双颌垫结合前方牵引及Ⅲ类颌间牵引治疗替牙期安氏Ⅲ类错畸形疗效分析

Effect of bimaxillary bite plate combined with protraction and class Ⅲ traction in the treatment of mixed dentition of class Ⅲ malocclusion

目的评价应用双颌垫结合前方牵引及Ⅲ类颌间牵引治疗替牙期安氏Ⅲ类错畸形的疗效。方法选择徐州市口腔医院正畸科2015年7月至2016年3月收治的替牙期安氏Ⅲ类错畸形患者18例(其中男8例,女10例;平均年龄9.2岁),上、下颌分别制作垫,上颌前方牵引配合Ⅲ类颌间牵引。用X线头影测量观察矫治前后的面部软硬组织变化。结果 18例患者治疗后前牙反解除,治疗后SNA角(蝶鞍中心、鼻根点及上齿槽座点所构成的角)、ANB角(上齿槽座点、鼻根点与下齿槽座点构成的角)、NA-PA(颌凸角)、ANS-Ptm(上颌长)、NANS(上面高)、U1-SN角(上中切牙长轴与前颅底平面相交的下内角)、U1-NA角(上中切牙长轴与鼻根点-上齿槽座点连线的交角)、U1-NA距(上中切牙切缘至鼻根点-上齿槽座点连线的垂直距离)、FCA(面型角)、ULP(上唇突度)等指标的值增大,差异有统计学意义(P<0.05);SNB角(蝶鞍中心、鼻根点及下齿槽座点所构成的角)、NPFH(面角)、L1-MP角(下中切牙长轴与下颌平面相交之上内角)、L1-NB角(下中切牙长轴与鼻根点-下齿槽座点连线的交角)、LLP(下唇突度)等指标的值减小,差异有统计学意义(P<0.05)。结论双颌垫结合前方牵引及Ⅲ类颌间牵引治疗替牙期安氏Ⅲ类错效果肯定,患者依从性好。

Objective To evaluate the treatment for the class Ⅲ malocclusion of mixed dentition with bimaxillary bite plate combined with protraction and class Ⅲ traction. Methods Totally 18 mixed dentition patients with class Ⅲ malocclusion were collected （8 males, 10 females, mean age： 9.2 years ） .Bite plates were made in both upper and lower arch, using maxillary protraction and class m traction. Hard and soft tissue changes of face were measured on cephalograms before and after treatment. Results Crossbite of 18 patients were corrected.After treatment, SNA, ANB, NA-PA, ANS- Ptm, N-ANS, U1-SN, U1-NA （°）, U1-NA （mm）, FCA and ULP increased, while SNB, NP-FH, L1-MP, L1-NB （°） and LLP decreased, all having statistically differences （P 〈 0.05）. Conclusion Bimaxillary bite plate combined with protraction and class Ⅲ traction is an effective method in treating class Ⅲ malocclusion of mixed dentition and the patients compliance is good.