未治疗的安氏Ⅲ类错下颌骨的生长旋转特点

Mandibular growth rotation in untreated Class Ⅲ malocclusion

目的:观察未治疗的安氏Ⅲ类错患者颈椎骨龄CS1-CS6期下颌骨的生长旋转特点,为安氏Ⅲ类错患者的生长改向提供参考。方法:收集安氏Ⅲ类错患者329例,男144例,女185例;拍摄头颅定位侧位片,按性别和颈椎CVM分期分组,应用Winceph8.0头影测量软件测量下颌角(ArGo'Me)、平面角(Occlusal pl.to SN)、下颌平面角(Go-Gn to SN)和面高比(S-Go/N-Me)值,数据采用SPSS16.0方差分析后进行组间多重对比(LSD-t检验)。结果:男性安氏Ⅲ类错患者SN-OP呈现先升后降趋势,CS3和CS6组间差异有统计学意义(P﹤0.05);在CS4-CS6期,ArGo'Me逐渐减小,S-Go/N-Me逐渐增加,CS4和CS6组间差异明显(P分别为0.041和0.009)。女性安氏Ⅲ类错患者SN-OP、SN-GoGn和ArGo'Me均在CS4-CS5有明显减小(P﹤0.05);S-Go/N-Me在CS4-CS5期增加(P=0.006)。结论:安氏Ⅲ类错患者下颌骨生长总体上呈向前上旋转趋势,在CS4期之后旋转明显。提示对安氏Ⅲ类错患者进行生长改向治疗时,应考虑到生长发育高峰期之后下颌骨的前上旋转对预后的影响。

Objective：A cross-sectional study was designed to investigate the characteristics of mandibular rotation in untreated patients with Class III malocclusion. Method：The sample consists of 329 subjects （144 males,185 females） with Class III malocclusion, who were divided into six consecutive developmental periods （from CS1 to CS6 according to cervical vertebral maturation method （CVM）. Their cephalograms were measured by Winceph8.0 software,which include Gonion Angle （ArGo＇Me）,Occlusal plane Angle （Occlusal pl. To SN）,Mandibular plane Angle （Go Gn to SN） and ratio（S-Go/N-Me） value; The data were analyzed by SPSS16.0. Result：For male,SN-OP displayed a ascending firstly and descending lately trend,the peak in CS3,and exhibited statistically significant increases between CS3 and CS6. In the transitions from CS4 to CS6,Ar- Go＇Me decreased,and S-Go/N-Me increased gradually;in addition,both the measures showed statistical significance between CS4 and CS6（（P value 0.041and 0.009,respectively）. In female,SN -OP, SN- GoGn and ArGoIMe showed statistically significant decreases from CS4 to CS5 （.P 〈 0.05）,meanwhile,S-Go/N-Me exhibited statistically stgnificantce accordingly （P = 0.006）. Conclusion：The results suggested that Mandibular growth showed a trend of upward and forward rotation generally, and their rotation was the most apparent from CS4 to CS6. This study indicated that mandibular growth rotation after the growth spurt should be considered,when orthodontists take out therapy plans for patients with Class III malocclusion.