矫形-正畸联合治疗乳牙反[牙合]

Clinical effect of orthopedic-orthodontic treatment in crossbite in deciduous dentition

目的通过头影测量分析了解矫形-正畸联合矫正在治疗乳牙反[牙合]中的临床效果。方法选取12例中度乳牙反[牙合]患者作为实验组，8例正常乳牙[牙合]儿童作为对照组。实验组每名患儿先接受经改良的前方牵引装置治疗，矫形力为2．94～4．90N（300～500g），方向一般取偏向[牙合]平面下方约37°，戴用时间约10h／a。治疗6个月后，停止前牵引，立即接受正畸治疗，直至反殆解除，并稳定2个月，拆除矫治器，治疗结束。通过比较治疗前（T1），矫形治疗后（T2）及正畸治疗结束后（T3）两组的头影变化，了解联合矫正的临床效果。结果治疗结束时12例患者均解除反[牙合]，实验组的A点前移约2．80mm，上前牙切缘前移了8．38mm，∠SNA增加2．65°，下切牙稍舌倾。以上变化与对照组相比，差异有统计学意义（P〈0．001）。结论矫形正畸联合矫正可以使患儿的骨骼畸形及牙[牙合]畸形均得到了较大的改善，是治疗乳牙中度反[牙合]的较好方法。

Objective To study the clinical effect of orthopedic-orthodontic treatment in crosshite in deciduous dentition through cephalmetric analysis. Methods 12 children with crossbite in deciduous den tition were enrolled in treatment group. Control group included 8 patients with normal deciduous denti tion. Modified reverse headgear was used in each patient in the treatment group. Orthodontic force was about 2.94-4.90 N （300 500 g）, and the direction of force was under occlusion plane for 37 degree. Each patient wore reverse headgear for 10 hour per day. Orthodontic treatment lasted for 6 months, and then orthodontic treatment began at once. Orthodontic treatment was not over until crossbite was corrected. The cephalmetric change was compared between two groups before treatment （T1）, after orthopedic treatment （T2）and after orthodontic treatment （T3）. The effect of orthopedic orthodontic treatment was analyzed in two group. Results Crossbite was corrected successfully in all patients in the treatment group. After treatment, A point moved forward by 2. 8mm, Is-FHp increased 8. 38 mm, ∠SNA in creased 2.65, incisors in mandible moved backward a little bit. All these changes were statistical different as compared with those in the control group. Conclusion Skeletal and dental deformity are improved progressively after combined orthopedic-orthodontic treatment. It is recommended to perform orthopedic or thodontic therapy in skeletal crosshite in deciduous dentition.