改良型FRⅢ与“2×4”矫治技术治疗替牙期前牙反𬌗的疗效研究

doi:10.13591/j.cnki.kqyx.2023.08.010

摘要/Abstract

摘要：

目的比较改良型FRⅢ与“2×4”矫治技术治疗替牙期前牙反𬌗患者的软硬组织变化,评价两种矫治方法的治疗效果,为临床选择应用提供理论参考。方法收集2018年9月至2022年10月在川北医学院第二附属医院口腔科门诊治疗的替牙期前牙反𬌗患者30例作为研究对象,根据治疗方法不同分为观察组(改良型FRⅢ,n=15)和对照组(“2×4”矫治技术,n=15)。对两组病例矫治前后的软硬组织位置变化进行对比分析。结果治疗完成后,观察组 SNA、ANB、MP-FH、Y轴角、U1-SN、U1-NA、NLA、PLA、FCA、ULP增加(P<0.05),SNB、L1-MP减小(P<0.05);对照组 SNA、ANB、MP-FH、U1-SN、U1-NA、Y 轴角、NLA、FCA增加(P<0.05),SNB、L1-MP、L1-NB减小(P<0.05);两组之间,SNB、ANB、SN-MP、NLA、L1-MB、PLA、FCA的变化量比较具有明显差异(P<0.05)。结论两种技术治疗均取得良好的治疗效果,前牙反𬌗得到有效解除,咬合关系及面型恢复正常,具有临床应用价值,值得推广。改良型FRⅢ更好地改善软组织侧貌和面型,而“2×4”矫治技术用时更短,牙列关系得到更好的解决。

关键词: 替牙期, 前牙反𬌗, 改良型FRⅢ, “2×4”矫治技术

Abstract:

Objective By comparing the changes in soft and hard tissue of patients with anterior crossbite dentition treated with the modified FR Ⅲ and “2×4” orthodontic techniques, to evaluate the therapeutic effects of two orthodontic methods, so as to provide theoretical reference for clinical selection and application. Methods Thirty patients with anterior crossbite dentition treated in the outpatient clinic of the Second Affiliated Hospital of North Sichuan Medical College from September 2018 to October 2022 were collected, and divided into the observation group (modified FRⅢ, n=15) and control group (“2×4” orthodontic technique, n=15) according to the treatment method. Changes in the position of hard and soft tissues of the two groups before and after orthodontic treatment were compared. Results After treatment, an increase in the SNA, ANB, MP-FH, Y-axis angle, U1-SN, U1-NA, NLA, PLA, FCA and ULP was revealed in the observation group (P<0.05) along with a decrease in the SNB and L1-MP. In control group, SNA, ANB, MP-FH, U1-SN, U1-NA, Y-axis angle, NLA, FCA increased (P<0.05); SNB, L1-MP, L1-NB decreased (P<0.05). Significant difference was found in the number of changes in SNB, ANB, SN-MP, NLA, L1-NB, PLA and FCA between the two groups (P<0.05). Conclusion Both techniques achieved good treatment outcomes. Anterior teeth were effectively released, followed by the normalized occlusal relationship and facial shape, which is worth promoting for clinical application. The modified FRⅢ could more prominently contribute to improving the lateral appearance and facial shape of soft tissues, while the “2 × 4” orthodontic technique costs less time and provides a better resolution for tooth alignment.

Key words: teething period, anterior crossbite, modified FRⅢ, “2 × 4” orthodontic technique

中图分类号:

R783.5

谢小亭, 杨渠, 米方林. 改良型FRⅢ与“2×4”矫治技术治疗替牙期前牙反𬌗的疗效研究[J]. 口腔医学, 2023, 43(8): 722-725.

XIE Xiaoting, YANG Qu, MI Fanglin. Study on the efficacy of FR Ⅲ and “2 × 4” techniques in the treatment of mixed dentition anterior crossbite[J]. Stomatology, 2023, 43(8): 722-725.

