上海口腔医学

上海口腔医学 ›› 2022, Vol. 31 ›› Issue (6): 643-647.doi: 10.19439/j.sjos.2022.06.014

• 论著 • 上一篇    下一篇

骨皮质切开术上颌快速扩弓辅助正畸-正颌联合治疗骨性Ⅲ类错畸形效果分析

窦尉尉1,2, 岳从雷2, 张家坤3, 张广德2, 沙耀利3, 刘娟3, 靳霞2, 杜衍晓4   

  1. 1.天津医科大学 研究生院,天津 300203;
    2.济宁口腔医院 口腔颌面外科; 3.济宁口腔医院 口腔正畸科,山东 济宁 272000;
    4.淮安市第五人民医院（淮安市淮阴人民医院） 口腔科,江苏 淮安 223399
  • 收稿日期:2021-10-22 修回日期:2021-12-02 发布日期:2022-12-29
  • 通讯作者: 杜衍晓,E-mail：yanxiaodu@126.com
  • 作者简介:窦尉尉（1984-）,男,硕士研究生,主治医师,E-mail：mason914@163.com
  • 基金资助:
    山东省医药卫生科技发展计划项目（202008030322）

Clinical effect of cortical incision with rapid maxillary expansion to assist orthodontic-orthognathic treatment of skeletal Class Ⅲ malocclusion

DOU Wei-wei1,2, YUE Cong-lei2, ZHANG Jia-kun3, ZHANG Guang-de2, SHA Yao-li3, LIU Juan3, JIN Xia2, DU Yan-xiao4   

  1. 1. Graduate School of Tianjin Medical University. Tianjin 300203;
    2. Department of Oral and Maxillofacial Surgery, 3. Department of Orthodontics, Jining Dental Hospital. Jining 272000, Shandong Province;
    4. Department of Stomatology, The Fifth People's Hospital of Huai'an(Huaiyin People's Hospital of Huai'an). Huai'an 223399, Jiangsu Province, China
  • Received:2021-10-22 Revised:2021-12-02 Published:2022-12-29

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摘要： 目的: 探讨骨皮质切开术上颌快速扩弓辅助正畸-正颌联合治疗骨性Ⅲ类错畸形的临床效果。方法: 选择2018年3月—2020年5月济宁口腔医院收治的84例骨性Ⅲ类错畸形患者,随机分为实验组与对照组,每组各42例。对照组采用正畸-正颌联合治疗,实验组采用骨皮质切开术上颌快速扩弓辅助正畸-正颌联合治疗。比较2组患者关闭间隙时间、排齐时间,上颌第一磨牙、上颌中切牙矢状方向牙移动距离。治疗前、治疗4周后分别测量上中切牙边缘终点至水平面的垂直距离（U1I-HP）、上中切牙根尖至冠状面的距离（U1I-CP）、上牙槽缘点至冠状面的垂直距离（Sd-CP）、上牙槽座点至水平面的垂直距离（A-HP）、唇上点至冠状面的垂直距离（Ls-CP）和鼻下点至冠状面的垂直距离（Sn-CP）,计算相关变化量,比较治疗期间2组患者并发症发生情况。采用SPSS 20.0软件包对数据进行统计学分析。结果: 2组排齐时间、A-HP变化量、Sn-CP变化量、上颌第一磨牙近中移动距离及上颌中切牙向远中移动距离相比,差异均无统计学意义（P>0.05）。实验组关闭间隙时间比对照组短（P<0.05）;实验组U1I-HP、U1I-CP、Sd-CP、Ls-CP变化量比对照组高（P<0.05）。2组治疗期间并发症发生率相比,差异无统计学意义（P>0.05）。结论: 骨皮质切开术上颌快速扩弓辅助正畸-正颌联合治疗骨性Ⅲ类错畸形患者可缩短关闭间隙时间,提高治疗效果,对牙矢状方向无明显影响。

关键词: 骨皮质切开术, 上颌快速扩弓, 正畸-正颌, 骨性Ⅲ类错畸形

Abstract: PURPOSE: To investigate the clinical effect of rapid maxillary expansion with cortical osteotomy combined with orthodontic- orthognathic treatment for skeletal Class Ⅲ malocclusion. METHODS: A total of 84 patients with skeletal Class Ⅲ malocclusion admitted to Jining Dental Hospital from March 2018 to May 2020 were randomly divided into experimental group and control group, with 42 cases in each group. The control group was treated with orthodontic-orthognathic treatment, while the experimental group was treated with orthodontic-orthognathic treatment with rapid maxillary arch expansion by cortical incision. The time of closing gap, alignment time, maxillary first molar and maxillary central incisor tooth movement distance in the sagittal direction were compared between the two groups. Before treatment and 4 weeks after treatment, the vertical distance from the end of the upper central incisor edge to the horizontal plane(U1I-HP), the distance from the apex of the upper central incisor to the coronal plane(U1I-CP), the vertical distance from the edge of the upper pressure groove to the coronal plane(Sd-CP), the vertical distance from the upper alveolar seat point to the horizontal plane(A-HP), the vertical distance from the point of the upper lip to the coronal plane(Ls-CP), and the vertical distance from the inferior point of nose to coronal plane(Sn-CP) were measured, and the relevant changes were calculated. During the treatment period, the complications of the two groups were compared. SPSS 20.0 software package was used for statistical analysis of the data. RESULTS: There was no significant difference in alignment time, A-HP change, Sn-CP change, maxillary first molar movement distance and maxillary central incisor movement distance between the two groups (P>0.05). The closing interval in the experimental group was significantly shorter than that of the control group (P<0.05). The changes of U1I-HP, U1I-CP, Sd-CP, and Ls-CP in the experimental group were significantly higher than those in the control group (P<0.05). There was no significant difference in the incidence of complications between the two groups during treatment (P>0.05). CONCLUSIONS: Rapid maxillary expansion of cortical incision assisted orthodontic-orthognathic treatment of skeletal Class Ⅲ malocclusion patients can shorten the closing gap time and improve the treatment effect, which has no obvious influence on the sagittal direction of the teeth.

Key words: Cortical incision, Rapid maxillary expansion, Orthodontic-orthognathic treatment, Skeletal Class Ⅲ malocclusion

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