前牵引与前牵引联合上颌快速扩弓对青少年Ⅲ类错[牙合]矫治效果的研究

Comparison of Face Mask Treatment with and Without Rapid Maxillary Expansion in Adolescent Subjects

【目的】比较前牵引（FM）与前牵引联合上颌快速扩弓（RME）对青少年Ⅲ类错[牙合]患者牙颌矫治效果的影响。【方法】35例上颌发育不足的青少年Ⅲ类错[牙合]患者分别进行单纯前牵引（FM组，13例）及前牵引联合上颌快速扩弓（FM＋RME组，22例）矫治。通过测量矫治前后头颅定位侧位片8个角度和8条线距，比较两种矫治方法对牙颌矫治的疗效。【结果】两组矫治前各个角度和线距测量值比较无统计学差异（P〉0．05）；FM组矫治后PP—SN角、Co—Gn距和Go—Me距与矫治前比较无统计学差异（P〉0．05），其余各角度和线距矫治前后的比较均有统计学差异（P〈0．05）。FM＋RME组矫治前后PP—SN角、U1-SN角、Co—Gn距和Go—Me距比较无统计学差异（P〉0．05）；其余各角和线距测量值矫治前后的比较均有统计学差异（P〈0．05）。组间比较：FM组上前牙（U1-SN角）发生了更多的唇倾，而FM＋RME组上颌骨更多的发生了前移（Wits值），其余各值在两组间无统计学差异（P〉0．05）。【结论】FM可使上颌骨前移，下颌骨产生顺时针旋转，而FM＋RME疗效更明显。

[Objective] To compare the skeletal and dental outcomes of face mask （FM）with and without rapid maxillary expansion （RME） in adolescents with maxillary retrognathia. [Methods] There were 16 males and 19 females with an age range of 8-13 years. Pretreatment and posttreatment cephalometric radiographs were analyzed for skeletal class III malocclusion. They were divided into two groups of FM alone （ n=13） and FM plus RME （ n =22）. Eight cephalometric linear and eight angular variables were measured to assess the skeletal and dental changes. Within-group and between-group comparisons were determined by paired t-test. [Results] For-ward displacement of maxilla and clockwise rotation of mandible occurred in two groups. The maxillary-mandibular relationship existed. Most indices presented statistical significance within group. However, only U1- SN and Wits were different between groups. [Conclusion] Forward movement of maxilla and clockwise rotation of mandible may be obtained in adolescents after face masking. Yet RME can further improve the treatment outcomes.