两种扩弓方式配合前方牵引治疗骨性Ⅲ类错𬌗畸形的效果评价

doi:10.19439/j.sjos.2025.04.017

上海口腔医学 ›› 2025, Vol. 34 ›› Issue (4): 440-443.doi: 10.19439/j.sjos.2025.04.017

两种扩弓方式配合前方牵引治疗骨性Ⅲ类错𬌗畸形的效果评价

董作英, 尚金正, 孙玉, 苟乃政

青岛市胶州中心医院口腔科, 山东青岛 266300

收稿日期:2024-11-22 修回日期:2024-12-30 出版日期:2025-08-25 发布日期:2025-08-26
通讯作者: 苟乃政,E-mail：Gounaizheng2005@126.com
作者简介:董作英（1982-）,硕士,主治医师,E-mail: dongzuoying@126.com

Evaluation of the effect of two types of arch expansion combined with maxillary protraction in the treatment of Class III bony malformations

Dong Zuoying, Shang Jinzheng, Sun Yu, Gou Naizheng

Department of Stomatology, Qingdao Jiaozhou Central Hospital. Qingdao 266300, Shandong Province, China

Received:2024-11-22 Revised:2024-12-30 Online:2025-08-25 Published:2025-08-26

摘要/Abstract

摘要： 目的：评价上颌快速扩弓与上颌交替快速扩缩配合前方牵引治疗骨性Ⅲ类错𬌗畸形的效果。方法：选择青岛市胶州中心医院2021年5月—2024年4月收治的82例骨性Ⅲ类错𬌗畸形患者,按就诊时间分为两组,对照组（n=40）采用上颌快速扩弓配合前方牵引,试验组（n=42）采用上颌交替式快速扩缩配合前方牵引,比较两组矫治效果。结果：治疗后3个月,试验组Z角、H角和上唇突角显著高于对照组,下唇倾角显著低于对照组（P<0.05）;试验组SNA、U1-NA、ANB、最大咬合接触面积和最大咬合力显著高于对照组,U1-L1、SNB显著低于对照组（P<0.05）;试验组咀嚼效率、口腔健康影响程度量表（OHIP-14）评分显著高于对照组（P<0.05）。结论：上颌交替式快速扩缩配合前方牵引能提高骨性Ⅲ类错𬌗畸形患者咬合功能和咀嚼效率,改善患者软、硬组织指标。

关键词: 前方牵引, 上颌快速扩弓, 上颌交替式快速扩缩, 骨性Ⅲ类错𬌗畸形

Abstract: PURPOSE: To evaluate the efficacy of rapid maxillary expansion and maxillary alternate rapid expansion combined with maxillary protraction in the treatment of Class III bony malformations. METHODS: A total of 82 patients with skeletal Class III malocclusion admitted to Jiaozhou Central Hospital of Qingdao from May 2021 to April 2024 were selected and divided into two groups according to admission time. The control group (n=40) was treated with simple maxillary rapid arch expansion combined with maxillary protraction. The experimental group (n=42) was treated with maxillary alternate rapid expansion and contraction combined with maxillary protraction, the therapeutic effect of the two groups was compared. RESULTS: Three months after treatment, the Z-angle, H-angle and upper lip angle of the experimental group were significantly higher than those of the control group, and the lower lip inclination was significantly lower than that of the control group(P<0.05). SNA, U1-NA, ANB indexes, maximum occlusal contact area and maximum biting force in the experimental group were significantly higher than those in the control group, while U1-L1 and SNB indexes were significantly lower than those in control group (P<0.05). The masticatory efficiency and oral health impact scale (OHIP-14) scores of the experimental group were significantly higher than those of the control group(P<0.05). CONCLUSIONS: Rapid maxillary expansion combined with maxillary protraction can improve the occlusal function and masticatory efficiency of patients with skeletal Class III malocclusion, and improve the soft and hard tissue indexes of the patients.

Key words: Maxillary protraction, Rapid maxillary expansion, Maxillary alternating rapid expansion and contraction, Skeletal Class III malocclusion

中图分类号:

R783.5

董作英, 尚金正, 孙玉, 苟乃政. 两种扩弓方式配合前方牵引治疗骨性Ⅲ类错𬌗畸形的效果评价[J]. 上海口腔医学, 2025, 34(4): 440-443.

