活动翼矫治技术治疗高角型双颌前突的临床研究

Clinical study of effects of active-wing appliance on treatment of high angle bimaxillary protrusion

目的研究活动翼矫治技术治疗高角型双颌前突的临床疗效方法选择54例拔除4颗第一前磨牙的双颌前突患者,根据治疗前的SN/MP角将患者分为2组,高角组27例,SN/MP≥40°。均角组27例,29°﹤SN/MP﹤40°。使用活动翼矫治技术进行矫治。对2组治疗前后的X线头影测量数据进行统计学分析。结果①活动翼矫治技术治疗的高角型双颌前突上下颌骨在矢状方向上无明显变化。②高角型双颌前突治疗后上下颌磨牙伸长量分别为1.04和0.99 mm。上下颌磨牙前移量分别为2.74和2.37 mm。下颌平面未发生顺时针旋转。活动翼矫治技术治疗的高角型双颌前突平面能够保持稳定③高角组的U1-PP、U1-V、L1-V、U1/NA、U1-NAmm、L1/NB和L1-NBmm治疗前后变化均有统计学意义。④高角型双颌前突治疗后的上下唇突度明显减小,上下唇长度变小,软组织突度减小。⑤高角组的上颌中切牙与上唇内收的比例为1∶0.357,下颌中切牙与下唇内收的比例为1∶0.879 9。结论活动翼矫治技术治疗的高角型双颌前突垂直向和矢状向支抗可以达到很好的控制,上下颌骨在矢状关系上更加协调,上下颌前牙突度和倾斜度明显减小,软组织侧貌有明显改善,临床疗效较好。

Objective To study the clinical effects of treating high angle bimaxillary protrusion with active-wing appliance. Methods 54 patients with bimaxillary protrusion were selected. Their four first premolars were extracted and they were divided into two groups by angle SN/MP before orthodontic treatment. The high angle group had 27 patients, whose SH/MP angles were more than 40 o. The normal angle group had 27 patients,whose SI-I/MP angles were between 29°to 40°. All patients were treated with active-wing appliances. Cephalometric analysis was carried out before and after treatment. The measurement data were analyzed statistically. Results @The maxillaries and mandibles did not change significantly in sagittal direction in the high angle group treated with active-wing appliances. @Elongation of maxillary and mandiblular molars was 1.04 mm and 0.99 mm. Antedisplacement of maxillary and mandiblular molars was 2.74 mm and 2.37 mm in the high angle group. Mandibular plane did not rotate clockwise. Protrusive occlusional planes in high angle group treated with active-wing appliances could keep stable. （3） There were significant changes in U1-PP,U1-V,L1-V,U1/ NA,U1-NAmm,L1/NB and LI-NB in the high angle group. The protrusion and the lengths of upper and lower lips decreased significantly, and protrusion of the soft tissue also decreased. （4）In the high angle group, the ratio of aduction of central incisors of the maxillaries and upper lips was 1：0.357, and the ratio of aduction of central incisors of the mandibles and lower lips was 1：0. 879 9. Conclusions In high angle group, the anchorage in sagittal and vertical direction was controlled preferably by the active-wing appliances. The maxillaries and mandibles became more harmonious in sagittal direction. The inclination and protrusion of the upper and lower anterior teeth decreased significantly. Soft tissue profiles were improved significantly. Clinical curative effect was good.