弹性矫治器在Ⅱ类错[牙合]畸形早期矫治中的中长期疗效评估与生长监控  

Medium and long-term evaluation of the efficacy and growth monitoring of elastic appliances in the early orthodontic treatment of ClassⅡmalocclusion

作　　者：罗平贤 王江婷 张瑞晶 陈梅 刘林毅 佘芮 温秀杰 LUO Pingxian;WANG Jiangting;ZHANG Ruijing;CHEN Mei;LIU Linyi;SHE Rui;WEN Xiujie(Department of Orthodontics,The Affiliated Stomatology Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China;Department of Orthodontics,Chongqing Ruitai Stomatological Hospital,Chongqing 401121,China)

机构地区：[1]西南医科大学附属口腔医院正畸科,四川泸州646000 [2]重庆瑞泰口腔医院正畸科,重庆401121

出　　处：《重庆医学》2025年第3期689-695,共7页Chongqing Medical Journal

摘　　要：目的探讨弹性矫治器在Ⅱ类错[牙合]畸形早期矫治中的临床效果。方法选取2018年6月至2023年8月西南医科大学附属口腔医院收治的15例7~9岁儿童作为观察组,同期在该院咨询但未治疗的15例儿童作为对照组,评估两组治疗观察前后的骨组织、牙及牙槽组织、软组织及咬合关系的变化;另外每8~10个月收集观察组4阶段X线片,进行全程动态监测。结果两组治疗前各指标比较,差异均无统计学意义(P>0.05);治疗后,两组骨组织中上下牙槽座角(ANB)、下颌支长(GO-CO)、下面高(ANS-Me)、下颌位置(S-GO)、上中切牙倾斜度(U1-NA角)、上中切牙倾斜度凸度(U1-NA)、下中切牙突距(L1-APo),软组织中Z角、软组织面角(FH-N’Pg’)比较,差异均有统计学意义(P<0.05);观察组治疗后覆(OB)、覆盖(OJ)均低于对照组,磨牙关系中ClassⅠ患者所占比例高于对照组,差异均有统计学意义(P<0.05)。经过3~4年的治疗ANB逐渐减小,前颅底平面-下颌平面角(SN-MP)基本维持稳定,在后期有轻微减小趋势;U1-NA角、下中切牙倾斜度(L1-NB角)在整个治疗过程中趋近正常均值水平。结论利用弹性矫治器治疗早期Ⅱ类错[牙合]患者,经过3~4年监控引导后,可有效改善磨牙关系及覆[牙合]覆盖,促进下颌向前生长使面部软组织侧貌协调美观。Objective To evaluate the efficacy of elastic appliances in the early correction of ClassⅡmalocclusions in the replacement dentition.Methods A total of 15 children aged 7-9 years who were admitted to the Affiliated Stomatology Hospital of Southwest Medical University from June 2018 to August 2023 were selected as the observation group,and 15 children who were consulted but not treated in the hospital during the same period were selected as the control group.The changes of bone tissue,dental and alveolar tissue,soft tissue and occlusal relationship before and after treatment were evaluated in the two groups.In addition,X-ray images of the observation group were collected every 8 to 10 months for the whole process dynamic monitoring.Results Before treatment,there was no significant difference in all indexes between the two groups(P>0.05).After treatment,there were statistical significances in the upper and lower alveolar base Angle(ANB),mandibular branch length(GO-CO),mandibular height(ANS-Me),mandibular position(S-GO),upper central incisor inclination(U1-NA Angle),upper central incisor inclination convexity(U1-NA),lower central incisor process distance(L1-APo),the Z Angle and FH-N’Pg’Angle of soft tissue between the two groups(P<0.05).After treatment,the covering OB and covering OJ in the observation group were lower than those in the control group,and the proportion of ClassⅠpatients in molar relationship was higher than that in the control group,with statistical significance(P<0.05).After 3-4 years of treatment,ANB gradually decreased,and the anterior-basilar plane-mandibular plane Angle(SN-MP)remained basically stable,and had a slight decreasing trend in the later period.The U1-NA Angle and the lower central incisor inclination(L1-NB Angle)were close to the normal mean during the whole treatment.Conclusion Using elastic appliances to treat patients with early replacement ClassⅡmalocclusion,after 3-4 years monitoring and guidance,it can effectively improve the molar relationship,promote forward jaw gro

关 键 词：儿童 Ⅱ类错[牙合]畸形 早期矫治 弹性矫治器 肌功能治疗 

分 类 号：R783.5[医药卫生—口腔医学]