安氏Ⅱ类1分类错[牙合]畸形临界病例非拔牙正畸治疗效果

Non-tooth extraction orthodontic effects in critical cases of classⅡ division Ⅰ malocclusion

目的探讨安氏Ⅱ类1分类错牙合畸形临界病例非拔牙正畸治疗效果。方法选取安氏Ⅱ类1分类错牙合畸形临界病例87例,根据治疗方法不同分为拔牙组(44例,采用拔牙+直丝弓矫治)与非拔牙组(43例,采用非拔牙+直丝弓远移上颌牙列矫治),采用加权PAR指数及面部正貌相关指标对治疗效果进行评估。结果两组治疗前后加权PAR指数总分值、加权PAR总分差值和加权PAR指数减少率均无显著差异(P> 0.05);拔牙组和非拔牙组正畸后效果明显,总改善率分别为86.36%和83.72%,两组总改善率比较无显著差异(P> 0.05)。矫治后,两组中下面高/瞳距、下面高/下颌宽及非拔牙组中面高/瞳距均较矫治前明显增加(P <0.05,表3),其他面部正貌指标无显著变化(P> 0.05);非拔牙组矫治后下面高/瞳距和下面高/下颌宽矫治前后差值显著大于拔牙组(P <0.05,表4),余项目比较无统计学意义(P> 0.05)。结论两种正畸矫治方式疗效均较好,其中非拔牙矫治的创伤较小,且完整保留了28颗牙齿,而拔牙矫治可能在改变患者容貌上相对较好。

Objective To explore the non-tooth extraction othodontic effects in critical cases of class Ⅱ division Ⅰ malocclusion. Methods A total of 87 critical cases of class Ⅱ division Ⅰ malocclusion were selected and divided into an tooth extraction group （n=44, treated with tooth extraction ＋ straight wire arch correction） and a non-extraction group （n=43, treated with non-tooth extraction ＋ straight wire arch to move the upper teeth） according to different therapies. The effects were evaluated by the weighted PAR index and facial normality index. Results There was no significant difference in the weighted PAR index total score, the weighted PAR total score difference and the weighted PAR index reduction rate before and after the treatment between the two groups （P 〉 0.05）; the effects of orthodontic therapy in the tooth extraction group and the non-tooth extraction group were obvious; and the total improvement rate was 86.36% and 83.72% respectively, showing no significant difference （P 〉 0.05）. After the treatment, the lower facial height/pupil distance, the lower facial height/jaw width in the two groups and the middle facial height/pupil distance in the non-tooth extraction group were significantly higher than those before the treatment （P 〈 0.05; Table 3）, and other facial nonnality indexes had no significant change （P 〉 0.05）; the post-treatment lower facial height/pupil distance and the difference between the pre-treatment and post-treatment lower facial height/jaw width in the non-tooth extraction were significantly greater than those in the tooth extraction （P 〈 0.05; Table 4）, and the comparison of other items showed no statistical significance（P 〉 0.05）. Conclusion Both orthodontic therapies have good effects. The non-tooth extraction correction has less trauma and can completely preserve 28 teeth; while tooth extraction eolTeetion may have better effects in changing the patient＇s appearance.