快速生长期骨性安氏Ⅱ类下颌后缩患者使用无托槽隐形矫治器前导下颌的临床效果分析

doi:10.13591/j.cnki.kqyx.2023.03.010

摘要/Abstract

摘要：

目的评价无托槽隐形矫治技术MA(mandibular advance)矫治安氏Ⅱ类骨性下颌后缩畸形的临床效果。方法收集符合条件的2018年1月至2021年5月至常熟市中医院口腔科就诊的处于生长发育高峰期的安氏Ⅱ类骨性下颌后缩19例患者资料,平均年龄(12.32±1.51)岁。10例患者经MA导下颌向前治疗。9例未治疗患者作为对照组。矫治前后或观察前后拍摄头颅定位侧位片。对X片测量并进行统计学分析。结果与对照组相比,治疗组SNB、L1-NB、L1-NB距、L6-MP距、Z角治疗后明显增加(P<0.05);Co-Go、Co-Gn、SL增加量明显大于对照组(P<0.05);ANB、U1-SN、U1-NA、U1-NA距、L1-MP、FCA治疗后明显减小(P<0.05);治疗组SE无明显变化,而对照组明显增加(P<0.05)。结论 MA可以促进下颌发育,矫治下颌后缩畸形,改善骨性畸形和侧貌;且可以维持下前牙唇倾度及下颌平面角。

关键词: 下颌后缩, 导下颌向前, 安氏Ⅱ类, 无托槽隐形矫治

Abstract:

Objective To evaluate the effects of non-bracket invisible appliance mandibular advance(MA) on skeletal Class Ⅱ growing patients with mandibular retrusion. Methods Nineteen skeletal Class Ⅱ growing patients with mandibular retrusion who were treated in the department of stomatology of Changshu traditional Chinese medicine hospital from January 2018 to May 2021 were selected. They had an average age of (12.32±1.51) years old. The treatment group consisted of 10 children who were treated with MA. The control group consisted of 9 children who refused to treat their malocclusion. Cephalometrics of all patients were taken before and after the observation or treatment. The cephalometric data of two groups were analyzed. Results Compared with the control group, in the treatment gruop SNB angle, L1-NB angle, L1-NB distance, L6-MP distance, Z angle increased significantly (P<0.05);Co-Go distance, Co-Gn distance, SL increased more greatly than the control group; ANB angle, U1-SN angle, U1-NA angle, U1-NA distance, L1-MP distance, FCA angle decreased significantly (P<0.05); SE did not change significantly in the treatment group, but increased significantly in the control group (P<0.05). Conclusion MA can promote mandibular growth and improve lateral profile. The angle of the lower teeth and the angle of the mandible plane can be controlled by MA appliance.

Key words: mandibular retrusion, mandibular advancement, skeletal Class Ⅱ malocclusion, mandibular advance

中图分类号:

R783.5

曹伟清, 林汤毅, 吕冬. 快速生长期骨性安氏Ⅱ类下颌后缩患者使用无托槽隐形矫治器前导下颌的临床效果分析[J]. 口腔医学, 2023, 43(3): 242-247.

CAO Weiqing, LIN Tangyi, LYU Dong. Research on clinical effects of non-bracket invisible appliance on the mandibular advancement treatment of skeletal Class Ⅱ growing patients with mandibular retrusion[J]. Stomatology, 2023, 43(3): 242-247.

图/表 4

表1

两组患者治疗前后头影测量数据分析"

测量指标	治疗组				对照组				两组差值对比
测量指标	术前	术后	差值	P	前	后	差值	P	P
SNA/(°)	80.60±2.95	80.68±3.03	0.08±0.74	0.74	80.00±2.49	80.12±2.55	0.12±0.46	0.39	0.89
SNB/(°)	74.58±2.97	76.88±2.58	2.30±0.99	0.00	74.07±2.60	74.30±2.62	0.23±0.71	0.29	0.00
ANB/(°)	6.13±1.24	3.80±0.79	-2.12±0.90	0.00	5.93±1.25	5.75±1.11	-0.18±0.87	0.48	0.00
SN-MP/(°)	32.06±5.12	31.76±5.03	-0.31±0.78	0.27	32.47±3.26	32.74±3.09	0.28±0.94	0.53	0.20
U1-SN/(°)	106.69±7.01	103.87±5.86	-2.82±1.92	0.00	108.50±6.13	108.39+6.11	-0.26+0.87	0.32	0.00
U1-NA/(°)	25.40±6.69	22.75±6.12	-2.65±2.10	0.00	27.92±6.10	28.18±5.76	0.26±1.15	0.45	0.00
U1-NA距/mm	6.08±1.58	4.81±1.70	-1.27±1.19	0.01	6.31±2.62	6.23±2.68	-0.08±0.33	0.44	0.00
U1-PP距/mm	27.53+1.46	27.66+1.53	0.13+0.53	0.48	27.17±2.58	26.95±2.33	-0.22±0.48	0.13	0.12
U6-PP距/mm	19.49±1.78	19.77±1.41	0.28±0.61	0.21	19.87±1.57	20.06±1.76	0.18±0.67	0.36	0.75
L1-NB/(°)	25.12±7.16	28.21±7.27	3.09±2.28	0.00	23.89±3.92	24.28±3.99	0.39±0.79	0.12	0.00
L1-NB距/mm	5.02±1.15	6.59±1.57	1.57±1.16	0.00	5.80±1.27	5.94±1.02	0.14±0.73	0.53	0.00
L1-MP/(°)	98.59±5.79	99.47±6.20	0.88±1.84	0.19	97.39±4.67	97.41±4.52	-0.02±0.67	0.93	0.15
L1-MP距/mm	37.00±2.35	36.31±2.06	-0.69±0.56	0.00	37.25±3.35	37.46±3.34	0.20±0.67	0.31	0.00
L6-MP距/mm	29.31±1.20	30.15±1.49	0.85±0.45	0.00	29.58±1.77	29.80±1.70	0.22±0.46	0.12	0.00
Co-Gn/mm	102.71±6.62	108.23±7.31	5.52±1.68	0.00	101.08±4.66	103.60±4.57	2.52±0.56	0.00	0.00
Co-Go/mm	49.84±3.85	53.01±3.73	3.08±0.65	0.00	50.15±3.78	51.86±3.66	1.71±0.54	0.00	0.00
Go-Gn/mm	68.02±2.78	70.95±2.03	2.93±0.91	0.00	66.46±2.65	68.98±2.56	2.51±0.69	0.00	0.15
SL/mm	40.30±5.08	43.01±5.50	2.71±0.65	0.00	39.40±3.84	41.10±3.94	1.70±0.66	0.00	0.00
SE/mm	19.63±1.91	19.92±1.69	0.29±0.47	0.10	19.03±1.81	19.87±1.81	0.85±0.54	0.00	0.03
FCA/(°)	16.06±3.07	9.57±3.07	-6.49±1.64	0.00	15.99±3.48	16.11±3.38	0.12±0.93	0.44	0.00
Z角/(°)	60.22±8.24	64.67±8.23	4.78±2.85	0.00	62.01±7.32	62.39±7.41	0.38±1.00	0.21	0.00

表1

图1

图2

图3

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