微型种植体支抗与口外弓支抗治疗上牙弓前突的疗效比较

Comparison of micro-implant anchorage with headgear anchorage in treatment of maxillary dentoalveolar protrusion

目的通过与口外弓支抗治疗上牙弓前突的疗效比较,评价微型种植体支抗作用效果。方法将20例严重上牙弓前突的患者随机分成两组,种植体支抗组10例,口外弓支抗组10例,分别应用种植体支抗与口外弓支抗配合MBT直丝弓矫治技术关闭拔牙间隙。通过头影测量方法比较两组患者矫治前、后的反映牙、颌、面形态特征的标志点位置变化,并通过成组t检验分析两组牙、颌、面形态变化的差异。结果矫治后在矢状向上,种植体支抗组上中切牙内收(6.56±1.37)mm,上唇突点后移(4.36±0.79)mm,口外弓支抗组上中切牙内收(5.56±0.66)mm,上唇突点后移(3.86±0.73)mm,两组差异均无统计学意义(P>0.05);而两组的上第一磨牙近中移动分别为(0.55±1.36)mm、(1.81±0.84)mm,差异有统计学意义(P<0.05)。在垂直向上,种植体支抗组上中切牙压低(1.96±0.82)mm,上第一磨牙压低(1.59±1.15)mm,口外弓支抗组上中切牙伸长(0.60±0.74)mm,上第一磨牙伸长(0.24±1.72)mm,两组差异均有统计学意义(P<0.05)。种植体支抗组U1-SN角减小(16.76±2.85)°、口外弓支抗组U1-SN角减小(20.10±2.09)°,两组差异有统计学意义(P<0.05)。结论微型种植体支抗不仅具备较强的矢状向支抗作用,同时具备有传统口外弓支抗难以实现的垂直向支抗能力,有效压低前牙以利于矫正深覆、露龈笑畸形,压低上磨牙以利于骨性Ⅱ类面型的改善。

Objective To compare micro-implant anchorage（MIA） with headgear anchorage（HGA） in treatment of maxillary dentoalveolar protrusion.Methods Twenty patients with maxillary dentoalveolar protrusion were divided into two groups：patients in group MIA（n=10） were treated with MIA and patients in group HGA（n=10） were treated with HGA as anchorage,MBT straight wire appliance and sliding technique was used to close the extraction space in both groups.Cephalometric analysis was performed to observe the changes of the characteristic lands on the dentofacial morphology before and after the treatment.The data were analyzed by using independent-samples t test.Results After the treatment in MIA group,in sagittal direction the maxillary incisors were retracted（6.56±1.37）mm and the upper lip points were retracted for（4.36±0.79） mm,while in the HGA group the maxillary incisors were retracted for（5.56±0.66） mm and the upper lip points were retracted for（3.86±0.73） mm,there was no significant difference between two groups（P0.05）.But the maxillary first molars in MIA group were moved（0.55±1.36）mm and in the HGA group moved（1.81±0.84）mm（P0.05）.In the vertical direction,in the MIA group the maxillary incisors were intruded to（1.96±0.82） mm and the maxillary first molars were intruded to（1.59±1.15）mm,while in the HGA group the maxillary incisors and the maxillary first molars were extrudedto（0.60±0.74） mm and（0.24±1.72） mm,respectively （P0.05）.In the MIA group U1-SN angles were reduced to（16.76±2.85）°and while in the HGA group reduced to（20.10±2.09）°（P0.05）.Conclusion Micro-implants have the same capacity of anchorage control in sagittal direction as headgear anchorage,and have better ability in vertical direction than headgear anchorage and improve the efficacy of maxillary dentoalveolar protrusion significantly.