Dong Zuoying, Shang Jinzheng, Sun Yu, Gou Naizheng. Evaluation of the effect of two types of arch expansion combined with maxillary protraction in the treatment of Class III bony malformations[J]. Shanghai Journal of Stomatology, 2025, 34(4): 440-443.

参考文献

[1] Elkalza AR, Yacout YM.Effect of SEC III protocol on upper airway dimensions in growing Class III patients: a retrospective study[J]. BMC Oral Health, 2023, 23(1): 841-851.
[2] Wang J, Yang Y, Wang Y, et al.Clinical effectiveness of different types of bone-anchored maxillary protraction devices for skeletal Class III malocclusion: systematic review and network meta-analysis[J]. Korean J Orthod, 2022, 52(5):313-323.
[3] Kim M, Li J, Kim S, et al.Individualized 3D-printed bone-anchored maxillary protraction device for growth modification in skeletal Class III malocclusion[J]. J Pers Med, 2021, 11(11):1087.
[4] Buyukcavus MH, Kale B, Aydemir B.Comparison of treatment effects of different maxillary protraction methods in skeletal Class III patients[J]. Orthod Craniofac Res, 2020, 23(4):445-454.
[5] 李超, 姜欢, 宋东升, 等. 上颌交替快速扩缩治疗骨性Ⅲ类患者的研究进展[J].中华口腔正畸学杂志, 2023, 30(4): 225-228.
[6] 张志愿. 口腔科学[M]. 9版. 北京: 人民卫生出版社, 2018: 79-82.
[7] Serrano J, López-Pintor RM, Fernández-Castro M, et al.Usefulness of implementing the OHIP-14 questionnaire to assess the impact of xerostomia and hyposalivation on quality of life in patients with primary Sjögren's syndrome[J]. J Oral Pathol Med, 2022, 51(9): 810-817.
[8] Rizk MZ, Torgersbråten N, Mohammed H, et al.Stability of single-jaw vs two-jaw surgery following the correction of skeletal Class III malocclusion: a systematic review and meta-analysis[J]. Orthod Craniofac Res, 2021, 24(3):314-327.
[9] Ventura L, Verdonk SJE, Zhytnik L, et al.Dental abnormalities in osteogenesis imperfecta: a systematic review[J]. Calcif Tissue Int, 2024, 115(5): 461-479.
[10] Alshehri A.Bimaxillary distalization with skeletal anchorage for management of severe skeletal Class III open bite malocclusion[J]. Children (Basel), 2022, 9(11):1666.
[11] 赵飘, 陈泽策, 廖成成, 等. 前方牵引治疗的不同方式及比较[J]. 北京口腔医学, 2023, 31(3): 225-228.
[12] 于晓艳, 郅晓雷, 张耐新, 等. 前方牵引联合快速扩弓治疗替牙期骨性Ⅲ类错𬌗畸形的疗效分析[J]. 现代口腔医学杂志, 2020, 34(2): 104-106.
[13] Srivastava SC, Mahida K, Agarwal C, et al.Longitudinal stability of rapid and slow maxillary expansion: a systematic review[J]. J Contemp Dent Pract, 2020, 21(9):1068-1072.
[14] Chamberland S.Maxillary expansion in nongrowing patients. Conventional, surgical, or miniscrew-assisted, an update[J]. J World Fed Orthod, 2023, 12(4):173-183.
[15] Patil GV, Lakhe P, Niranjane P.Maxillary expansion and its effects on circummaxillary structures: a review[J]. Cureus, 2023, 15(1):e33755.
[16] Cornelis MA, Tepedino M, Riis NV, et al.Treatment effect of bone-anchored maxillary protraction in growing patients compared to controls: a systematic review with meta-analysis[J]. Eur J Orthod, 2021, 43(1):51-68.
[17] 刘晔, 葛晓磊, 张士珑, 等. 改良前方牵引矫治器治疗骨性Ⅲ类错𬌗伴拥挤的疗效评价[J]. 上海口腔医学, 2024, 33(2): 180-185.
[18] 杨圣仙. 2种不同前牵引在骨性Ⅲ类错𬌗畸形治疗中的疗效分析[J]. 现代医学与健康研究电子杂志, 2019, 3(23): 45-46.
[19] Emek Kayafoglu G, Esenlik E.Comparison of rapid maxillary expansion and alternate rapid maxillary expansion and constriction protocols with face mask therapy[J]. Turk J Orthod, 2023, 36(4):231-238.
[20] Lee WC, Shieh YS, Liao YF, et al.Long-term maxillary anteroposterior changes following maxillary protraction with or without expansion: a meta-analysis and meta-regression[J]. PLoS One, 2021, 16(2):e0247027.
[21] 郭靖晗, 郭姜莉, 王可鑫, 等. 前方牵引对骨性Ⅲ类口呼吸儿童面型及上气道的影响[J]. 临床口腔医学杂志, 2024, 40(3): 151-155.

