成人双颌前突支抗控制中微种植与横腭杆临床疗效对比研究

Comparative study on the effect of miniscrew implants and transpalatal arch anchorage in the control of bimaxillary dentoalveolar in adults

目的对比分析成人双颌前突支抗控制中,采用微种植或横腭杆支抗治疗前后患者颜面软、硬组织的变化。方法 2012年1月至2015年1月深圳市龙华新区人民医院收治的双颌前突患者30例(年龄≥18岁),随机均分为2组,均采用MBT直丝弓矫治治疗,观察组以微种植体为支抗,对照组以Nance弓联合横腭杆为支抗。采用X线头影测量分析2组治疗前后软、硬组织的变化及临床疗效。结果观察组1例微种植体脱落,对照组9例多次松动、1例脱焊,2组支抗稳定性差异有统计学意义(P<0.05)。观察组间隙关闭时间明显短于对照组,差异有统计学意义(P<0.05)。观察组治疗前后U6_A-Sv、U6_S-Sv、L6_A-Sv和L6_S-Sv变化量明显低于对照组,U1_A-Sv、U1_E-Sv和L1_E-Sv变化量明显高于对照组,差异有统计学意义(均P<0.05)。观察组治疗前后Ls-E变化量明显大于对照组,差异有统计学意义(P<0.05)。结论对成人双颌前突患者,采用微种植支抗能更好地控制磨牙,内收切牙,改善软组织侧貌,并能减少间隙关闭时间,临床疗效更为确切。

Objective To compare the changes of soft and hard tissues before and after treatment in adults with bi-maxillary dentoalveolar treated by miniscrew implants and transpalatal arch anchorage.Methods Thirty adults aged above 18 with bi-maxillary dentoalveolar in hospital from Jan.2012 to Jan.2015 were included and randomly divided into two groups.All were treated by Mclaughlin Bennett Trevisi （MBT）sliding straight wire appliance;patients in observation group were anchored by miniscrew implants,while patients in control group were anchored by transpalatal arch combined with Nance arch.The changes in hard and soft tissues and the clinical effects were analyzed in both groups by lateral cephalometric measurement before and after active orthodontic treatment.Results Miniscrew implants in one case in the observation group were lost,while in the control group nine cases showed repeatedly loosening and one case showed desoldering.The differences on anchorage stability had statistical significance （P 〈 0.05）.The clearance time in the observation group was significantly shorter than that in the control group （P 〈 0.05）.The change in U6A-Sv,U6s-Sv,L6A-Sv and L6s-Sv in the observation group was significantly less than in the control group（P 〈 0.05）,while the change in U1A-Sv,U1E-Sv and L1E-SV in the observation group was significantly more than in the control group（P 〈 0.05）.The change in Ls-E in the observation group was significantly more than that in the control group （P 〈 0.05）.Conclusion For adults with bi-maxillary dentoalveolar,the miniscrew implants anchorage can control molar and incisor better,improve the soft tissue profile and reduce the gap closing time.