上海口腔医学

上海口腔医学 ›› 2026, Vol. 35 ›› Issue (3): 294-299.doi: 10.19439/j.sjos.2026.03.012

• 论著 • 上一篇    下一篇

SGTB联合固定矫治器治疗青少年骨性Ⅱ类错畸形的长期效果评价

宋鹤1,*, 李春颖2,*, 王发文3, 赵宁3#, 苏红如1#   

  1. 1.上海市徐汇区口腔医院 儿童口腔科,上海 200030;
    2.淄博市市立医院 口腔科,山东 淄博 255400;
    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:2025-04-28 修回日期:2025-07-05 发布日期:2026-07-02
  • 通讯作者: 赵宁,E-mail: zhaon1995@126.com;苏红如,E-mail: xyfyfk@163.com。#共同通信作者
  • 作者简介:宋鹤（1989—）,女,硕士,主治医师,E-mail: dentistsh@126.com;李春颖（1979—）,女,本科,副主任医师,E-mail: Chunying2013kq@163.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）

Evaluation of the long-term effects of SGTB combined with fixed appliances in the treatment of skeletal Class Ⅱ malocclusion in adolescents

Song He1, Li Chunying2, Wang Fawen3, Zhao Ning3, Su Hongru1   

  1. 1. Department of Pediatric Dentistry, Stomatological Hospital of Shanghai Xuhui District. Shanghai 200030;
    2. Department of Stomatology, Zibo Shili Hospital. Zibo 255400, Shandong Province;
    3. Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China
  • Received:2025-04-28 Revised:2025-07-05 Published:2026-07-02

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摘要： 目的: 探讨矢状引导双板矫治器（sagittal-guidance Twin-block appliance,SGTB）联合固定矫治器双期治疗对青少年骨性Ⅱ类错畸形的颅面生长改良作用,评估该方案功能矫形效果的长期稳定性。方法: 纳入21例生长发育期安氏Ⅱ类1分类错畸形患者,治疗初始平均年龄（12.02±1.02）岁,均采用“一期SGTB功能矫形+二期固定矫治”的非拔牙方案,分别在治疗初始（T0）、SGTB 拆除后（T1）、固定矫治结束（T2）及术后随访时（T3）进行头影测量分析,比较各时间点颅面骨骼、牙及软组织指标的变化,评估治疗效果及稳定性。结果: 双期治疗后,颌骨矢状向不协调显著纠正（SNB角增大,ANB角减小,Wits值降低,覆盖减小）;颌骨整体长度增加,下颌骨位置前移（Co-Gn、Co-Go、Pog-Nperp显著增大）;上颌骨生长轻度抑制（Ptm-A减小,P=0.013）。此外,上切牙后移,下牙列近中移动,磨牙关系恢复中性。随访期（T2-T3）内,骨骼指标（SNB、ANB、Wits 值等）无显著复发（P>0.05）,仅覆盖、覆及鼻唇角出现轻微生理性回弹,整体稳定性良好。结论: SGTB矫治器与固定矫治器的联合双期治疗能够有效纠正骨性Ⅱ类错畸形,促进髁突和下颌骨生长,并在长期随访中显示出良好稳定性。

关键词: SGTB矫治器, 固定矫治器, 骨性Ⅱ类错畸形, 青少年, 双期治疗, 长期稳定性

Abstract: PURPOSE: To explore the craniofacial growth modification effect of two-stage treatment with sagittal-guidance Twin-block appliance (SGTB) combined with fixed appliances on skeletal Class Ⅱ malocclusion in adolescents, and to evaluate the long-term stability of the functional orthopedic effect of this protocol. METHODS: A total of 21 adolescent patients with Class Ⅱ division 1 malocclusion in the growth and development period were included, with an average initial age of (12.02±1.02) years. All patients received a non-extraction treatment protocol consisting of "stage 1: SGTB functional orthopedics + stage 2: fixed appliance therapy". Cephalometric analysis was performed at the initial stage of treatment (T0), after SGTB removal (T1), at the end of fixed appliance treatment (T2), and during the follow-up period after treatment (T3). Changes in craniofacial skeletal, dental and soft tissue indicators at each time point were compared to evaluate the treatment effect and stability. RESULTS: After two-stage treatment, the sagittal jaw discrepancy was significantly corrected (increased SNB angle, decreased ANB angle, reduced Wits value, and diminished overjet); the overall jaw length increased, and the mandible moved forward (Co-Gn, Co-Go, and Pog-Nperp significantly increased); maxillary growth was slightly inhibited (decreased Ptm-A, P=0.013). In addition, the upper incisors retracted, the lower dentition moved mesially, and the molar relationship was restored to Class Ⅰ. During the follow-up period (T2-T3), there was no significant recurrence of skeletal indicators (such as SNB angle, ANB angle, and Wits value) (P>0.05); only slight physiological rebound occurred in overjet, overbite and nasolabial angle, and the overall stability was good. CONCLUSIONS: The two-stage combined treatment with SGTB appliance and fixed appliances can effectively correct skeletal Class Ⅱ malocclusion, promotes the growth of the condyle and mandible, and shows good stability in long-term follow-up.

Key words: SGTB appliance, Fixed appliance, Skeletal Class Ⅱ malocclusion, Adolescents, Two-stage treatment, Long-term stability

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