采用两种不同功能矫治器治疗骨性Ⅲ类错牙合畸形的临床研究

doi:10.13591/j.cnki.kqyx.2023.05.013

摘要/Abstract

摘要：

目的比较前方牵引和双阻板磁力矫治器早期治疗轻中度骨性Ⅲ类错牙合畸形的临床疗效。方法选取40例替牙晚期或恒牙早期的轻中度骨性Ⅲ类错牙合畸形的患者,随机分为三组,Ⅰ组:前方牵引组(n=20,男9例,女11例);Ⅱ组:双阻板磁力组(n=20,男10例,女10例)。另外选择暂时未开始治疗但处于定期随访的16例轻中度骨性Ⅲ类错畸形的患者(男7例,女9例)作为对照组(Ⅲ组),患者平均年龄9岁5个月。选择20项相关头颅测量数据进行测量,使用方差分析进行多组间比较,两两比较采用最小显著差异法(LSD检验)。结果 Ⅰ组和Ⅱ组与Ⅲ组相比都具有统计学差异。Ⅰ组和Ⅱ组两组比较中有7项头影测量差异具有显著性(P<0.05)。Ⅰ组中上颌切牙唇倾度加大,前牙覆盖增加,磨牙关系矫正量增加。Ⅱ组A点向下移动较少,下颌平面(SNL-ML)顺时针旋转较少,上颌切牙垂直萌出较多。结论前方牵引和双阻板磁力矫治器都可以促进上颌骨发育(促进A点前移),但抑制下颌骨的作用有限。在预防前牙唇倾及支抗磨牙近中移动中,双阻板磁力矫治器较前方牵引矫治更具有优势。

关键词: 前方牵引, 双阻板磁力矫治器, 骨性Ⅲ类错牙合畸形

Abstract:

Objective To compare the clinical efficacy of maxillary protraction and Twin-block magnetic appliance in the treatment of mild-to-moderate skeletal Class Ⅲ malocclusion in the late stage of mixed dentition or early permanent teeth stage. Methods A total of 40 patients with mild-to-moderate skeletal Class Ⅲ malocclusion in thelate stage of mixed dentition or early permanent teeth stage were randomly divided into three groups. The first group of 20 patients received treatment with maxillary protraction appliance and the second group of 20 patients received treatment with Twin-block magnetic appliance. Sixteen patients in the third group with mild-to-moderate skeletal Class Ⅲ malocclusion who did not initiate treatment but were regularly followed up were selected as the control group, with an average age of 9 years and 5 months. Twenty cephalometric measurements were selected and the changes before and after treatment were analyzed by variance analysis and least-significant difference (LSD) test. Results There were significant statistical differences between group Ⅰ, group Ⅱ and the control group Ⅲ. Seven cephalometric measurements were significantly different between group Ⅰ and group Ⅱ(P<0.05). In the maxillary protraction group, the inclination of anterior teeth was increased; the overjet of anterior teeth and the molar relationship was improved. In the Twin-block magnetic appliance group, the A point moved down less; the mandibular plane(SNL-ML)rotated clockwise less, and the maxillary incisors erupted vertically more. Conclusion Both maxillary protraction and Twin-block magnetic appliance can promote maxillary development, but Twin-block magnetic appliance has more advantages in preventing labial inclination of anterior teeth and mesial movement of anchorage molars than maxillary protraction.

Key words: maxillary protraction, Twin-block magnetic appliance, skeletal Class Ⅲ malocclusion

中图分类号:

R783.5

杨任,马巧玲,林爽,李贵凤. 采用两种不同功能矫治器治疗骨性Ⅲ类错牙合畸形的临床研究[J]. 口腔医学, 2023, 43(5): 460-464.

YANG Ren,MA Qiaoling,LIN Shuang,LI Guifeng. A clinical study of two different functional appliances of skeletal Class Ⅲ malocclusion[J]. Stomatology, 2023, 43(5): 460-464.

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变量	治疗前后差值			P
变量	Ⅲ组	Ⅰ组	Ⅱ组	Ⅰ vs. Ⅱ vs. Ⅲ	Ⅰ vs. Ⅲ	Ⅱ vs. Ⅲ	Ⅰ vs. Ⅱ
矢状向
OLp-A/mm	0.79±0.17	1.51±1.46	1.53±1.40	0.042^*	0.025^*	0.031^*	0.813
OLp-Pg/mm	1.07±0.06	0.07±2.17	-0.14±3.11	0.031^*	0.018^*	0.012^*	0.258
wits/mm	0.26±0.01	2.45±2.75	2.57±2.41	0.042^*	0.002^*	<0.001^*	0.726
OLp-Is/mm	1.32±0.24	3.44±1.46	2.19±2.67	0.019^*	0.012^*	0.015^*	0.026^*
OLp-Ii/mm	1.22±0.17	-2.18±2.50	-1.26±2.50	0.028^*	0.013^*	0.007^*	0.198
覆盖/mm	0.10±0.08	5.63±2.08	3.45±2.53	<0.001^*	<0.001^*	<0.001^*	0.002^*
OLp-Ms/mm	1.25±0.14	2.60±1.67	2.44±1.92	0.036^*	0.019^*	0.013^*	0.492
OLp-Mi/mm	1.22±0.11	-0.09±0.66	1.42±3.04	0.047^*	0.032^*	0.298	0.067
磨牙关系/mm	0.10±0.19	2.63±1.74	1.28±2.18	0.013^*	<0.001^*	0.019^*	0.015^*
SNA/(°)	0.28±0.26	0.67±2.00	1.57±2.39	0.046^*	0.033^*	0.025^*	0.253
SNB/(°)	0.52±0.26	-1.67±1.77	-0.80±2.25	0.037^*	0.013^*	0.018^*	0.136
ANB/(°)	-0.23±0.07	2.35±1.87	1.94±2.48	0.048^*	0.009^*	0.006^*	0.687
垂直向
OL parallel-A/mm	1.88±0.27	3.03±2.27	1.48±1.67	0.039^*	0.029^*	0.045^*	0.012^*
Is-NL/mm	0.83±0.03	0.31±1.53	2.17±2.83	0.019^*	0.028^*	0.012^*	0.014^*
Ii-ML/mm	0.67±0.31	0.76±2.49	1.27±2.03	0.047^*	0.249	0.029^*	0.502
Msc-NL/mm	0.47±0.51	1.27±2.07	1.56±2.37	0.038^*	0.023^*	0.029^*	0.553
Mic-ML/mm	0.30±0.21	0.96±1.57	1.19±1.59	0.045^*	0.035^*	0.027^*	0.487
SNL-ML/(°)	0.49±0.05	3.25±1.44	0.24±2.95	0.029^*	0.008^*	0.039^*	0.006^*
U1-NL/(°)	0.43±0.15	1.33±10.75	1.03±3.25	0.043^*	0.045^*	0.033^*	0.194
L1-ML/(°)	0.36±1.37	-3.94±4.67	2.26±2.97	0.012^*	0.019^*	0.007^*	0.019^*