直丝弓矫治技术在下颌歪斜中的应用

Application of straight wire appliance in mandibular deviation

目的探讨下颌歪斜应用直丝弓矫治技术治疗的临床效果。方法回顾性分析2014年7月至2017年7月期间在湛江中心人民医院口腔科接受治疗的42例下颌歪斜患者的诊疗情况。所有患者均应用直丝弓矫治技术治疗,分别于矫治前后测量22例替牙期患者和20例恒牙列期患者的髁突高度、前后径、内外径,下颌支高度,髁突内、外突点距离,下颌角点距离,髁突最大横截面积,髁突前、后斜面长度和髁突前、后斜面倾斜角。结果治疗前,替牙期患者偏斜侧的髁突前斜面长度[(6.75±1.01)mm]和倾斜角[(54.20±4.17)°]均小于对侧[(7.03±0.96)mm和(55.23±2.61)°],差异均有统计学意义(P<0.05);治疗后,偏斜侧和对侧的各项测量结果相比差异均无统计学意义(P>0.05),而对侧治疗后的髁突前斜面长度[(6.92±1.06)mm]和倾斜角[(55.08±2.20)°]均小于治疗前,差异有统计学意义(P<0.05);治疗前,恒牙列期患者偏斜侧的髁突高度[(20.25±1.02)mm]、髁突内外径[(18.30±2.16)mm]和下颌支高度[(56.16±2.78)mm]均小于对侧[(22.21±2.23)mm、(19.94±1.75)mm和(58.85±3.37)mm],髁突后斜面长度[(8.41±0.79)mm]和倾斜角[(49.46±2.15)°]均大于对侧[(7.10±1.01)mm和(47.15±2.54)°],差异均有统计学意义(P<0.05);治疗后,偏斜侧和对侧的各项测量结果比较差异均无统计学意义(P>0.05)。结论下颌歪斜应用直丝弓矫治技术治疗,操作便捷,可明显改善患者面部外形,疗效显著,对于替牙期和恒牙列期患者均适用。

Objective To investigate the clinical effect of straight wire appliance in treating mandibular deviation. Methods A retrospective analysis was conducted on the diagnosis and treatment of 42 cases of mandibular deviation treated in Department of Stomatology, Zhanjiang People’s Central Hospital from July 2014 to July 2017. All patients were treated with straight wire appliance. The condyle height, front and back diameter, internal and external diameter,the height of the mandibular branch, the distance of the inner condyle and exodus, the distance of the mandibular angle,the maximum cross section of condyle, the length of the anterior and posterior oblique condyle and the angle of the anterior and posterior oblique surface of the condyle were measured in 22 patients in mixed dentition period and 20 cases of permanent dentition period. Results Before treatment, the length and inclination of the anterior slope of the condyle in patients of mixed dentition period were（6.75±1.01） mm and（54.20±4.17）°on the tilted side versus（7.03±0.96） mm and（55.23±2.61）°on the contralateral side（P〈0.05）, while there was no statistically significant difference after treatment（P〉0.05）. The length（6.92±1.06） mm and inclination（55.08±2.20）°of the anterior slope of the condyle after treatment were all significantly smaller than those before treatment（P〈0.05）. Before treatment, the condyle height, internal and external diameter of condyle, and the height of the mandibular branch in patients of permanent dentition period were（20.25 ±1.02） mm,（18.30 ± 2.16） mm, and（56.16 ± 2.78） mm on the tilted side versus（22.21 ± 2.23） mm,（19.94 ± 1.75） mm and（58.85 ± 3.37） mm on the contralateral side, and the length of posterior condyle and inclination were（8.41 ± 0.79） mm,（49.46±2.15）°versus（7.10±1.01） mm and（47.15±2.54）°on the contralateral side（P〈0.05）. There was no significant difference in the indexes between the tilted side and the contralateral side after treatment（P〉0.05）. Conclusion Treatment of mandibular deviation by straight wire appliance is simple, convenient and effective, which is suitable for the patients of mixed dentition period and permanent dentition period. It can obviously improve the facial appearance of patients and is worthy of clinical promotion.