上颌前方牵引治疗青少年骨性反的临床研究

Clinical study of changes in dentofacial morphology in skeletal class Ⅲ patients after pubertal growth by maxillary protraction

目的 分析上颌前方牵引矫治青春快速生长期减速阶段的安氏Ⅲ类错牙合前牙反牙合的可行性及疗效。方法 选择12例安氏Ⅲ类错牙合前牙反牙合患者,在治疗前及使用上颌前方牵引器械解除反牙合后,摄头颅侧位定位片,并进行投影测量分析。结果 覆盖增加(3.90±0 .4 0 )mm(P <0 .0 0 1) ,A点矢状方向增加(1.80±0 .37)mm(P <0 .0 5 ) ,B点矢状方向减少(0 .6 0±0 .19)mm(P <0 .0 5 ) ,Wits增加(3.10±0 .5 7)mm(P <0 .0 5 ) ,ANB增加(3.0 0±0 .5 7)°(P <0 .0 5 ) ,其中4 1%为骨性改变,5 9%为牙性代偿。结论 上颌前方牵引对于错过青春快速生长期,由上颌骨发育不足造成的安氏Ⅲ类骨性错牙合仍是有效的。

Objective To show cephalometrilally possible orthopadics of a maxillary protraction on dentofacial morphology in skeletal Class Ⅲ patients after the pubertal growth spurt period. Methods Twelve patients with anterior crossbite were treated with reverse headgear. Lateral cephalometric film taken at the beginning and the end of the treatment were analyzed. Results Overjet was over correted(3.90±0.40)mm(P<0.001) with mean A point sagittal advancement of (1.80±0.37)mm(P<0.05),while B point backward was (0.60±0.19)mm(P<0.05).Wits was increased by(3.10±0.57)mm(P<0.05),and ANB by (3.00±0.57)°(P<0.05). 41% was found to be due to skeletal maxillary advancement while 59% due to tooth movement. Conclusion The maxillary protraction may be a good method to correct Angle Ⅲ malocclusion.