前方牵引结合多曲方丝弓技术矫治10-15岁骨性Ⅲ类错的临床研究

The clinical study in patients between 10-15 years old with skeletal class Ⅲ malocclusion treatedwith maxilla protraction and MEAW technology

目的探讨一种矫治较大年龄骨性Ⅲ类错(牙合)的良好治疗方法,并评价其对软硬组织改变的效果。方法选取30例10-15岁骨性Ⅲ类错(牙合)患者,将治疗分为两个阶段,第一阶段给予上颌前方牵引配合快速扩弓治疗,约半年之后开始第二阶段多曲方丝弓技术治疗,直至咬合关系达理想状态,给予保持。结果所有患者经两个阶段治疗后,上颌及上切牙前移,下颌向后下旋转,伴下切牙后移,均显著改善了骨性Ⅲ类错(牙合)的凹陷型侧貌,且咬合关系调整理想,达到了功能与外形的完美统一。结论前方牵引可使骨改建,多曲方丝弓技术可产生牙性代偿及部分牙槽骨改建,将前方牵引与多曲方丝弓技术相结合矫治骨性Ⅲ类错(牙合),充分调动了患者的生长潜能,值得在临床推广。

Objective To develop a new treatment method for patients aged 10 to 15 years old with malocclusion skeletal class Ⅲ and to evaluate the treatment effects on the hard and soft tissues. Methods Thirty patients ranging in age from 10 to 15 years old, with skeletal class Ⅲ malocclusion were selected for the study. The treatment was divided into two phases. During the first phase, the entire stuffy group was treated with a bonded maxillary expansion and protraction. After 6 months, the entire study group 1 received multiple- loop edgewise- arch wire (MEAW) treatment until an ideal occlusal relationship was achieved. Results After the second phase of treatment, the maxillary and maxillary incisors were moved to the anterior. The mandible was rotated and the mandibular incisors were moved to the posterior. Satisfactory occlusal relationships were significantly improved and the class concave profile became balanced in all cases. Conclusion For the 10-to 15-year-old patients with malocclusion skeletal class Ⅲ, the maxilla protraction can result in skeletal rebuilding. The MEAW treatment induced dental and dentoalveolar reconstruction. The treatment could alleviate the degree of deformation, reduce the treatment period and cost, and has potential for clinical applications.