舌刺联合头帽颏兜矫治前牙反的头影测量分析

Cephalometric study of tongue crib combined with chincup treatment for anterior crossbite

目的 :通过X线头影测量分析,评价应用舌刺联合头帽颏兜矫治有不良舌习惯的前牙反患者的疗效。方法 :测量分析25例应用舌刺联合头帽颏兜矫治完成的前牙反患者治疗前、后的X线头颅侧位片,采用SPSS 17.0软件包对19个相关测量项目进行Mann-Whitney U秩和检验和Wilcoxon符号秩检验,比较治疗前、后各项测量指标的差异,分析矫治效果。结果:25例患者均达到良好的矫治效果,上、下颌骨相对矢状向位置关系得到明显改善,前牙反解除。SNA、ANB、颌凸角、U1-SN、U1-NA角、前牙覆盖及上唇到E线的距离均增大,差异显著(P<0.05)。SN-PP、SNOP、L1-MP、L1-NB角均减小,差异有统计学意义(P<0.05)。与性别有关的2个测量项目ANS-PNS和Cd-Gn线距,治疗后男性及女性均较治疗前显著增大(P<0.05)。结论:舌刺能有效纠正舌不良姿势位,同时促进上颌骨发育,配合头帽颏兜纠正下颌骨前移位,是阻断性矫治有不良舌习惯的前牙反的理想方案。

PURPOSE： To evaluate the effect of anterior crossbite patients with bad tongue habit treated by tongue crib combined with chincup by cephalometric analysis. METHODS： A total of 25 patients（8 males, 17 females, age range 7～13 years, average age 8.6 years） of anterior crossbite with bad tongue habit or incorrect tongue position were selected. All cases used tongue crib combined with chincup therapy. Lateral cephalometric films taken at the beginning and the end of treatment were analyzed by Winceph 9.0 cephalometric software. All 19 measurement items were assessed by SPSS 17.0software package. Following the consistency test, Mann-Whitney U test and Wilcoxon singed-rank test were carried out to compare the differences between pre- and post-treatment. RESULTS： All 25 cases obtained satisfactory results, the saggital relative position of maxilla and mandible was improved, anterior crossbite was corrected, occlusion was perfect and bad tongue habit and position were improved. Compared with pre-treatment, SNA, ANB, convexity were U1-SN, U1-NA,overjet and upper lip to E line increased significantly（P〈0.05）. SN-PP, SN-OP, L1-MP, L1-NB decreased significantly after treatment（P 〈0.05）. The measurement items related to gender were analyzed separately. ANS-PNS and Cd-Gn increased in both male and female（P〈0.05）. CONCLUSIONS： Tongue crib can effectively correct bad tongue position,promote maxillary forward growth, and prevent the mandible from going ahead combined with chincup. It is an ideal interceptive orthodontic scheme for anterior crossbite with bad tongue habit.