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测量项目	测量方法
FCA	型角,额点与鼻下点连线和鼻下点与软组织颏前点连线的后交角
NLA	鼻唇角,鼻下点与鼻小柱点连线和鼻下点与上唇突点连线的前交角
PLA	颏唇角,由颏唇沟最凹处,分别向下唇软组织外轮廓前缘及颏部软组织外轮廓前缘所做切线构成的夹角
ULP	上唇突度,UL到Sn-Pos连线距
LLP	下唇突度,LL到Sn-Pos连线距
SNA	蝶鞍中心点S、鼻根点 N、上齿槽座 A 点所构成的角
SNB	蝶鞍中心点 S、鼻根点 N、下齿槽座点B 所构成的角
ANB	上齿槽座点 A、鼻根点 N 与下齿槽座点 B 所构成的角
SN-MP	下颌平面角,下颌平面 MP与 SN平面形成的前下交角
NA-PA	颌凸角,NA与PA延长线之交角
Y轴角	Y轴(S-Gn)与 FH 平面所成之前下角
U1-SN	上中切牙长轴与前颅底平面相交的下内角
U1-NA	上中切牙长轴与鼻根点至上齿槽座点连线的交角
L1-MP	下中切牙长轴与下颌平面相交的下内角
L1-NB	下中切牙长轴与鼻根点至下齿槽座点连线的交角

测量项目	观察组(n=15)			P1	对照组(n=15)			P2	P3
测量项目	矫治前	矫治后	变化值	P1	矫治前	矫治后	变化值	P2	P3
SNA/(°)	79.23±1.21	81.61±1.25	0.99±0.67	0.004^**	80.16±1.37	82.21±1.36	1.94±1.38	0.001^**	0.053
SNB/(°)	79.52±1.63	78.42±1.78	-0.76±0.28	0.003^**	78.56±2.03	75.20±1.32	-2.57±0.54	0.001^**	0.000^**
ANB/(°)	0.30±2.15	1.85±1.94	1.76±0.77	0.001^**	1.540±1.42	5.93±1.86	4.31±1.25	0.000^**	0.000^**
NA-PA/(°)	5.65±1.67	6.23±1.25	0.65±1.60	0.313	5.63±2.02	6.65±1.38	1.15±1.68	0.124	0.517
SN-MP/(°)	33.05±1.53	33.10±0.91	0.77±0.89	0.032^*	32.93±1.54	34.32±0.69	2.60±0.85	0.001^**	0.000^**
Y轴角/(°)	65.32±2.64	66.45±2.71	0.75±0.93	0.043^*	65.56±3.12	66.63±2.14	1.30±1.02	0.033^*	0.376
U1-SN/(°)	101.23±3.12	104.58±2.36	4.41±1.68	0.001^**	100.15±2.88	102.52±2.15	3.45±2.40	0.002^**	0.168
L1-MP/(°)	89.65±3.13	87.87±2.33	-0.75±1.15	0.043^*	89.86±2.24	88.25±1.74	-1.21±1.62	0.034^*	0.512
U1-NA/(°)	18.36±2.05	20.16±1.22	1.75±1.18	0.002^**	18.84±2.73	20.55±3.20	1.43±1.20	0.009^**	0.255
L1-NB/(°)	25.34±2.15	25.67±1.22	-0.68±1.21	0.122	25.57±2.12	25.15±2.39	-0.17±0.53	0.002^**	0.030^*
NLA/(°)	92.32±3.66	96.45±3.27	4.61±3.42	0.001^**	91.75±4.45	92.65±4.28	0.94±0.71	0.003^**	0.001^**
PLA/(°)	72.46±13.24	103.10±6.38	27.32±18.41	0.002^**	66.10±13.89	68.54±14.33	2.81±5.36	0.213	0.002^**
FCA/(°)	4.54±1.36	6.25±2.11	1.86±0.92	0.001^**	4.52±2.32	5.34±1.67	0.77±0.78	0.015^*	0.041^*
ULP/mm	4.45±1.45	5.34±0.88	0.65±0.78	0.024^*	5.12±1.34	5.23±1.11	0.16±1.06	0.656	0.312
LLP/mm	6.52±1.36	6.65±0.83	-0.38±0.74	0.232	6.67±1.76	5.33±1.36	-0.67±1.15	0.078	0.426