隐形下颌前导矫治器治疗骨性Ⅱ类效果研究

doi:10.13591/j.cnki.kqyx.2022.09.009

摘要/Abstract

摘要： 目的以Twin-Block(TB)对青少年骨性Ⅱ类患者的治疗效果为对照,评价隐形下颌前导矫治器的临床疗效。方法本回顾性研究纳入接受隐形前导矫治器(21例)及TB(28例)治疗的患者49例,测量治疗前后头颅定位侧位片,分析比较两组牙性、骨性指标及Holdaway软组织测量结果。结果治疗后,两组SNB均显著增大,隐形组增加量(ΔT=3.18±1.67)显著大于TB组(ΔT= 1.73±1.53)(P=0.013)。两组ANB及OJ均显著减小,组间无统计学差异,但隐形组ANB (ΔT=-2.76±1.48)比TB组(ΔT=-2.40±1.33)有减小更多的趋势。隐形组比TB组更好地控制了上下切牙唇倾度,并对下颌平面角有减小趋势。两组Holdaway分析结果显示均能明显改善患者侧貌。结论隐形下颌前导矫治器对于骨性Ⅱ类患者有与TB相似的前导下颌及改善软组织突面型的效果,并且在牙性效应及垂直生长型患者的控制上有独特优势,TB则更显著地诱导下颌升支发育。

关键词: 下颌后缩, 正畸功能矫治器, 前导下颌, 回顾性研究

Abstract: Objective To assess the clinical efficacy of invisible mandibular-advancement appliances on skeletal Class Ⅱ teenagers with Twin-Block as the control. Methods Forty-nine patients were involved in the retrospective study (21 in invisible group and 28 in TB group), whose lateral cranial radiographs taken before and after treatment were traced and analyzed. Dental, skeletal indexes and Holdaway analysis results of two groups were statistically compared. Results After treatment, SNB increased significantly in both groups. Increase in invisible group (ΔT=3.18±1.67) was significantly larger than that in TB group (ΔT=1.73±1.53) (P=0.013). ANB and OJ, meanwhile, decreased with no statistical difference. But in ANB, invisible group (ΔT=-2.76±1.48) showed a more obvious trend of decreasing than TB group (ΔT=-2.40±1.33). The invisible group also revealed better control of incisors′ inclination as well as a trend of decreasing in mandibular plane angle. Both groups demonstrated major improvement of patients′ profiles according to Holdaway analysis. Conclusion Invisible mandibular-advancement appliances display a similar effect of mandibular advancement, which is confirmed in the treatment of skeletal Class Ⅱ patients with TB. In addition, the invisible group has an advantage when a control of frontal teeth and vertical growth pattern is needed, while TB is more efficient in inducing the mandibular ramus. Both appliances could significantly improve soft tissue protrusion.

Key words: retrognathia, functional orthodontic appliance, mandibular advancement, retrospective study

中图分类号:

R783.5

于晓艺, 陈思宇, 李慧, 杨婉琪, 李欣怡, 朱宪春. 隐形下颌前导矫治器治疗骨性Ⅱ类效果研究[J]. 口腔医学, 2022, 42(9): 813-817.

YU Xiaoyi, CHEN Siyu, LI Hui, YANG Wanqi, LI Xinyi, ZHU Xianchun. Study on the effect of invisible mandibular-advancement applianceon the treatment of skeletal Cass Ⅱ patients[J]. Stomatology, 2022, 42(9): 813-817.

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