下颌前导矫形与单纯拔牙矫治骨性Ⅱ类错 中软组织线距测量与分析

上海口腔医学 ›› 2015, Vol. 24 ›› Issue (2): 232-235.

下颌前导矫形与单纯拔牙矫治骨性Ⅱ类错中软组织线距测量与分析

宫耀¹,李佩伦¹,汪虹虹¹,于泉¹,魏斌²,沈刚¹

1. 上海交通大学医学院附属第九人民医院·口腔医学院口腔正畸科,上海市口腔医学重点实验室,上海 200011;
2. 上海交通大学医学院附属第九人民医院·口腔医学院口腔特需科,上海市口腔医学重点实验室,上海 200011

收稿日期:2015-03-02 出版日期:2015-04-20 发布日期:2015-07-24
通讯作者: 沈刚,Tel：021-23271699-5278,E-mail:gangshen@orthosh.com
作者简介:宫耀（1967-）,女,学士,副主任医师, E-mail:gongyao0328@hotmail.com

Soft tissue linear evaluation of fixed Twin-block appliance treatment and tooth extraction in skeletal Class Ⅱ malocclusion

GONG Yao¹,LI Pei-lun¹,WANG Hong-hong¹,YU Quan¹,WEI Bin²,SHEN Gang¹

1. Department of Orthodontics, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology. Shanghai 200011, China;
2. Department of First Dental Clinic, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology. Shanghai 200011, China

Received:2015-03-02 Online:2015-04-20 Published:2015-07-24

摘要/Abstract

摘要： 目的通过X线头影测量软组织侧貌线距,评价并比较前导矫形联合固定矫治器与单纯拔牙对治疗生长发育期安氏Ⅱ类骨性错的疗效。方法选取31例生长发育期安氏Ⅱ类错伴下颌后缩的病例。其中18例采用Ⅰ期固定式Twin-Block矫治器联合Ⅱ期固定矫治;13例采用传统单纯拔牙后直丝弓矫治进行治疗。在治疗前、Twin-block矫治完成后以及全部固定矫治结束后拍摄X线头颅侧位片,进行软组织侧貌线距测量分析。使用SPSS15.0软件包分别比较前导矫形组、单纯拔牙组治疗前、后的组内差异以及2组的组间差异。结果前导矫形组下颌凸距、下唇厚度、颏唇沟厚度、上唇凸距在治疗前后差值改变均有显著性,单纯拔牙组在下唇厚度、下唇凸距、上唇凸距的治疗前后差值改变均有显著性。2组进行比较,下唇凸距治疗前、后差值的改变有显著性,而下颌凸距、上颌凸距、下唇厚度、上唇凸距、颏唇沟厚度在治疗前后差值的改变无显著性。结论前导矫形联合固定矫治与单纯拔牙固定矫治相比,在治疗生长发育期骨性Ⅱ类下颌后缩患者中的疗效相近,而前导矫形组对下唇凸度的改变大于拔牙组。

关键词: 骨性Ⅱ, 类错, Twin-block矫治器, 拔牙矫治, 软组织线距测量分析

Abstract: PURPOSE: This cephalometric study was designed to evaluate the soft tissue profile effects of Twin-block combined with straight wire appliances to treat growing adolescents with skeletal Class Ⅱ malocclusion and mandibular retrognathia. METHODS: The samples comprised 31 growing individuals with skeletal Class Ⅱ and mandibular retrognathia. They were divided into 2 groups. The study group (18 patients) was treated with fixed Twin-block combined with fixed appliance, while the control group (13 patients) was only treated with fixed appliance after tooth extraction. Pretreatment and posttreatment lateral cephalograms were taken before and after Twin-block treatment and after all the fixed appliance treatment. Linear cephalometric measurements of soft tissue were analyzed statistically. Intragroup and intergroup changes of the 2 groups were evaluated using SPSS 15.0 software package. RESULTS: Significant changes of G'-Pg', Li-1, Si-B and Ls-E line between before and after treatment were found in the study group, while Li-1, Ls-E line and Li-E line changed significantly in control group. The change of Li-E line was different between the 2 groups. CONCLUSIONS: Twin-block combined with fixed appliance treatment is better than extraction with fixed appliance treatment in promoting lower facial profile in cases of skeletal Class Ⅱ malocclusion and mandibular retrognathia with growth potentials.

