多曲方丝弓技术在非手术、非拔牙矫治骨性Ⅲ类错畸形中的应用

NONSURGICAL AND NONEXTRACTION TREATMENT OF SKELETAL CLASS Ⅲ MALOCCLUSION,USING MULTILOOP EDGEWISE ARCH WIRE

目的使用多曲方丝弓(multiloop edgewise wire arch,MEAW)技术对恒牙期骨性Ⅲ类错手术适应证患者进行非拔牙矫治并观察其疗效。方法选取恒牙期骨性Ⅲ类错手术适应证患者6例(男性1例,女性5例),至少1侧下颌第三磨牙存在,使用MEAW技术进行非拔牙矫治,并在治疗前后常规摄X线头颅侧位片分析对比治疗变化。结果前牙均建立了正常的覆覆盖关系,下前牙舌侧倾斜、移动及下磨牙远中竖直、移动明显,上前牙轻微前倾,上下唇相对位置获得改善,骨改变不明显。结论对于拒绝手术及拔牙却又迫切要求部分改善上下前牙关系及侧貌的具有良好医患协作沟通能力的骨性Ⅲ类错患者,MEAW技术是一个很好的选择。②非手术、非拔牙的选择给磨牙的竖直、远中移动及中线的调整带来很大困难。③这种代偿性矫治并不能从根本上解决患者的原有骨性畸形。

Objective To evaluate the nonextraction orthodontic therapy effects of multiloop edgewise arch wire （MEAW） on patients who had previously been classified as orthognathic surgical cases. Methods Six permanent dentition patients with skeletal Class Ⅲ malocclusion,classified as orthognathic surgical cases,at least one side of lower third molar was present,were treated with MEAW therapy. Lateral cephalograms were taken before and after treatment. Results Normal overbite and overjet were established, the mandibular dentition was Ⅲ distalized and significantly uprighted,a slight proclination was found in the upper anterior teeth, the relative relationship of upper and lower lip get some improvement but few for skelecton. Conclusion ①For the skeletal Class Ⅲ malocclusion patients who refuse surgery and extraction but accept a partial improvement for their anterior cross bite and facial profile,MEAW therapy is a good choice. ②The nonsurgical and nonextraction of patients make the upright and distal movement of molar and correction of midline more difficult.③This kind of dental compensation could not change the original characteristic skeletal morphology.