自攻型微钛钉支抗在矫治成人上颌前突中的临床应用

The clinical application of self-drilled titanium-alloy miniscrew as anchorage in treating adult patients with maxillary protrusion

目的:探讨自攻型微钛钉矫治成人上颌前突的临床疗效。方法:应用自攻型微钛钉作为支抗矫治19例安氏Ⅱ类1分类上颌前突成年患者,拔除双尖牙并排齐牙列后,微钛钉植入上颌第一恒磨牙和第二前磨牙颊侧,2周后以每侧1.0～1.5N滑动内收前牙。通过前后X线头影测量分析,比较前牙内收情况和磨牙支抗的变化。结果:19例上颌前突均得到明显改善,切牙切缘平均内收7.49mm,切牙牙轴与SN交角平均减少17.94°,与NA交角平均减少12.46°,前牙覆盖平均减少了7.4mm,上颌切牙治疗前后差异有统计学意义(P<0.05)。上颌第一磨牙平均前移0.38mm,上颌第一磨牙治疗前后垂直向移动差异无统计学意义,94.7%种植体保持了稳定。结论:自攻型微钛钉能够有效治疗上颌前突成年患者,改善侧貌,起到强支抗的作用。

Objective The purpose of this study was to evaluate the treatment results of adult patients with Maxillary Protrusion by using self-drilled titanium-alloy miniscrew as anchorage. Methods The study comprised 19 adult patients of Angel＇s Class ⅡDivision 1 malocclusion and maxillary protrusion. After premolars extraction,leveling and alignment of the remaining teeth,self-drilled miniscrews were impanted in the bilateral buccal alveolar bone between the upper first molars and second premolars. The anterior teeth were retracted together by using microscrews as anchorage with 1.0 to 1.5N force each side after 2 weeks.According to the analysis of cephalometric X-rays before and after orthodontic treatment, the alternation of anterior teeth retraction and molars＇ anchorage were compared. Results The maxillary protrusion of 19 cases were improved significantly.The edges of incisors were retracted by 7.49mm at average. The angle between the axis of incisor and SN decreased 17.94° at average. The angle between the axis of incisor and NA decreased 12.46°at average.The overjet decreased 7.4mm at average. The differences of incisors before and after treatment were statistically significant（P〈0.05）.Upper first molars moved mesially by 0.38 mm at average. There were no significant differences in anteroposterior and vertical directions for upper first molars.94.7% implants remained steady throughout the orthodontic treatment. Conclusion The self-drilled titanium-alloy miniscrews can be used as strong anchorage to treat the adult patients with maxillary protrusion effectively and improved their profiles greatly.