上颌快速扩弓联合多曲方丝技术矫治年轻成人骨性反（牙合）伴下颌偏斜畸形

Treatment of skeletal crossbite young adults with mandibular deviation by RME and MEAW techniques

目的评价上颌快速扩弓（rapid maxillary expansion，RME）联合多曲方丝技术（multi—loop edgewise arch wire。MEAW）矫治年轻成人骨性反[牙合]伴下颌偏斜畸形的临床疗效。方法选择成年安氏Ⅲ类骨性错[牙合]伴下颌偏斜患者9例，年龄16．2～18．8岁，采用上颌快速扩弓纠正单侧后牙反[牙合]，多曲方丝技术配合颌间牵引调整咬合关系，纠正下颌及中线偏斜。矫治前后拍摄头颅侧位片和正位片，并进行X线头影测量分析。结果（1）矢状方向上，SNA增大（1.4±1.7）°，SNB减少（0．7±0．9）°，ANB增加（2．1±0．9）°，颌骨前后向不协调减轻；U1-SN，L1-MP矫治前后分别增加（2．7±3．7）°和减少（5．4±2．9）°，前牙覆盖减少（3．8±1．0）mm。（2）垂直方向上，MP-SN和MP-FH分别增加（1．9±2．0）°和（1．1±2．6）°，矫治前后差异均无统计学意义。（3）矫治前后Maz—Maz’增加（2．6±2．8）mm，Um-Um’增加（6．2±5．9）mm，后者矫治前后差异具有统计学意义。（4）矫治前后，ACd-Me和ACd-Go分别减少（3．7±2．1）mm和（2．8±1．6）mm；ManDP-MSL和Me-MSL分别减少（3．8±2．3）mm和（3．6±2．5）mm，矫治前后差异均具有统计学意义。结论上颌快速扩弓联合多曲方丝技术可以有效地矫治年轻成人轻、中度骨性反[牙合]伴下颌偏斜畸形，纠正异常咬合关系，改善颜面部不对称畸形。

Objective To evaluate the effects of multiloop edgewise arch wire （MEAW） tech nique combined with rapid maxillary expansion （RME） in correcting skeletal erossbite young adults with mandibular deviation. Methods 9 young adults with skeletal class III malocclusion and mandibular deviation were selected （4 males, 5 females, aged from 16.2-18.8 years）. They were all corrected with RME and MEAW techniques. Cephalometric radiographs were taken and analyzed at the pretreatment （T1） and post-treatment （T2）. Students＇ t-test was used to determine if there were signifi cant differences between the 2 time periods. Results SNA increased by （1.4±1.7）°, SNB decreased by （0.7±0.9）°, and ANB increased by（2.1±0.9）°; U1-SN increased by （2.7±3.7）°and L1-MP decreased by （5.4±2.9）°. MP-SNand MP-FH increased by （1.9±2.0）° and （1.1±2.6）° respectively, neither of which had significant difference. Maz-Maz＇ increased by （2.6±2.8）mm, while Urn-Urn＇ increased by （6.2±5.9）mm. The latter had significant difference. ACd-Me and ACd-Go decreased by （3. 7 ± 2.1）mm and （ 2. 8 ± 1. 6 ） mm respectively; while ManDP-MSL and Me-MSL decreased by （3.8±2.3）mmand （3.6±2.5）mm, respectively. All of them had significant differences. Conclusion MEAW technique combined with RME is a clinically effective method for correcting adults with mild and moderate skeletal erossbite and mandibular deviation.