上海口腔医学

上海口腔医学 ›› 2025, Vol. 34 ›› Issue (5): 540-544.doi: 10.19439/j.sjos.2025.05.016

• 论著 • 上一篇    下一篇

矢向引导双垫矫治器对青少年骨性Ⅱ类错畸形下颌骨三维生长改建的影响

李春颖1,*, 宋鹤2,*, 王发文3, 赵宁3   

  1. 1.淄博市市立医院 口腔科,山东 淄博 255000;
    2.上海市徐汇区口腔医院 儿童口腔科,上海 200030;
    3.上海交通大学医学院附属第九人民医院 口腔正畸科,上海 200011
  • 收稿日期:2025-05-16 修回日期:2025-07-18 出版日期:2025-10-25 发布日期:2025-10-31
  • 通讯作者: 赵宁,E-mail: zhaon1995@126.com
  • 作者简介:李春颖（1979-）,女,本科,副主任医师,E-mail: Chunying 2013 kq@163.com;宋鹤（1989-）,女,硕士,主治医师,E-mail: dentistsh@126.com。*并列第一作者
  • 基金资助:
    上海申康医院发展中心促进市级医院临床技能与临床创新三年行动计划资助（SHDC2023CRD020）

Three-dimensional evaluation of sagittal-guidance Twin-block appliance on mandibular growth remodeling in adolescents with skeletal Class Ⅱ malocclusion

Li Chunying1, Song He2, Wang Fawen3, Zhao Ning3   

  1. 1. Department of Stomatology, Zibo Municipal Hospital. Zibo 255000, Shandong Province;
    2. Department of Pediatric Dentistry, Shanghai Xuhui District Stomatological Hospital. Shanghai 200030;
    3. Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China
  • Received:2025-05-16 Revised:2025-07-18 Online:2025-10-25 Published:2025-10-31

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摘要： 目的:应用三维头影测量技术分析矢向引导双垫矫治器（sagittal-guidance Twin-block,SGTB）对青少年骨性Ⅱ类错畸形下颌骨生长的促进作用。方法:纳入43例青少年骨性Ⅱ类错畸形患者,其中,SGTB治疗组22例,治疗周期（13.26±1.71）个月;未治疗对照组21例,观察期（12.72±0.59）个月。通过治疗前后CBCT数据进行三维头影测量,比较两组下颌骨及牙列变化。结果:治疗组双侧下颌支垂直生长量[左侧（3.16±1.63） mm,右侧（3.18±1.23） mm]显著大于对照组[左侧（1.49±1.13） mm,右侧（1.15±0.76） mm]（P<0.001）,而下颌体长度变化无组间差异（P>0.05）;治疗组ANB角减少1.87°±1.06°,显著高于对照组的0.41°±0.20°（P<0.001）;治疗组上切牙舌倾6.12°,下切牙唇倾2.48°,对照组无明显变化;三维测量显示下颌骨呈现向前、向下的复合生长模式。结论:SGTB可有效促进下颌支垂直向生长,改善矢状骨面型,其作用机制包含骨性改建与牙代偿的协同效应。

关键词: 骨性Ⅱ类错畸形, 功能矫形治疗, 三维头影测量, 矢向引导双垫矫治器, SGTB矫治器

Abstract: PURPOSE: To three-dimensionally evaluate the effects of sagittal-guidance Twin-block (SGTB) appliance on mandibular growth in adolescents with skeletal Class Ⅱmalocclusion. METHODS: Forty-three adolescents with skeletal Class Ⅱ malocclusion were divided into SGTB treatment group [n=22, treatment duration (13.26±1.71) months] and untreated control group [n=21, observation period (12.72±0.59) months]. CBCT scans were obtained pre- and post-intervention for 3D cephalometric analysis. RESULTS: The treatment group showed significantly greater vertical ramus growth (left (3.16±1.63) mm vs. (1.49±1.13) mm; right (3.18±1.23) mm vs. (1.15±0.76) mm, P<0.001) with no intergroup difference in mandibular body length (P>0.05). ANB angle decreased by 1.87°±1.06° in SGTB group, significantly greater than 0.41°±0.20° in controls (P<0.001). In the treatment group, the maxillary incisors were lingually inclined by 6.12°, and the mandibular incisors were labially inclined by 2.48°, no significant changes were observed in the control group. Three-dimensional measurements showed that the mandible exhibits a combined growth pattern of forward and downward direction. CONCLUSIONS: SGTB effectively enhances vertical ramus development and improves sagittal jaw relationship through combined skeletal adaptation and dentoalveolar compensation.

Key words: Skeletal ClassⅡmalocclusion, Functional orthopedics, Three-dimensional cephalometrics, Sagittal-guidance twin-block appliance, SGTB appliance

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