上颌前牵引联合FRⅢ型矫治器保持对儿童生长发育期骨性Ⅲ类错[牙合]畸形的疗效

Effect of maxillary anterior traction and FRⅢ type teeth correcting appliance maintaining for skeletal class Ⅲ malocclusion during growth and development of children

目的分析生长发育期骨性Ⅲ类错[牙合]畸形儿童应用上颌前牵引联合FRⅢ型矫治器进行后期保持的效果及临床价值。方法选取61例骨性Ⅲ类错[牙合]畸形的患儿,对所有患儿实施上颌前牵引联合FRⅢ型矫治器后期保持治疗,比较治疗前后各项指标的变化。结果头影测量显示,与治疗前比较,治疗后蝶鞍中心、鼻根点和上齿槽座点构成的夹角(SNA),齿槽座点、鼻根点、下齿槽座点构成的夹角(ANB),上中切牙长轴与前颅底平面的交角(U1-SN),下中切牙长轴与下颌平面的交角(L1-MP),上下中切牙角(U1/L1)均增加,差异有统计学意义(P<0.05);治疗前后鞍中心、鼻根点和下齿槽座点构成的夹角(SNB)、下颌平面与前颅底平面的交角(SN/MP)比较,差异无统计学意义(P>0.05)。治疗后,患儿前牙、后牙反[牙合]解除,U1点、A点向垂直方向移动,差异有统计学意义(P<0.05);与治疗前比较,患儿治疗后舌骨到x轴的水平距离与舌骨到颈椎的距离增大,差异有统计学意义(P<0.05);与治疗前比较,治疗后硬腭处、颈椎处气道间隙增大,差异有统计学意义(P<0.05)。结论上颌前牵引联合FRⅢ型矫治器后期保持能够有效治疗骨性Ⅲ类错[牙合]畸形疾病,改善上下颌骨关系,促使牙颌面关系协调。

Objective To analyze the effect and clinical value of maxillary protraction and FRⅢ type teeth correcting appliance maintaining for skeletal class Ⅲ malocclusion during growth and development of children. Methods A total of 61 children with skeletal class Ⅲ malocclusion were treated by maxillary protraction and FRⅢ type teeth correcting appliance. The changes of indexes before and after treatment were compared. Results Cephalometric measurement showed that compared with treatment before,angle of point of sella center,nasal root point and upper alveolar seat point (SNA),angle formed by the alveolar base point,the nasal root point and the lower alveolar base point (ANB),angle of intersection between the long axis of the upper central incisor and the plane of the anterior skull base (U1-SN),angle between the main axis of the lower central incisor and the mandibular plane (L1-MP),angle between upper and lower central incisors (U1/L1) were all significantly increased after treatment (P < 0. 05);no significant differences were found in angle formed by the center of the saddle,the nasal root point and the lower alveolar base point (SNB) and angle of intersection between the mandibular plane and the anterior skull base plane (SN/MP) (P > 0. 05). After treatment,the reverse occlusion of anterior and posterior teeth of the children were released,and U1 and A moved vertically,significant differences were found (P < 0. 05). Compared with treatment before,the horizontal distance from hyoid bone to x-axis and the distance from hyoid bone to cervical vertebra increased significantly after treatment (P < 0. 05). Compared with before treatment,the airway space in hard palate and cervical spine increased after treatment,and the difference was statistically significant (P <0. 05). Conclusion Maxillary anterior traction plus FRⅢ type teeth correcting appliance can effectively treat skeletal class Ⅲ malocclusion,improve the relationship between upper and lower jaws,promote the coordination of dento-maxillofacial relationship.