不同生长期安氏Ⅱ类1分类错畸形患者非拔牙矫治的疗效评估

Evaluation about the effects of non-extraction treatment for patients of different growth periods with Angle class Ⅱ division 1 malocclusion

目的探讨生长期安氏Ⅱ类1分类错畸形患者固定正畸治疗的最佳时机以及与生长发育的相互影响。方法选取安氏Ⅱ类1分类错畸形患者60例,按Baccetti骨龄分期将其分为生长高峰期(CVMⅡ期)非拔牙组与对照组、生长高峰后期(CVMⅢ期)非拔牙组与对照组共4组,每组男女各半。收集患者治疗前后的X线头颅侧位片进行头影测量分析。结果患者治疗后软硬组织均有改变,其中CVMⅡ期非拔牙组治疗后骨组织变化较CVMⅢ期非拔牙组明显,差异具有统计学意义(P<0.05),两者大部分牙组织与软组织变化差异则无统计学意义(P>0.05)。结论对于CVMⅡ期的安氏Ⅱ类1分类错畸形患者,非拔牙正畸治疗可在一定程度上抑制上颌的生长,促进下颌和颏部的发育,故临床上应该在CVMⅡ期的早期阶段给予治疗,以获得更好的骨效应。

Objective To evaluate the optimal time for fixed appliance treatment and the relation between orthodontic treatment and growth of Angle class Ⅱ division 1 malocclusion during growth periods. Methods 60 patients with Angle class Ⅱ division 1 malocclusion were selected according to the cervical vertebral maturation （CVM） method for the assessment of mandibular growth made by Baccetti, including non-extraction group and control group in the growth peak, and non-extraction group and control group after growth peak. The number of male and female in each group was the same. All the lateral cephalometric photos before and after treatment were analyzed. Results Soft and hard tissues had been changed after treatment. The bone effect of non-extraction group in the growth peak after treatment was better than the non-extraction group after the growth peak （P〈0.05）, but no statistically significant difference was found in most parts of teeth and soft tissues between the two groups （P〉0.05）. Conclusion The development of maxilla is restrained and the growth of mandible and chin is stimulated after non-extraction treatment of Angle class Ⅱ division 1 malocclusion during growth period. In order to get a better bone effect, treatment should be given as early as possible in the growth peak .