摘要
目的 研究使用传动矫治技术非手术治疗成功的骨性Ⅲ类牙颌畸形病例矫治前后头颅侧位片中软硬组织的变化,下切牙长轴IA(long axis of the lower incisors),与下颌联合长轴(颏轴)MA(long axis of the mandibular symphysis)所成角度MIA(angle between MA and IA)的变化,为骨性Ⅲ类非手术正畸治疗中确定下切牙健康目标位提供参考.方法 选取50例使用传动矫治技术完成的骨性Ⅲ类非手术治疗病例,平均年龄(16.5±4.9)岁,平均疗程(24.6±8.8)月,男16例,女34例.在治疗前后头颅侧位片上测量常用的软硬组织项目以及牙轴颏轴角MIA.计算各测量项目的均值与标准差,采用配对t检验分析治疗前后各项目的统计学差异.结果 治疗后上下切牙建立了正常的覆盖关系,覆盖测量值从治疗前的(-1.47±1.50) mm变成治疗后的(3.77±1.12) mm.软组织侧貌明显改善,上下唇至Sn-Pg的唇突距差,由矫治前的(-1.62±1.77) mm变为矫治后的(0.24±1.27) mm.下切牙牙长轴与下颌平面所成角L1-MP平均减少-8.54°±5.98°,发生较明显的舌倾.但治疗后牙轴颏轴角MIA为0.31°±5.42°,说明牙轴和颏轴基本一致.结论 传动矫治技术能够实现轻力作用下的牙齿传动效应和牙槽骨弯曲形变效应,不仅能够解除前牙反(牙合)和显著改善侧貌,而且疗效稳定.在轻力作用下,下切牙舌倾和周围牙槽骨的舌向弯曲改建同步进行,治疗后下切牙牙长轴与颏轴依然保持一致,有利于咬合力的传导,说明轻力矫治更有益于健康.传动矫治技术使非手术健康矫治骨性Ⅲ类牙颌畸形成为可能,拓展了非手术矫治适应证.
Objective To investigate the changes of hard and soft tissue as well as the consistency between the long axis of the lower incisors(IA)and the long axis of the mandibular symphysis(MA),ie.the angle between MA and IA,MIA,in cephalometric analysis after successful treatment of skeletal Class I malocclusion with Force-transmission appliance and technique.Methods Pre-and post treatment cephalograms of 50 skeletal Class I patients(male 16,female 34)treated non-surgically with Force-transmission appliance and technique were collected.The average age was(16.5±4.9)years old,ranging from 10 to 29 years old.The average treatment time was(24.6±8.8)months,Cephalometric analysis was performed,Common measurements for both hard and soft tissues as well as the angle between IA and MA(MIA)were included.Mean and standard deviation were calculated for each variable.Paired t-test was performed to evaluate the significant treatment change.Results Anterior crossbite was successfully corrected.Overjet increased from(-1.47±1.50)mm pre-treatment to(3.77±1.12)mm post treatment,with(5.24±1.77)mm significant increasement(P<<0.01).Obvious profile improvement was noticed.The distance difference of upper lip and lower lip to SnrPg changed from negative value before treatnent to positive value after treatment with significant difference(P<0.01).Inclination of lower incisors decreased-8.54°±5.98°when measured with the angle of lower incisor to mandibular plane,indicating lingual tipping of the lower incisors.However,the post-treatment MIA was 0.31°±5.42,suggesting the simultaneous occurrence of the alveolar bending and lower incisor retraction.Conclusions Efficient teeth moverment and alveolar bone reformation effect could be realized under the light force delivered by the Force transmission appliance and technique.Besides the correction of the anterior crossbite and significant profile improvement,the consistency between the long axis of the lower incisors and the long axis of the mandibular symphysis was maintained,which was suitable for the healtby conduction of the occlusal force.Therefore,the Healthy Orthodontics Philosophy could be implemented in the non-surgical orthodontic treatment of skeletal Class I malocclusion with the Force--transmission appliance and technique.
作者
陈斯
吕汶諠
黄文斌
张云帆
张凌云
刘晓默
张杰妮
孙燕楠
梁炜
韩冰
林久祥
Chen Si;Lyv Wenxuan;Huang Wenbin;Zhang Yunfan;Zhang Lingyun;Liu Xiaomo;Zhang Jieni;Sun Yannan;Liang Wei;Han Bing;Lin Jiuxiang(Department of Orthodontics,Peking University School and Hospital of Stomatology&National Engineering Laboratory for Digital and Material Technology of Stomatology&Beijing Key Laboratory of Digital Stomatology,Beijing 100081,China;Craniofacial Grouth and Development Center,Peking University School and Hospital of Stomatology,Beijing 100081,China)
出处
《中华口腔正畸学杂志》
2021年第1期2-8,共7页
Chinese Journal of Orthodontics
基金
国家自然科学基金(81200806,51972005,51672009)
北京大学口腔医院临床新技术新疗法项目(20B04)。
关键词
传动矫治技术
骨性Ⅲ类牙颌畸形
健康矫治
Force transmission appliance and technique
Skeletal class I malocclusion
Healthy orthodontics
