无托槽隐形功能矫治器治疗青少年骨性Ⅱ类错𬌗的疗效分析

doi:10.13591/j.cnki.kqyx.2023.07.011

摘要/Abstract

摘要：

目的观察生长发育期骨性Ⅱ类错𬌗采用无托槽隐形功能矫治器治疗前后颅颌面软硬组织的变化并探讨其矫治机制。方法 22例通过采用无托槽隐形功能矫治器治疗的青少年患者(男9例,女13例,平均年龄11.2岁),将其治疗前后的头颅侧位片进行测量并统计分析。结果矫治后ANB角、NA-PA、TUL-E线、TLL-E线减小,覆盖变浅,SNB角、U1-L1、Go-Gn、Cd-Go、ANS-Me、ANS-Me/N-Me、Z角、Cm-Sn-Ls角、FH-N'Pg'角明显增加,同时有S-Go、Ar-Go的代偿性生长。结论无托槽隐形功能矫治器能有效促进下颌骨的生长发育,改善上下颌间关系,但不会导致下颌顺时针旋转引起下颌平面角的增加。

关键词: 骨性Ⅱ类错𬌗, 无托槽隐形矫治器, 功能性矫治器, 下颌后缩, 青少年

Abstract:

Objective To observe the changes of craniomaxillofacial soft and hard tissues before and after the treatment of skeletal Class Ⅱ malocclusion with invisible functional appliance in adolescents, and to explore its correction mechanism. Methods Lateral cephalometric films of 22 adolescent patients(9 males, 13 females, average age 11.2 years)who were treated with the invisible functional appliance were measured and statistically analyzed before and after treatment. Results The difference was significant, such as the ANB, NA-PA, overjet. TUL-E and TLL-E were decreased and the SNB, U1-L1, Go-Gn, Cd-Go, ANS-Me, ANS-Me/N-Me, Z angle Cm-Sn-Ls, FH-N'Pg', S-Go and Ar-Go were increased. Conclusion The invisible functional appliance can effectively promote the growth and development of the mandible and improve the relationship between the maxilla and mandible, but it will not lead to the increase of mandibular plane angle due to clockwise rotation of the mandible.

Key words: skeletal Class Ⅱ malocclusion, invisible appliance, functional appliance, mandibular retrusion, adolescent

中图分类号:

R783.5

周斌, 吴晓勇, 刘名燕. 无托槽隐形功能矫治器治疗青少年骨性Ⅱ类错𬌗的疗效分析[J]. 口腔医学, 2023, 43(7): 643-646.

ZHOU Bin, WU Xiaoyong, LIU Mingyan. Effect of invisible functional appliance in the treatment of skeletal Class Ⅱ malocclusion in adolescents[J]. Stomatology, 2023, 43(7): 643-646.

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参考文献 21

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测量项目	定义硬组织
SNA	蝶鞍中心、鼻根点、上牙槽座点构成的交角
SNB	蝶鞍中心、鼻根点、下牙槽座点形成的交角
ANB	上牙槽座点、鼻根点、下牙槽座点形成的交角
NA-PA	鼻根点至上牙槽座点连线,与颏前点至上牙槽座点连线之交角
GoGn-SN	下颌角点、下颌颏顶点连线与蝶鞍中心、鼻根点连线交角
ANS-Me	下面高,前鼻棘至颏下点的距离
N-Me	全面高,鼻根点至颏下点的距离
Go-Gn	下颌角点至下颌颏顶点的距离
Cd-Go	髁突颈部中点至下颌角点的距离
ANS-Me/N-Me	前鼻棘点、颏下点垂直距离与鼻根点、颏下点垂直距离的比值
S-Go/N-Me	蝶鞍中心至下颌角点间距离与鼻根点至颏下点间距离的比值
Ar-Go/ANS-Me	关节点、下颌角点间距离与前鼻棘点、颏下点间距离的比值
牙齿
U1-L1	上、下中切牙牙长轴所形成的夹角
U1-PP	上颌中切牙长轴与腭平面的夹角
L1-MP	下颌中切牙长轴与下颌平面的夹角
U1-PP	上颌中切牙切端至腭平面的垂直距离
U6-PP	上颌第一磨牙至腭平面的垂直距离
L1-MP	下颌中切牙切端至下颌平面的垂直距离
L6-MP	下颌第一磨牙至下颌平面的垂直距离
覆盖	上前牙切端至下颌牙面距离
软组织
Z角	颏唇软组织轮廓线与眶耳平面形成的交角
Cm-Sn-Ls	鼻小柱点、鼻下点、上唇凸点形成的交角
FH-N'Pg'	耳点、眶点连线与软组织鼻根点、颏前点连线之交角
TUL-E线	上唇凸点至审美平面的垂直距离
TLL-E线	下唇凸点至审美平面的垂直距离
TUL-Ls	上唇内侧至上唇凸点的距离
TLL-Li	下唇内侧至下唇凸点的距离

测量项目	治疗前	治疗后	t	P
SNA/(°)	81.37±1.49	81.23±2.22	0.25	0.81
SNB/(°)	75.89±2.74	78.92±1.67	-4.43	<0.01^**
ANB/(°)	5.48±1.61	2.31±1.02	7.80	<0.01^**
NA-PA/(°)	11.01±4.33	8.34±5.12	2.87	<0.01^**
GoGn-SN/(°)	32.91±2.55	33.16±3.10	-0.29	0.77
ANS-Me/mm	61.14±2.30	64.01±2.16	-4.27	<0.01^**
N-Me/mm	118.20±3.77	121.52±4.26	-2.74	<0.01^**
Go-Gn/mm	87.91±6.53	92.32±5.98	-2.34	0.02^*
Cd-Go/mm	50.38±2.53	52.53±3.12	-2.51	0.02^*
ANS-Me/N-Me	0.52±0.02	0.53±0.02	-1.54	0.13
S-Go/N-Me	0.68±0.02	0.69±0.02	-2.27	0.03^*
Ar-Go/ANS-Me	0.71±0.02	0.72±0.02	-0.62	0.54

测量项目	治疗前	治疗后	t	P
U1-L1/(°)	112.12±2.17	128.45±1.73	-27.60	<0.01^**
U1-PP/(°)	116.53±5.32	107.26±4.78	6.08	<0.01^**
L1-MP/(°)	94.51±5.62	99.03±6.01	-2.58	0.01^*
U1-PP/mm	17.05±2.17	15.33±2.81	2.27	0.03^*
U6-PP/mm	11.18±2.03	12.34±2.17	-1.83	0.07
L1-MP/mm	28.22±1.71	27.01±2.28	1.99	0.05
L6-MP/mm	20.67±2.66	22.83±2.79	-2.63	0.01^*
覆盖	7.15±0.14	2.45±0.18	96.67	<0.01^**

测量项目	治疗前	治疗后	t	P
Z角/(°)	52.37±9.76	57.56±8.25	-2.91	0.01^*
Cm-Sn-Ls/(°)	86.22±6.38	90.96±7.02	-2.34	0.02^*
FH-N'Pg'/(°)	87.99±4.28	89.14±4.43	-0.88	0.39
TUL-E线/mm	6.57±2.47	3.17±2.66	4.39	<0.01^**
TLL-E线/mm	3.87±1.55	1.58±1.46	5.04	<0.01^**
TUL-Ls/mm	16.32±2.47	16.47±2.30	-0.21	0.84
TLL-Li/mm	18.12±2.73	17.38±2.52	0.93	0.36