早期功能矫治在安氏Ⅱ类替牙期非暂时性错患儿中的应用研究

Early application of functional appliance in Class Ⅱ dentition non-temporary malocclusion in children

目的探讨早期功能矫治在安氏Ⅱ期替牙期非暂时性错患儿的临床疗效。方法选取2011年2月至2016年2月收治的安氏Ⅱ期替牙期非暂时性错患儿作为受试对象。系统性分析使用早期矫正治疗前后患儿X线头赢测量片上,分别先定位蝶鞍点S、鼻根点N、耳点P、眶点O、前鼻棘点ANS、上齿槽座点A、上中切牙点UI、下齿槽座点B、下切牙点LI以及颏下点Me,再作SN、NA、NB、PO(PO连线即为下文的FH平面)、ANS-Me、NP连线以及过UI的上中切牙牙长轴和过LI的下切牙牙长轴,然后测量SNA角、SNB角、ANB角、LI-NB角、UI-NA角、NP-FH角和ANS-Me高度的变化,并分析得到的结果。结果使用早期矫正治疗后,SNA角变化不明显,SNB角平均增加3.05°,ANB角平均减小2.64°,均有显著性差异。Co-Pg、Go-Pg、OLP等矫治后均与矫治前有显著性差异。颌骨的垂直方向变化结果表明,经过早起矫治后,患者的N-Me、ANS-Me和Ar-Co均显著高于治疗前。牙列的变化结果表明,经过矫治后上切牙和上磨牙均显著向后移动,而下磨牙和下切牙均显著向后移。矫治前后头颅侧位治疗前后软组织的结果表明,颏部软组织增厚、H角与矫正前相比无显著差异、颏唇沟深度则与治疗前相比,显著减少(P<0.05)。其他软组织指标无显著性差异(P>0.05)。结论对安氏Ⅱ类替牙期非暂时性错患儿进行早期矫治,可以促进患儿下颌渐进性前伸,促进下颌骨生长,符合颌骨的生理性改建过程;同时患者咬关系改变,有助于患儿面型的改变,是临床上值得推广的治疗手段。

Objective To investigate the application of functional appliance in early functional treatment of mixed dentition malocclusion Ⅱ malocclusion non - transitory children. Methods From February 2011 to February 2016 dentition malocclusion children in Angle Ⅱ non - transitory period were selected as subjects. Systematic analysis were performed using early after orthodontic treatment children with X thrum win on measure-ment sheet, respectively, first locate the sella S, nasion N, ear point P, the orbital point 0, anterior nasal spine point ANS, the alveolar base point a, the upper central incisor point UI, lower teeth groove base point B, point LI and lower incisors submental point Me, further SN, NA, NB, PO （PO wiring FH is below the plane） , ANS - on Me, NP connection and cut through the UI LI teeth long axis and over the teeth cut the long axis, and then measuring the SNA angle, SNB angle, ANB angle, LI - NB angle, UI - NA angle, ANS NP - FH angle and Me elevation changes, and analyze the results obtained. Results The use of early orthodontic treatment, SNA angle did not change significantly, SNB angle increased by an average 3. 05° , ANB angle was reduced 2. 64° , there were significant differences. There were significant differences before treatment with Co - Pg, Go - Pg, OLP Once treatment. Vertical maxillary changes results showed that, after early treatment, the patients N - Me, ANS - Me and Ar - Co were significantly higher than those before treatment. The results showed that changes in dentition, after treatment on the upper incisors and molars were signifi-cantly moves backward, while the lower molars and lower incisors were significantly backward shift. The results before and after treatment cephalometric soft tissue before and after treatment showed that the chin soft tissue thickening, H angle compared with the previous correction did not differ significantly, chin lip groove depth as compared with before treatment, a significant reduction （ P 〈 0 .0 5 ） . There was no significant difference （ P 〉0.05） other soft tissue targets. Conclusion If Angle Class Ⅱ dentition of children with non - temporary malocclusion were treated early, progressive mandibular protrusion and the growth of the mandible can be promoted and it is accord with the physiological remodeling of the mandible, maxillary and mandibular rotation dont occur. The occlusal relationship changes, and it can help to change the face type of children. It is worth popularizing in clinical treatment.