低角与均角安氏Ⅱ类1分类错牙合肌激动器治疗前后软硬组织变化

The effects of activator treatment on the hard and soft tissue profile of different skeletal patterns

目的:探讨肌激动器对不同骨面型的安氏Ⅱ类1分类患者矫治前后软硬组织变化的影响。方法:纳入22例骨性安氏Ⅱ类1分类患者[(男12例,女10例,平均年龄(11.5±0.67)岁],根据其骨面型分为低角组(n=15)和均角组(n=7)。肌激动器矫治前后拍摄头颅侧位定位片,头影测量分析治疗前后软硬组织的变化。用SPSS 13.0软件,t检验分析治疗结果差异。结果:所有患者治疗前后Co-Pg、ANB、Wits、NA-Pg、L1-APg和L6-MP值差异具有统计学意义(P<0.05)。骨组织项目中低角组和均角组治疗前后Wits值变化分别为1.34°±1.82°和3.50°±1.77°,NA-Pg值变化分别为(3.06±2.00)mm和(5.80±3.17)mm,牙齿项目中L1-APg变化值分别为(-1.16±1.74)mm和(-2.83±1.48)mm,组间差异均具有显著统计学意义(P<0.05)。低角与均角组软组织测量项目比较差异无统计学意义(P>0.05)。结论:肌激动器矫治低角和均角骨性安氏Ⅱ类1分类患者均能取得较理想的治疗效果,均角患者对矫治器的反映效果好于低角患者。

Objective： To evaluate skeletal, dentoalveolar and soft tissue profile changes by activator therapy in patients with different skeletal patterns of Class II 1 malocclusions. Methods： 22 subjects （ 10 girls, 12 boys, mean age 11.5 ± 0.67 years） in the mixed or early permanent dentition, were included and divided into low angle （ n = 15 ） and average angle （ n = 7 ） groups on the basis of skeletal pattern. All patients were treated with a traditional activator. The skeletal, dentoalveolar and soft tissue profile changes were com- pared on lateral cephalograms before and after treatment. Statistical analysis was performed with t-test of SPSS 13.0 at a level of significance of P 〈 0.05. Results： Activator treatment in these growing patients resulted in a correction of the skeletal Class II relationship （decrease of ANB , Wits and NA-Pg）, an advancement of the mandibular structures（increase of Co-Pg and L1-APg）, and changes of the teeth（increase of L6-MP）. The changes of Wits, NA-Pg and L1-APg value of low and average angle groups were 1.34° ± 1.82° and 3.50°±1.77°,（ 3.06 ±2.00） mm and （5.80 ±3.17） mm,（ -1.16±1.74） mm and （ -2.83 ±1.48） mm respectively（P 〈0.05 ）. No statistical significance was found in the soft tissue profile changes whether intra-class or inter-group comparison. Conclusion： The activator appliance is effective in treating growing patients with mandibular deficiency, and mandibular reconstruction, in patients with average angle it is more effective than in those with low angle.