改良式压膜间隙保持器与传统丝圈保持器临床应用对比研究

Comparison of clinical application between improved vacuum formed space maintainer and traditional band and loop space maintainer

目的 评价单个乳磨牙早失儿童戴用改良式压膜间隙保持器与传统丝圈保持器的间隙保持效果.方法 选择2011-2013年苏州卫生职业技术学院附属口腔医院正畸科收治的单例或双侧下颌第二乳磨牙早失患儿54例（患牙60颗）,随机分为3组,每组18例（患牙20颗）.A组：全天戴用传统带环丝圈间隙保持器;B组：全天戴用改良式压膜间隙保持器;C组：仅在夜间戴用改良式压膜间隙保持器,戴用12 ～ 14 h.在载用前和戴用后3、6、12个月后分别取精确模型.利用游标卡尺对缺牙间隙两侧邻牙近远中外形高点进行测量,观察间隙保持情况.结果 戴用两种间隙保持器3、6、12个月后,3组患儿的缺牙间隙较戴用前均无明显改变或略有增宽.戴用间隙保持器12个月后与戴用前比较,缺牙间隙改变量分别为：A组（0.23±0.11）mm;B组（0.20±0.09）mm;C组（0.04±0.07） mm.A组与B组的缺牙间隙改变量差异无统计学意义（P＞0.05）;而C组与A、B组的缺牙间隙改变量差异均有统计学意义（p＜0.05）.结论 改良式压膜间隙保持器与传统丝圈保持器有类似的间隙保持效果,其制作简便,安全卫生,舒适美观,并能恢复一定的口腔咀嚼功能,为缺牙间隙保持提供了一种新的治疗选择.

Objective To observe the clinical effect of maintaining the space in patients treated with a new style of improved vacuum formed space maintainer and traditional band and loop space maintainer. Methods Totally 54 patients losing primary molars were randomly divided into 3 groups, 18 cases （20 teeth）in each group. Group A ：wearing traditional band and loop space maintainer during the whole day; group B ： wearing improved vacuum formed space maintainer during the whole day;group C：wearing improved vacuum formed space maintainer during night for 12h-14h. The space lengths were measured before and 3,6 and 12 months after treatment in order to observe the space condition during experiment. Results The space lengths of the three experimental groups remained constant, or were increased a little between before and 3,6 and 12 months after treatment. After 12 months of wearing space maintainer, the changes were： group A（0.23 ± 0.11）mm;group B（0.20 ±0.09）mm; group C（0.04 ± 0.07）mm. The significant differences of the changes were found between group A and group C,group B and group C（P 〈 0.05）but not found between group A and group B （P 〉 0.05）. Conclusion The improved vacuum formed space maintainer has goodeffect in maintaining the space. Its clinical advantages include：cost and time saving, no mental allergy, being easy to clean, natural feel, being pleasing to the eye, and mastication function restoration. It is another choice for dentist to protect edentulous space.