垂直生长型安氏Ⅱ类1分类拔牙病例矫治前后硬组织的改变

Hard tissue outcomes of Class Ⅱ division 1 malocclusion with vertical growth pattern before and after treatment

目的研究垂直生长型安氏Ⅱ类1分类青少年与成人硬组织在矫治前后的变化,以期为正畸临床治疗方案的制定和治疗方法提供参考。方法选择38例垂直生长型安氏Ⅱ类1分类拔牙病例,在矫治前后拍摄X线头颅侧位片,对39个硬组织测量指标进行测量,并对青少年与成人矫治前后的变化量进行比较。结果研究对象矫治后ANB角、NA-PA、U1-FH、U1-NA、U1-Ptm、Spr-Ptm、Id-Go等青少年组与成人组的变化差异有统计学意义;Pog-Go、Cd-Go、S-Go、N-Me等都分别有所增加;与青少年组的OP-FH在正畸治疗后的减小相比较,成人组的OP-FH有所增加,成人组的平面发生了顺时针旋转。结论青少年在正畸治疗中表达更多的骨效应,即青少年通过正畸治疗能够更大程度地改善其Ⅱ类骨面型,更有利于其侧貌美观的改善;青少年上颌磨牙的伸长量基本是在有益的范围内,结合下颌升支等后面高的发育,能够使下颌平面、平面发生逆时针旋转,这对于垂直生长型Ⅱ类1分类病例的正畸治疗和面型改善以及治疗效果的稳定是有利的,同时也提示了垂直生长型Ⅱ类1分类错畸形的正畸治疗最佳时间为生长发育时期。

Objective This study is aimed to evaluate the orthodontic treatment outcomes of patients with An-gle Class Ⅱ division 1 malocculsion with vertical growth pattern;and provide experimental results to help to make orthodontic treatment plan and treatments.Methods 38 patients with Angle Class Ⅱ division 1 malocculsion with vertical growth pattern were included in our study.Their pre-and post-treatment cephalometric Xrays were measured.39 cephalometric items of hard tissue of groups of adolescents and adults were measured before and after treatments,and the different of the measurements between the adolescent and the adult were studied.Results The changes of ANB angle,NA-PA,U1-FH,U1-NA,U1-Ptm,Spr-Ptm,Id-Go between the groups of adolescent and adult were statistically different.The measurements of Pog-Go,Cd-Go,S-Go,N-Me were all increased.While the OP-FH plane was decreased in the adolescent group,the OP-FH plane was increased in the adult group after orthodontic treatment,indicating the clockwise rotated of the adult occlussal plane.Conclusion The orthodontic treatment in adolescent expressed more bony effects,showing that the profiles of Angle Class Ⅱ of adolescents could be improved more than adults.The extrusions of the upper molars were basically within the beneficial range of amount.And with the mandibular ramus growth,these combined effects of molar extrusion and ramus growth could rotate the mandibular plane and occlussal plane anti-clockwisely which benefited to the corrections of Angle Class Ⅱ divison 1 malocclusions with vertical growth pattern and helped to maintain the stability of the treatment results.Our research also suggested that the most effective time to treat Angle Class Ⅱ division 1 malocclusion with vertical growth pattern was during the fast growth period time of adolescent.