两种扩弓方式配合前方牵引治疗骨性Ⅲ类错𬌗畸形的效果评价

Evaluation of the effect of two types of arch expansion combined with maxillary protraction in the treatment of Class III bony malformations

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 13

编辑推荐

Metrics

本文评价

[1]	刘晔, 葛晓磊, 张士珑, 覃缘, 侯彦, 卢海燕, 马文盛. 改良前方牵引矫治器治疗骨性Ⅲ类错𬌗伴拥挤的疗效评价[J]. 上海口腔医学, 2024, 33(2): 180-185.
[2]	窦尉尉, 岳从雷, 张家坤, 张广德, 沙耀利, 刘娟, 靳霞, 杜衍晓. 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[J]. 上海口腔医学, 2022, 31(6): 643-647.
[3]	黄纯, 温馨, 黄乐, 赵宁. 上颌前方牵引对恒牙早期骨性Ⅲ类错上、下颌骨宽度影响的三维模拟分析[J]. 上海口腔医学, 2022, 31(5): 550-555.
[4]	孟坤, 孙健, 李亚莉, 刘延山, 陈晨, 徐泽先, 孙鸣, 张秀秀, 周东阳. 正颌手术对骨性Ⅲ类错畸形患者语音功能的影响[J]. 上海口腔医学, 2021, 30(4): 394-401.
[5]	刘明瑾, 李乐, 陈菊芳, 郝鑫, 杨儒, 田玉楼. 舌刺联合头帽颏兜与前方牵引矫治前牙反的疗效比较[J]. 上海口腔医学, 2021, 30(4): 429-434.
[6]	刘青, 陈菲, 卢成焱, 李静, 李晓乐, 张君. 槲皮素在大鼠上颌快速扩弓时对腭中缝骨改建的影响[J]. 上海口腔医学, 2020, 29(1): 1-6.
[7]	姜卫, 夏松, 月慧, 李晓智. 上颌快速扩弓联合前方牵引后骨性Ⅲ类伴上颌骨发育不足患者上气道变化的meta分析[J]. 上海口腔医学, 2019, 28(2): 218-224.
[8]	徐超, 王旭霞, 王英姿, 杨盼盼, 赵姝亚, 张君. 雷奈酸锶对大鼠快速扩弓过程中腭中缝BMP-2表达的影响[J]. 上海口腔医学, 2016, 25(6): 647-651.
[9]	章依文, 沈刚. 上颌骨前方牵引配合快速括弓治疗骨性Ⅲ类错牙合畸形的疗效分析[J]. 上海口腔医学, 2016, 25(3): 327-333.
[10]	张晓洁,郑苍尚,张敏. Herbst配合口外弓及上颌快速扩弓结合直丝弓种植支抗矫正骨性Ⅱ类错的效果评价[J]. 上海口腔医学, 2015, 24(3): 361-366.
[11]	秦燕军, 沈云娟, 谷妍, 王珊, 刘可, 赵春洋. 骨性Ⅲ类畸形上颌前方牵引治疗的三维测量分析[J]. 上海口腔医学, 2014, 23(6): 699-703.
[12]	刘宛鑫, 王旭霞, 张文娟, 董瑞, 陈云, 张君,. 前方牵引矫治器不同力值反作用力的三维有限元分析[J]. 上海口腔医学, 2013, 22(5): 498-503.
[13]	陈析华;谢兴潜. 2种不同扩弓方法对恒牙早期骨性Ⅲ类错?前方牵引的影响 [J]. 上海口腔医学, 2012, 21(5): 580-583.