上海口腔医学

上海口腔医学 ›› 2024, Vol. 33 ›› Issue (2): 180-185.doi: 10.19439/j.sjos.2024.02.013

• 论著 • 上一篇    下一篇

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

刘晔1, 葛晓磊1, 张士珑1, 覃缘2, 侯彦1, 卢海燕1, 马文盛1   

  1. 1.河北医科大学口腔医学院·口腔医院 正畸科,河北省口腔医学重点实验室,河北省口腔疾病临床医学研究中心,河北 石家庄 050017;
    2.遂宁市中心医院 口腔医学中心,四川 遂宁 629000
  • 收稿日期:2023-03-29 修回日期:2023-06-15 出版日期:2024-04-25 发布日期:2024-05-14
  • 通讯作者: 马文盛,E-mail: wsma02@sina.com,现工作单位为天津市口腔医院
  • 作者简介:刘晔（1982-）,女,硕士,副主任医师,E-mail: liuye226@126.com
  • 基金资助:
    河北省医学科学研究重点课题计划（20180609）; 河北医科大学口腔医院自主培育计划（kq201934）

Evaluation of a modified maxillary protraction appliance for the treatment of patients with skeletal Class Ⅲ malocclusion associated with crowding

LIU Ye1, GE Xiao-lei1, ZHANG Shi-long1, QIN Yuan2, HOU Yan1, LU Hai-yan1, MA Wen-sheng1   

  1. 1. Department of Orthodontics, School and Hospital of Stomatology, Hebei Medical University; Hebei Key Laboratory of Stomatology; Hebei Clinical Research Center for Oral Diseases. Shijiazhuang 050017, Hebei Province;
    2. Department of Orthodontics, Suining Central Hospital. Suining 629000, Sichuan Province, China
  • Received:2023-03-29 Revised:2023-06-15 Online:2024-04-25 Published:2024-05-14

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摘要： 目的: 评价改良前方牵引矫治器治疗骨性Ⅲ类错𬌗伴拥挤的疗效。方法: 将40例骨性Ⅲ类错𬌗患者,按磨牙关系分为2组,每组20例,试验组磨牙中性或远中关系,应用改良前方牵引矫治器;对照组磨牙近中关系,应用传统前方牵引矫治器。2组患者治疗前后分别拍摄头颅侧位片进行比较,采用SPSS 22.0软件包对数据进行统计学分析。结果: 2组患者治疗前后角度测量中,SNA、ANB、SN-MP、U4-SN显著增加（P<0.01）,SNB显著减小（P<0.01）;SN-OL在试验组治疗前后变化有显著差异（P<0.05）。2组患者治疗前后矢状向测量指标中,除对照组上颌牙弓长度外,其余指标均有显著改变（P<0.05）;垂直向测量指标中,U1-PP、L1-MP、U4-SN、U6-SN、ANS-Me显著增加（P<0.05）;U4-PP、U6-PP在对照组治疗前后的变化有显著差异（P<0.05）。2组患者治疗前后头影测量值变化量与对照组相比,试验组治疗后上颌牙弓长度显著增加,U6位置更偏远中,磨牙关系变化更小（P<0.01）。结论: 改良前方牵引矫治器对磨牙中性或远中关系的骨性Ⅲ类错𬌗伴拥挤患者具有良好的前方牵引和推磨牙向远中的效果。

关键词: 骨性Ⅲ类错𬌗, 改良前方牵引, 牙列拥挤, 推磨牙向远中

Abstract: PURPOSE: To investigate the efficacy of a modified maxillary protraction appliance in patients of skeletal Class Ⅲ with crowding. METHODS: Forty patients with skeletal Class Ⅲ malocclusion were divided into two groups, with 20 patients in each group. The experimental group had molar in a neutral or distal relationship and applied a modified maxillary protraction appliance, while the control group had molar mesial relationship and applied a conventional maxillary protraction appliance. Lateral cephalometric radiographs were taken before and after treatment in both groups for comparison. SPSS 22.0 software package was used for data analysis. RESULTS: The angle measurements taken before and after treatment showed a significant increase in SNA, ANB, SN-MP and U4-SN(P<0.01), while SNB decreased(P<0.01) in both groups. SN-OL changes were statistically different before and after treatment in the experimental group(P<0.05). The sagittal measurements before and after treatment in both groups showed significant alterations in all(P<0.05) but the length of the maxillary arch in both groups. For vertical measurements, U1-PP, L1-MP, U4-SN, U6-SN, and ANS-ME all increased (P<0.05), while the changes of U4-PP and U6-PP in the two groups before and after treatment were statistically different(P<0.05). Compared with the control group, the experimental group had a significantly increased maxillary arch length, a more remote location at U6, and a less variable molar relationship after treatment(P<0.01). The two groups showed a variable amount of cephalometric measurements before and after treatment: the experimental group had a significant increase in maxillary arch length, a more remote position at U6, and a smaller change in molar relationship compared to the control group(P<0.01). CONCLUSIONS: The modified maxillary protraction appliance showed good results for maxillary protraction and pushing the molar distally in patients with skeletal Class Ⅲ with crowding at neutral or distal molar relationship.

Key words: Skeletal Class Ⅲ, malocclusion, Modified maxillary protraction, Crowding, Molar distalization

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