恒牙列Ⅱ类骨面型患者拔牙矫治后微笑变化的相关临床研究

Study on smile changes in permanent dentition patients with skeletal class Ⅱ malocclusion byextraction treatment

目的了解拔牙矫治及相关肌功能训练在改善恒牙列Ⅱ类骨面型患者正畸后微笑美中的作用。方法 20例恒牙期Ⅱ类骨面型患者,在拔牙设计,直丝弓矫治技术应用技术同时,配合相关微笑美肌功能训练。应用Adobe Photoshop CS7软件对矫治前后微笑相进行定点和测量(包括上前牙曲度、下唇曲度、颊廊、微笑宽度、微笑高度、上下前牙暴露量、微笑弧及上唇曲度形态等),应用SPSS17.0软件对矫治前后颅颌面结构及微笑相测量数据进行统计分析。结果矫治后上前牙曲度增大,颊间隙比率和上切牙比率有所增加,下切牙暴露量减少,与矫治前比较差异有统计学意义(P<0.05);矫治后理想笑弧和上唇曲度向上的例数明显增加,平坦笑弧和向下的上唇曲度例数明显减少,差异有统计学意义(P<0.05);矫治后U1-SN角变化与上牙曲率变化呈负相关,SN-MP角变化与颊旁间隙比率变化呈负相关(P<0.05)。结论恒牙列Ⅱ类骨面型患者拔牙矫治并配合微笑美肌功能训练各项微笑美指标矫治后均有所改善,其中颊廊与面下1/3高度相关,笑弧与上前牙唇倾度高度相关。

ObjectiveTo study the influence on smile beauty and the relevant factors with skeletal classⅡmalocclusion by extraction and myofunctionaltherapy.MethodsTwenty permanent dentition patients of skeletal classⅡmalocclusion were selected.All the research subjects had been treated with maxillary and mandibular straight wire technique by extraction and using additional enhancement palatal measures.The frontal smile photographs were measured with Adobe Photoshop CS7(including curvature of forward tooth,lower lip curvature,buccal corridor,smile width,smile height,smiling arc and upper lip shape),All of the measurements were analyzed by SPSS version 17.0.ResultsAfter treatment,the curvature of upper incisor was increased;Buccal space ratio increased;Upper incisor ratio increased,and exposure of lower incisors was decreased(P<0.05).The number of ideal smile arc curvature and upward upper lip increased significantly(P<0.05).There was a negative correlation between the change of∠U1 SN and the changes of the curvature change of upper incisor.There was a negative correlation between the change of∠SN MP and the change of buccal space ratio.ConclusionThe permanent dentition patients of skeletal classⅡmalocclusion are treated with smile myofunctional therapy,and the smile measurements are improved after treatment.The changes of smile arc are correlated with the changes of upper incisors inclination.The changes of buccal corridor are correlated with the changes of the vertical height.