for comparison.SPSS 22.0 software package was used for data analysis.RESULTS:The angle measurements taken before and after treatment showed a significant increase in SNA,ANB,SN-MP and U4-SN(P<0.01),while SNB decreased(P<0.01)in both groups.SN-OL changes were statistically different before and after treatment in the experimental group(P<0.05).The sagittal measurements before and after treatment in both groups showed significant alterations in all(P<0.05)but the length of the maxillary arch in both groups.For vertical measurements,U1-PP,L1-MP,U4-SN,U6-SN,and ANS-ME all increased(P<0.05),while the changes of U4-PP and U6-PP in the two groups before and after treatment were statistically different(P<0.05).Compared with the control group,the experimental group had a significantly increased maxillary arch length,a more remote location at U6,and a less variable molar relationship after treatment(P<0.01).The two groups showed a variable amount of cephalometric measurements before and after treatment: the experimental group had a significant increase in maxillary arch length, a more remote position at U6, and a smaller change in molar relationship compared to the control group(P<0.01). CONCLUSIONS: The modified maxillary protraction appliance showed good results for maxillary protraction and pushing the molar distally in patients with skeletal Class Ⅲ with crowding at neutral or distal molar relationship.

关 键 词：骨性Ⅲ类错[牙合] 改良前方牵引 牙列拥挤 推磨牙向远中 

分 类 号：R783.5[医药卫生—口腔医学]