磁力Twin-block矫治器治疗安氏Ⅱ类Ⅰ分类错后颌骨及颞下颌关节变化的研究

A prospective study on skeletal and TMJ change in patients treated by magnetic Twin-block appliance for AngleⅡ~1 malocclusion

目的探讨安氏Ⅱ类Ⅰ分类错患者使用磁力Twin-block矫治器(简称TB)治疗后颌骨及颞下颌关节的改建。方法30例替牙列晚期或恒牙列早期的安氏Ⅱ类Ⅰ分类错患者随机分成实验组与对照组,每组15例,实验组使用磁力TB,对照组使用传统TB。治疗前后拍摄头颅侧位定位片和颞下颌关节定位正中位片,分别观测颌骨、牙齿以及颞下颌关节骨性结构的变化,所得结果进行统计学分析。结果磁力TB治疗组治疗前后SNB增加了(1.97±1.01)°,ANB减少了(1.94±0.72)°,MP-FH增加了(4.80±1.37)°,关节前间隙增加(0.32±0.07)mm,关节后间隙减少(0.69±0.11)mm(P<0.001)。治疗组比对照组平均疗程减少(1.47±0.65)个月,对下颌骨的矢状向、垂直向作用更明显,对颞下颌关节的生长促进更显著,差异有统计学意义(P<0.05)。结论磁力TB能更有效治疗安氏Ⅱ类Ⅰ分类错,促进颌骨与颞下颌关节髁突后上部发生适应性改建。

Objective To investigate the changes of bone and TMJ after treated by magnetic Twin-block appliance for Angle ⅡⅠ malocclusion. Methods 30 of mixed-dentition cases with Class Ⅱ division Ⅰ malocclusion were divided into two groups, 15 cases in each group. The treatment group was treated by magnetic Twin-block appliance, while the control group was treated by ordinary Twin-block. X-ray films were taken before and after treatment. The bones, teeth, and TMJ changes were observed, and statistical analysis was carried out. Results In the treatment group, SNB increase （1.97± 1.01）°, ANB decrease （1.94±0.72）°, MP-FH increase （4.80±1.37）°, the volume of the anterior joint space increases （0.32±0.07） mm, the volume of the posterior joint space decreases （0.69 ± 0.11）mm （P 〈 0.001）. The therapy period of the treatment group was （1.47± 0.65）months shorter than that of the control group （P 〈 0.05）. The treatment effect was significantly better in the treatment group than that in the control group. Conclnsions Jaw bone and TMJ remodeling were more significant in Magnetic Twinblock treated group.