粘接式快速扩弓配合上颌前方牵引矫治替牙期骨性Ⅲ类错牙合前后鼻部形态变化

Bonded Maxillary Expansion Combined with Maxilla Protraction in the Treatment of Nasal Shape Changes of Skeletal Class Ⅲ Malocclusion Patients in Mixed Dentition

目的采用粘接式快速扩弓配合上颌前方牵引对替牙期骨性Ⅲ类错牙合患者进行矫治,观察其矫治前后鼻部形态变化。方法选取2010年7月—2012年12月在江苏大学附属人民医院口腔科就诊的替牙期骨性Ⅲ类错牙合患者30例,所有患者分别于矫治前后进行头颅侧位X线检查,比较其矫治前后鼻部线距测量项目和鼻部角度测量项目。结果本组30例患者矫治后鼻背长、鼻厚度、鼻小柱突度、鼻中点距离、鼻尖点距离大于矫治前(P<0.05),软组织面突度、鼻面角大于矫治前(P<0.05),鼻唇角、鼻额角、鼻尖角、鼻颏角小于矫治前(P<0.05)。结论粘接式快速扩弓配合上颌前方牵引矫治替牙期骨性Ⅲ类错牙合效果满意,使患者鼻部形态得到了很大改善,与面部软组织的关系也更加协调,值得临床推广应用。

Objective To investigate the changes of nasal profile of early skeletal class III malocclusion patients trea- ted with bonded maxillary expansion combined with maxilla protraction. Methods 30 cases of skeletal class III malocclusion pa- tien＇~s with maxillary deficiencies admitted to Department of Stomatology of the Affiliated People＇s Hospital of Jiangsu University from July 2010 to December 2012 were selected. Lateral cephalograms were taken before and after orthodontic treatment. Results After the expansion and protraction, N＇-Pr, Ndepth, Cconv, Mn 3-SE- Ptm, Pr SE- Ptm, SFC and nasofacial angle in- creased significantly （P 〈 0. 05 ）, while NLA, nasofrontal angle, columella - tip angle and NMA decreased significantly （ P 〈 O. 05 ） . Conclusion The bonded maxillary expansion and maxilla protraction can get good results in treating the skeletal class III malocclusion patients in mixed dentition. The concave profile, especially the nasal profile is effectively improved. It should be pro- moted in clinic.