舌侧正畸对口腔功能和美观的影响

Effects of lingual orthodontics on function and aesthetics of stomatognathic system

目的通过评价舌侧正畸对患者口腔功能和美观的干扰，初步探讨舌侧正畸中临床与技工室技术操作的要点。方法通过收集安氏Ⅰ类牙列拥挤患者30例，分为两组，每组15例，分别行舌侧正畸和传统唇侧正畸非拔牙治疗，在粘结矫治器当天、7d、28d、56d分别对软组织不适感、进食困难、语音障碍、外观影响等指标进行评估比较，并进行术前和术后头影测量分析。结果舌侧正畸技术与传统唇侧正畸技术相比较，在对美观方面有明显的优势（P〈0．01）；语音障碍在粘结舌侧托槽当日和7d内差异有统计学意义（P〈0．01），进食困难在两组间的差异持续到28d左右（P〈0．01）。结论在开始治疗的前2个月内，发音和进食困难是舌侧正畸最大的不足。然而，舌侧正畸在美观方面具有不可替代的优势，必将成为正畸学的发展方向之一。

Objective To evaluate the functional and aesthetic disturbance of patients treated with lingual orthodontic surgery and to investigate the key points of laboratory procedure and clinical treatment of lingual orthodontic deformity. Methods A total of 30 cases of Angle class I with moder ate crowding were selected. They were equally divided into two groups： one group was treated using lingual brackets, and the other using conventional labial brackets. Each patient completed a four-part survey right after the bracket placing and 7, 28, 56 days after the treatment. The differences of tongue-lip-cheek soreness, eating and speech difficulties and aesthetic problems were evaluated between two groups. Lateral cephalograms were analyzed at the start of the treatment and the end of the overall treatment. Results Speech difficulties of lingual orthodontics were significantly greater （P〈0.01） than that in the labial orthodontics group in the first week of the treatment. Eating difficulties were greater （P〈0.01） in the lingual orthodontics group by 28 days, whereas aesthetic problems were greater in group using labial appliance than group lingual appliance. Conclusions In the first two months of the orthodontic treatment, eating and speech difficulties are the most severe problems for the lingual group. Lingual orthodontics offers important aesthetic advantages over labial orthodontics, and it will be one of the development directions of current orthodontics.