Activator和Frankel-Ⅱ治疗骨型Ⅱ类生长发育期儿童后切牙牙根吸收的比较

Apical root resorption of incisors between Activator versus Frankel-Ⅱ in skeletal class Ⅱ malocclusion adolescents

背景:Activator和FR-Ⅱ是临床常用的治疗骨型Ⅱ类生长发育期儿童的功能矫治器,功效显著;而对其引起的牙根吸收等副作用关注甚少。目的:比较两种功能矫治器—Activator和FR-Ⅱ—治疗后发生切牙牙根吸收的情况,以及上下切牙牙根吸收的发生率。对象:选择采用Activator和FR-Ⅱ治疗的安氏Ⅱ类一分类错患者各27名(未加用固定矫治的患者编为亚组),及另外未经治疗的安氏Ⅱ类一分类错患者27名(对照组)。方法:拍摄治疗前后的全颌曲面断层片和根尖周片进行比较。对上下切牙进行牙根吸收等级测量分析。主要观察指标:①患者全颌曲面断层片和根尖周片分析检测结果一致性的比较。②各组间性别比例、治疗组间初始年龄和治疗时间及各组间评价年龄的比较。③各组间牙根吸收等级的比较。④各组牙根吸收发生率及各切牙及上下牙弓牙根吸收发生率。结果:K-W检验表明各治疗组及Activator亚组与对照组牙根吸收等级间的差异有统计学意义(P<0.05),各治疗组间的差异没有统计学意义(P>0.05)。两治疗组各切牙牙根吸收发生率不同,FR-Ⅱ治疗组切牙牙根吸收发生率最高的是上中切牙,接下来依次为上侧切牙,下中切牙和下侧切牙;Activator治疗组切牙牙根吸收发生率最高的是下中切牙,接下来依次为下侧切牙,上中切牙和上侧切牙。结论:使用Activator和FR-Ⅱ两种功能矫治器均能引起轻微的切牙牙根吸收,FR-Ⅱ吸收程度更轻微;如果功能矫治后加用固定矫治则发生明显的牙根吸收。

BACKGROUND： Activator and FR- Ⅱ are commonly used in clinical treatment for skeletal class Ⅱ malocclusion adolescents, with a significant efficacy. However, root resorption investigations with the two functional appliances have not been conducted so far. OBJECTIVE. To compare the amounts of incisors apical root resorption that occur after treatment with two functional appliances-the activator and the Frankel function regulator- Ⅱ, and to determine the prevalence of root resorption in the maxillary and mandibular incisors. PARTICIPANTS： Fifty-four patients with skeletal class Ⅱ malocclusion were treated with Activator or FR- Ⅱ （patients who had used exclusively 1 functional appliance served as subgroups） and 27 patients without treatment were regarded as control group. METHODS： All patients were taken panoramic radiographs before and after treatment. Root resorption grade of incisors were analyzed. MAIN OUTCOME MEASURES： Orthopantomography and root perriapical film examination comparison; comparison of sex proportion among all groups, initial age and treatment duration in treatment group, and evaluation age among all groups; root resorption grade; root resorption rate and resorption of incisors, maxillary lateral, mandibular central, and mandibular lateral. RESULTS： There were statistical differences in the root resorption grade between two treatment groups, the Activator subgroup and the control group （P 〈 0.05）, but there was no statistical difference between two treatment groups （P 〉 0.05）. The prevalence of resorption for the incisors with FR- Ⅱ treatment was greatest for the maxillary central, followed by the maxillary lateral, mandibular central, and mandibular lateral; the prevalence with Activator treatment was greatest for the mandibular central, followed by the mandibular lateral, maxillary central, and maxillary lateral. CONCLUSION： Activator and FR- Ⅱ can cause slight root resorption of incisors, and the amounts of resorption after treatment with FR- Ⅱ are smaller. Fixed appliance treatment will cause further root resorption.