两种不同矫治器结合微种植体矫治上颌前突临床研究(1)

http://www.100md.com 2018年3月15日 《中国美容医学》 2018年第6期

     [摘要]目的：临床使用自锁托槽和直丝弓矫治器结合微种植体支抗，矫治上颌前突错牙合畸形的疗效比较。方法：选取32例上颌前突错牙合畸形患者，分别使用自锁托槽矫治器结合微种植体支抗(实验组，16例)和传统直丝弓托槽矫治器结合微种植体支抗(对照组，16例)。记录并分析两组患者排齐、关闭间隙和总的治疗时间；测量两组患者尖牙牙根长度和牙槽骨高度，以及头影测量项目，并对治疗前、后的变化进行比较分析。结果：实验组总疗程平均(19.6±5.39)个月，短于对照组的(25.7±5.76)个月， 差异有统计学意义(P<0.05)；两组尖牙牙根长度和牙槽骨高度治疗前后变化比较，差异均无统计学意义(P>0.05)；32例牙弓突度均得到改善，实验组治疗后U1-SN角、U1-X(mm)、U1-Y(mm)、A-Y(mm)、UL-Y(mm)均显著低于对照组，两组比较差异有统计学意义(P<0.05)。结论：自锁托槽矫治器结合微种植体支抗矫治上颌前突拔牙患者，能显著缩短拔牙间隙关闭的时间，缩短总疗程，前牙覆牙合覆盖的变化显著，侧貌改善明显，且尖牙牙根和牙槽骨无明显吸收。
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    [关键词]自锁托槽矫治器；微种植体；上颌前突

    [中图分类号]R783.5 [文献标志码]A [文献编号]1008-6455(2018)06-0094-05

    Abstract： Objective To study the efficacy of Self-ligating and Straight wire appliances combine with micro-implant anchorage to treat maxillary protrusion. Methods 32 cases of maxillary protrusion patients as research subjects，were randomly divided into the experimental group and the control group， each group contained 16 cases.The control group treated with Roth straight wire brackets combined micro-implant anchorage；the experimental group treated with Quick brackets (made by Germony) combine the micro-implant anchorage. Results The average duration of the treatment group was( 19.6+5.39) months； Shorter than the control group (25.7±5.76) there was a statistical difference in the month(P<0.05)； the canine root length and height of alveolar bone changes in the experimental group were smaller than the control group，but the differences were not statistically significant (P>0.05)； 32 cases of hard and soft profile were improved，the U1-SN，U1-X(mm)，U1-Y(mm)，A-Y(mm)，UL-Y(mm) in the experimental group after treatment were significantly lower than the control group(P<0.05). Conclusion Self-ligating appliance combine micro implant anchorage compared with roth straight wire appliance combined micro implant anchorage can effectively shorten the tooth extraction clearance and total course oftreatment time， increases the degree of retraction front teeth. Overbite and overjet had been changed significantly，hard and soft of profile obviously improved， and the canine root and alveolar bone had no obvious absorption， good clinical curative effect.
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    Key words：self-ligating； micro-implant anchorage；protrusion

    上頜前突错牙合畸形的患者大部分是安氏Ⅱ类1分类错牙合和部分安氏1分类双颌前突。牙颌面畸形不仅影响青少年的颜面美观、咀嚼功能，还造成青少年的心理障碍[1]。对此类患者大多采用拔牙矫治，需要2～3年时间，如何在缩短疗程的前提下达到良好的矫治效果，显得尤为迫切。

    自锁托槽矫治技术的使用，实现了轻力矫正，但单纯自锁托槽矫治仍存在支抗问题。近年来出现的种植体支抗作为“绝对支抗”[2]，具有临床操作简单、创伤小、适应证广、易取出、成本低等优点，它的应用给正畸矫治效果带来了突破性的进展。在本研究中，将自锁托槽结合种植体支抗与普通直丝弓托槽结合种植体支抗矫治上颌前突的临床效果进行分析比较，探索上颌前突错牙合病例矫治的高效途径，强支抗控制下的轻力矫治模式，解决传统技术摩擦力大的缺陷，大大拓展了临床矫治范畴。, http://www.100md.com(邱伟芳 江飞宇 何学君)

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