下颌前导矫形与单纯拔牙矫治骨性Ⅱ类错中相关软组织角度测量与分析

上海口腔医学 ›› 2016, Vol. 25 ›› Issue (1): 82-86.

下颌前导矫形与单纯拔牙矫治骨性Ⅱ类错中相关软组织角度测量与分析

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，口腔特需科；
2.上海市口腔医学重点实验室，上海 200011

收稿日期:2015-03-03 修回日期:2015-05-12 出版日期:2016-02-25 发布日期:2016-03-09
通讯作者: 沈刚，Tel：021-23271699-5278，E-mail:gangshen@orthosh.com
作者简介:宫耀（1967-），女，硕士，副主任医师, E-mail:gongyao0328@hotmail.com

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

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

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

Received:2015-03-03 Revised:2015-05-12 Online:2016-02-25 Published:2016-03-09

摘要/Abstract

摘要： 目的： 通过X线头影测量对软组织侧貌角度的分析，评价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病例的临床疗效。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例采用传统的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，进行软组织侧貌角度测量分析。使用SPSS15.0软件包比较前导矫形组、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： 2组中，软组织面角、全面凸角、下唇角、上下唇角治疗后均有明显变化。前导矫形组中，面凸角、上下唇基角以及下唇基角治疗前、后差异显著；而单纯拔牙组中，上唇角、Z角治疗后有明显变化。前导矫形组下唇颏唇沟部软组织与鼻底之间的改变大于拔牙组，而拔牙组的上唇软组织改变大于前导矫形组，2组间上唇角、上下唇基角治疗前后差值的差异均有统计学意义。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类下颌后缩的患者中，固定式Twin-Block矫治器的应用更有利于面下1/3软组织侧貌的改善。

关键词: 骨性Ⅱ类错畸形, Twin-Block矫治器, 拔牙矫治, 软组织角度测量分析

Abstract: PURPOSE: This cephalometric study was designed to evaluate the soft tissue profile effects of Twin-Block combined with straight wire appliances in the treatment of skeletal Class Ⅱ malocclusion with mandibular retrognathia in growing individuals by angulation. METHODS： The sample comprised 31 growing individuals with skeletal Class Ⅱ and mandibular retrognathia, which were divided into 2 groups. One group (18 patients) was treated with fixed Twin-Block combined with fixed appliance， the other 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. Angular cephalometric measurements of soft tissue were analyzed statistically. Intragroup and intergroup changes of the 2 groups were evaluated by Student’s t test using SPSS 15.0 software package. RESULTS: Significant difference of FH-N’Pg’, G-Pn-Pg’, LiSi-SN and SnLs-SiLi were discovered in both groups (P<0.05). With Twin-Block combined with fixed appliance, N’-Sn-Pg’, Sn-N’-Si and Si-N’-S changed significantly, while LsSn-SN and Z angle differed significantly before and after treatment with extraction and fixed appliance. After treatment of Twin-Block combined with fixed appliance, Sn-N’-Si decreased significantly, and the difference between the change of the 2 groups was significant. Meanwhile LsSn-SN was stable in combined treatment group while it decreased greatly after extraction. CONCLUSIONS: Compared with extraction with fixed appliance treatment, Twin-Block combined with fixed appliance treatment is more favorable in promoting lower facial profile in growing skeletal Class Ⅱ individuals with mandibular retrognathia.

Key words: Skeletal Class Ⅱ malocclusion, Twin-Block appliance, Tooth extraction, Soft tissue angular 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类错中相关软组织角度测量与分析[J]. 上海口腔医学, 2016, 25(1): 82-86.

GONG Yao, LI Pei-lun, WANG Hong-hong, YU Quan, WEI Bin.. Soft tissue angle evaluation of fixed Twin-Block appliance treatment and tooth extraction treatment in skeletal Class Ⅱ malocclusion[J]. Shanghai Journal of Stomatology, 2016, 25(1): 82-86.

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