改良上颌前方牵引对生长发育高峰后期上颌发育不足患者软组织侧貌的影响  

The effects of modified maxillary protraction on the soft tissue profile of patients with maxillary hypoplasia during the later period of pubertal peak

作　　者：周孙欣 霍娜[1] 李帅臣 李天琪 孟祥博 王恒心 张彤[1] ZHOU Sunxin;HUO Na;LI Shuaichen;LI Tianqi;MENG Xiangbo;WANG Hengxin;ZHANG Tong(Department of Stomatology,First Medical Center,PLA General Hospital,Chinese PLA Medical School,China,100853 Beijing)

机构地区：[1]解放军总医院第一医学中心口腔科,解放军医学院,北京100853

出　　处：《实用口腔医学杂志》2024年第3期365-370,共6页Journal of Practical Stomatology

基　　金：军队后勤科研项目(编号:BKJWS221C002);军队医学科技青年培育计划孵化项目(编号:21QNPY104)。

摘　　要：目的:利用头影测量分析探讨改良上颌前方牵引治疗对上颌发育不足患者面部软组织侧貌的影响。方法:纳入生长发育高峰后期(CVMⅤ~Ⅵ期)骨性Ⅲ类错[牙合]畸形伴上颌发育不足病例26例(男16例,女10例),使用改良[牙合]垫式口内矫治器配合双杆式上颌前方牵引器进行治疗,治疗前后拍摄头颅侧位片进行头影测量分析,比较面部软组织相关指标变化。结果:(1)治疗前后面中部软组织相关标志点突距测量值增加(P<0.05),其中鼻尖点、鼻底点、软组织A点和上唇突点的平均前移量均超过3mm;(2)治疗后面型角、全面凸角与上唇基角的变化具有高度显著性(P<0.01),其中面型角平均增大3.23°±3.74°,全面凸角平均减小2.56°±4.99°,上唇基角平均增大2.63°±3.39°;(3)治疗后软组织张力及面高比例的变化无统计学意义(P>0.05)。结论:应用改良[牙合]垫式口内矫治器配合双杆式上颌前方牵引器能有效促进生长发育高峰后期上颌发育不足患者面中部软组织侧貌的改善,协调鼻唇颏软组织关系。Objective:To study the effects of modified maxillary protraction therapy on the changes in facial soft tissue in patients with maxillary hypoplasia using cephalometric measurements.Methods:26 cases(16 males and 10 females)of ClassⅢskeletal malocclusion with maxillary hypoplasia during the later period of pubertal peak(CVMⅤtoⅥ)were included.Treatment was carried out using modified palatal anchorage with a combination of a modified bite-jumping appliance and bilateral maxillary anterior traction.Cephalometric measurements were taken before and after treatment using lateral cephalograms,the changes in facial soft tissue-related parameters were compared.Results:(1)After treatment,the measurements of soft tissue landmarks in the midfacial region showed a significant increase(P<0.05),with the average anterior movement exceeding 3 mm for the nasal tip,subnasale,soft tissue A point and upper lip protrusion point.(2)The changes in the G-Sn-Pos,Ns-Prn-Pos,and S-Ns-Sn were highly significant(P<0.01),with an average increase in the G-Sn-Pos of 3.23°±3.74°,a decrease in Ns-Prn-Pos of 2.56°±4.99°,and an average increase in S-Ns-Sn of 2.63°±3.39°.(3)Changes in soft tissue tension and facial height proportion after treatment were not statistically significant(P>0.05).Conclusion:The use of a modified pad type intraoral appliance in conjunction with bilateral maxillary anterior traction can effectively promote the improvement of mid facial soft tissue profile in patients with maxillary underdevelopment during the peak growth and development period,and coordinate the relationship between nasal,lip and chin soft tissue.

关 键 词：上颌前方牵引 上颌发育不足 软组织侧貌 头影测量分析 

分 类 号：R783.5[医药卫生—口腔医学]