正畸配合肌功能训练改善骨性错患者微笑美的临床研究

Effect of the orthodontic treatment combined with myofunctional therapy on improving the smile attractiveness of patients with skeletal malocclusion

目的:评价正畸配合相关肌功能训练改善骨性错患者微笑美的临床效果。方法:30例骨性错患者(男11例、女19例),其中安氏Ⅱ类24例(ANB角5°~8°),安氏Ⅲ类6例(ANB角0°^-6°)。年龄13~34岁,平均(21.08±6.67)岁,拔牙设计26例,非拔牙设计4例。随机分为实验组、对照组各15例,实验组正畸治疗中配合微笑美相关肌功能训练。两组矫治技术、矫治原则相同,基线条件进行了一致性检验。正畸治疗前后分别拍正面微笑像以评价两组矫治前后微笑指标变化的差异。应用SPSS16.0统计软件对所有数据进行统计分析。结果:实验组矫治前后口角高度、微笑宽度、颊廊比例变化差异有统计学意义(P<0.05);实验组矫治前后理想笑弧例数、平行笑弧例数变化也有统计学意义(P<0.05)。对照组矫治前后各微笑指标变化差异无统计学意义(P>0.05)。实验组、对照组矫治后口角高度、上颌牙龈暴露量、下前牙平均暴露量、颊廊比例及笑弧形态变化差异有统计学意义(P<0.05)。结论:正畸同时配合微笑美肌功能训练,可使骨性错患者口周组织改建与正畸牙颌变化同步、协调,使骨性错患者在矫治错畸形的同时,微笑美也能得到不同程度的改善。

Objective To investigate the clinical results using the fix appliance combined with myofunctional therapy forimproving the smile attractiveness of patients with skeletal malocclusion. Methods 30 patients (11 male and 19 female ,agedfrom 13 to 34 years old ,average 21.08± 6.67 years old)with skeletal malocclusion were collected. There were 24 cases withclass Ⅱ sagittal skeletal pattern(ANB angle: 5 to 8°)and 6 with class Ⅲ sagittal skeletal pattern(ANB angle: 0°to -6°). Thecases were randomly divided into experimental group and control group, each group had 15 cases, and 26 cases were treatedwith extraction, 4 cases were treated with noextraction. The cases in experimental group undergone orthodontic treatmentcombined with myofunctional therapy, the cases in control group with orthodontic treatment alone. The techniques andprinciples of orthodontic treatments were the same, and the baseline check of two groups was consistent. The frontal smilephotographs were taken for each cases before and after the treatment to evaluate the items about the smile attractiveness. Allthe measurements were analyzed by SPSS 16.0 software. Results There were significant differences in the items of the heightof the outermost corner of lip, the smile width and the proportion of buccal corridor in experimental group between beforeand after the treatment(P <0.05) . The number of patients with ideal smile arc increased and the straight smile arc decreasedsignificantly after the treatment in experimental group(P <0.05). The change of smile index before and after the treatment incontrol group had no statistical significance (P >0.05 ). After the treatment, there were significant differences in the items of theheight of the outermost corner of lip, maxillary gingival display, average mandibular incisal exposure, the proportion of buccalcorridor and the shape of smile arc between the two groups(P <0.05). Conclusion Orthodontic treatment combined with smilemyofunctional therapy can make the patients with skeletal malocclusion to rebuild the muscular tissues around the mouth withthe change of the teeth and jaws synchronously and harmoniously and help the patient achieve attractive smile at the same time.