2种上颌前牙压低方法的疗效比较

Comparison of two treatment method for maxillary incisors intrusion

目的:比较微螺钉种植体支抗与多用途弓在压低上颌前牙时的临床疗效。方法:选择牙列排齐后仍表现为前牙Ⅲ°深覆的成年患者20例,随机分为微螺钉种植体支抗组和多用途弓组进行上颌前牙压低治疗。治疗前、后分别拍摄头颅定位侧位片,并进行上颌前牙区牙周组织检查,测量项目包括上颌第一磨牙和上颌中切牙的矢状向和垂直向变化、前牙覆改变、上颌中切牙临床冠改变、上颌切牙菌斑指数、牙周探诊深度变化等。利用PASW statistics18软件包对测量数据进行统计学分析。结果:微螺钉种植体支抗组治疗前、后U1-SN、U6-SN和U6-PP距无显著变化(P>0.05);前牙覆、U1-Stm减小,有统计学差异(P<0.01);上颌切牙牙周探诊深度增加(P<0.05),角化龈宽度减小(P<0.01),有统计学差异。多用途弓组在U1-SN、U6-SN、OP-SN、PLI2的改变上与微螺钉种植体支抗组有所不同(P<0.05);在牙周组织改变方面2组无显著差异(P>0.05)。结论:微螺钉种植体支抗在上颌前牙压低量、唇齿关系改善、治疗时间上优于多用途弓,在牙周组织改变方面2组无显著差异。

PURPOSE： To compare the clinical effects of miniscrews and conventional utility arch in the maxillary incisors intrusion. METHODS： Twenty adult patients with I~ degree deep bite were chosen and divided into two groups randomly. The cephalometric films, intraoral periapical radiographies with metal guide bars, and periodontium parameters were taken before and after intrusion. The major measurement items included alteration of the maxillary first molar in vertical dimension, torque and length of maxillary central incisors, overbite, clinical crown of maxillary central incisors, probing depth （PD）, gingival index （GI）, plaque index （PI） and etc. PASW statistics 18.0 was used for statistical analysis. RESULTS： In the miniscrew group, there was no change of U1-SN, U6-PP distance, U6-SN （P〉0.05）, but significant reductions in overbite and U1-Stm distance （P〈0.05）. The probing depth （PD） increased （P〈0.05）, and the width of keratinized gingiva （WKG） decreased significantly （P〈0.05）. In the conventional utility arch group, significant differences were found in U1-SN, U6-SN, OP-SN, PLI2 （P〈0.05）. There was no difference in periodontal supporting tissue changes between the two groups（P＇M3.05）. CONCLUSIONS： Compared with the conventional utility arch, minisrew has advantages on intruding upper incisors, and improving lip-tooth relationships. Less treatment period is needed in the minisrew group, and the impact on periodontal supporting tissue is similar. Supported by Science and Technology Development Plan of Shangdong Province（2010GWZ20255） and Special Project for Educational Science of Shandong Province（2050205）.