正畸治疗中磨牙的拔除和保留(五十二)——骨钉牵引全牙弓后移中的咬合打开问题探讨

The study of opening the bite in treatment of traction dentition to the distal usiong skeletal anchorage implant

目的:评价各种打开前牙咬合方法在应用骨钉牵引牙弓整体远移过程中的效果及其作用机理。方法:共选取采用骨钉进行全牙弓整体后移的病例100例,其中男性22例,女性78例,年龄12～45岁,平均19.4岁。减数第二或第三磨牙者82例,不减数者18例。所有病例均采用上颌颧牙槽嵴区及下颌外斜线区骨钉牵引全牙弓远中移动。采用不同方式打开前牙咬合。结果:以临床打开咬合的效果来看,单纯应用高弹摇椅形圆丝打开咬合效果最差,应用高弹摇椅形圆丝与平导组次之,其余组均有好的咬合打开效果,最好为NiTi方丝复合牵引钩组。结论:摇椅形唇弓不适用于应用骨钉全牙弓整体向后牵引,而NiTi方丝附复合牵引钩不仅可以产生明显的前牙咬合打开效果,同时不妨碍全牙弓的整体后移,是骨钉应用的一种重要矫治手段。

Objective：To study the effect and mechanism of different opening bite methods in traction dentition to the distal using skeletal anchorage implant.Method：100 cases,22 males and 78 females,aged 12 to 45 years old,with an average 19.4 years of age,were selected.All cases were treated with skeletal anchorage implant in traction dentition to the distal.82 cases were treated with second molar or third molar extraction,18 cases were treated with non-extraction.Different methods were used in opening the bite.Result：In the view of clinical effectiveness of opening bite,a simple application of high-elastic rocking-chair-shaped round wire was the worst,the application of high elastic rocking-chair-shaped round wire and flat plate group followed.The other groups have a good bite opening effect,the best was the NiTi square wire with composite traction hook group.Conclusion：The rocking chair bow-shaped lips was not suit to application of traction the dentition to the distal with skeletal anchorage implant,while the NiTi square wire attached to composite traction hook can not only produce a clear effect of anterior bite opening,but also not handicap the distal movement of whole dentition.It was an important application of skeletal anchorage implant.