自攻型微螺钉支抗远移下颌牙弓的临床研究

Clinical Study on Distalizing Mandibular Dentition with the Anchorage of Self-drilling Microscrew Implants

目的:探讨应用自攻型微螺钉支抗远中移动下颌牙弓的临床效果。方法:选择50例仅下颌第三磨牙拔除或缺失、需要远中移动下颌牙弓的成年患者,在下颌磨牙后区或颊棚区植入自攻型微螺钉,以其为支抗远中移动下颌牙弓。通过临床评价、X线头影测量分析,比较治疗前后下颌第一磨牙、中切牙矢状向以及牙合平面、下颌平面的变化情况。结果:所有病例治疗后均达到预期效果,达到正常前牙覆牙合、覆盖及良好后牙尖窝关系。微螺钉治疗过程中均保持稳定。治疗前后X线头影测量分析显示下颌第一磨牙及中切牙分别平均远中移动(3.55±0.25)mm、(3.45±0.11)mm(P<0.01),差异有统计学意义,而下颌第一磨牙远中倾斜、中切牙舌向倾斜以及牙合平面、下颌平面变化均无统计学意义(P>0.05)。结论:自攻型微螺钉能发挥强支抗作用,可有效地同步远中移动下颌牙弓。

Objective To evaluate the efficiency of distalizingmandibular dentition with theanchorage of self-drilling microscrew implants.Methods The study comprised50adult patients were treated by distalization of mandibular dentition using microimplant anchorage and without extraction of the premolars or other teeth except the third molars.The self-drilling microscrew implants were embedded in bilateralmandibular retromolar tubercle or buccal shelf area.Clinical evaluation were used.Lateral cephalograms of the dental and skeletalchanges in the sagittal and vertical planes were measured and analyzed by statistics before and after treatment.Results All patients achieved the desired purpose.All microscrews remained stable.Mandibular dentition were retracted greatly.The mandibular firstmolar were distalized by(3.55±0.25)mm,(3.45±0.11)mm with statistical significance(P<0.01).The SN-MP and FH-MP angles were decreased with no sta-tistical significance,After distalization,on the cephalograms,themandibular first molars and incisorswere distalized on average(3.55±0.25)mm,(3.45±0.11)mm respectively,the differences were statistically significant(P<0.01),however,they were tilted distally1.08±0.60,1.13±0.11degrees respectively,which was of no statistic significance(P>0.05).There was no statistically significant change in OP-FH,MP-FH(P>0.05).Conclusion Self-drilling microscrews could provide absolute anchorage control to distalize mandibular fulldentitionsimultaneously and effectively.