Key words: Skeletal Class Ⅱ, malocclusion, Twin-block appliance, Tooth extraction, Soft tissue linear cephalometric analysis

中图分类号:

R783.5

宫耀,李佩伦,汪虹虹,于泉,魏斌,沈刚. 下颌前导矫形与单纯拔牙矫治骨性Ⅱ类错中软组织线距测量与分析[J]. 上海口腔医学, 2015, 24(2): 232-235.

GONG Yao,LI Pei-lun,WANG Hong-hong,YU Quan,WEI Bin,SHEN Gang. Soft tissue linear evaluation of fixed Twin-block appliance treatment and tooth extraction in skeletal Class Ⅱ malocclusion[J]. Shanghai Journal of Stomatology, 2015, 24(2): 232-235.

参考文献

[1] 傅民魁, 张丁,王邦康, 等. 中国25392名儿童与青少年错畸形患病率的调查 [J]. 中华口腔医学杂志, 2002, 37(5): 51-53.
[2] 傅民魁. 口腔正畸学[M]. 北京: 人民卫生出版社,2003.
[3] McNamara JA Jr. Components of class Ⅱ malocclusion in children 8-10 years of age [J]. Angle Orthod, 1981, 51(3): 177-202.
[4] Moyers RE, Riolo ML, Guire KE, et al. Differential diagnosis of class Ⅱ malocclusions. Part 1. Facial types associated with Class Ⅱ malocclusions [J].Am J Orthod, 1980, 78(5): 477-494.
[5] 邹冰爽, 曾祥龙, 曾应魁. 安氏Ⅱ 1 错颅面类型的研究 [J]. 口腔正畸学, 1998, 5(1): 61.
[6] Williams R, Hosila FJ. The effect of different extraction sites upon incisor retraction [J]. Am J Orthod, 1976, 69(4): 388-410.
[7] Tulloch JF, Phillips C, Koch G, et al. The effects of early intervention on skeletal pattern in Class Ⅱ maloeclusion: a randomized clinical trial [J]. Am J Orthod Dentofacial Orthop, 1997, 111(4): 391-400.
[8] O’Brien K, Wright J, Conboy F, et al. Effectiveness of early orthodontic treatment with the Twin-block appliance: a multicenter, randomized, controlled trial. Part 2 : psychosocial effects [J]. Am J Orthod Dentofacial Orthop, 2003, 124(5): 488-494.
[9] Shaw WC, O’Brien KD, Riehmond S, et al. Quality control in orthodontics: risk/benefit considerations [J].Br Dent J, 1991, 170(l): 33-37.
[10] 李巍然. Twin block 在安氏Ⅱ类错治疗中的应用 [J].中华口腔正畸学杂志, 2004, 22(1): 25-28.
[11] 彭静, 邓辉, 曹采方. 7-12岁女性儿童的颅上颌复合体深度变化的纵向研究[J]. 口腔正畸学, 2001, 8(4): 164-167.
[12] Pancherz H. Treatment of Class Ⅱ malocclusions by jumping the bite with the Herbst appliance. A cephalometric investigation [J]. Am J Orthod, 1979, 76(4): 423-442.
[13] Pancherz H. The mechanism of Class Ⅱ correction in Herbst appliance treatment. A cephalometric investigation [J]. Am J Orthod, 1982, 82(2): 104-113.
[14] Pancherz H.The Herbst appliance-its biologic effects and clinical use [J]. Am J Orthod, 1985, 87(1): 1-20.
[15] Hägg U, Pancherz H. Dentofacial orthopaedics in relation to chronological age, growth period and skeletal development. An analysis of 72 male patients with Class Ⅱ division 1 malocclusion treated with the Herbst appliance [J]. Eur J Orthod, 1988, 10(3): 169-176.
[16] 肖林喜. 西北地区近5 年来拔牙矫治回顾性研究[D].西安: 第四军医大学, 2000: 17-20.