前方牵引联合唇挡矫治替牙期骨性Ⅲ类错临床疗效研究

Clinical study on skeletal Class Ⅲ malocclusion treatment with maxillary protraction and lip bumper in the mixed dentition period

目的研究前方牵引联合唇挡矫治替牙期骨性Ⅲ类错的临床疗效。方法选择2010—2011年大庆油田总医院集团五官医院口腔正畸科门诊就诊的替牙期上颌发育不足的骨性Ⅲ类错患者30例。随机分为试验组和对照组,各15例。试验组使用前方牵引联合唇挡进行矫治;对照组则仅使用前方牵引矫治。在治疗前后对所有患者进行X线头影测量分析并比较组间差异。结果试验组治疗前后变化差值与对照组比较,X线头影测量分析结果显示,SNA、ANB、U1-SN、U1-NA角、U1-NA距、Ptm-U6差异均有统计学意义(P<0.01);模型测量结果显示,TAL、AD、拥挤度差异亦均有统计学意义(P<0.01)。结论采用前方牵引和唇挡联合矫治替牙期骨性Ⅲ类错,可有效消除单一采用前方牵引矫治带来的负面影响,是一种切实可行的办法。

Objective To study the clinical effect of maxillary protraction combined with lip bumper in the treatment of skeletal Class m malocclusion in mixed dentition period. Methods Thirty patients with skeletal Class Ⅲ malocclusion due to maxillary deficiency were treated with maxillary protraction and crossbite occlusion was removed with distal relationship. Thirty patients with crowding upper teeth after maxillarY protraction treatment were equally divided into two groups at random： the lip bumper group and the contrast group. 15 patients in the lip bumper group were further treated with lip bumpers to adjust the occlusion relation. Results Point A was obviously moved froward, Ptm-U6 distance and the total length of arc tooth bow as well as the arch depth became larger, and the degree of crowding was relaxed. Conclusion Combined application of maxillary protraction with lip bumper on skeletal Class 11I malocclusion treatment during the mixed dentition period can effectively avoid the negative effects. This is a practical and feasible method for treating skeletal crossbite occlusion without tooth extraction in the permanent dentition period.