微型种植钉支抗治疗Ⅲ类错[牙合]畸形的临床研究

Clinical Study of Mini-Implant Anchorage in the Treatment of Class Ⅲ Malocclusion

目的:观察分析微型种植钉支抗治疗Ⅲ类错[牙合]畸形患者疗效及硬组织与软组织侧貌变化。方法:选取2016年5月-2017年5月东莞健力口腔医院正畸科收治的60例Ⅲ类错[牙合]畸形患者为研究对象,通过数字随机原则将所选择病例分为对照组与实验组,每组30例,其中对照组应用多曲方丝弓技术进行矫治,实验组则行微型种植钉支抗治疗,比较两组患者应用不同矫治方式干预后的临床效果,以及硬组织与软组织侧貌变化。结果:根据两组数据显示,实验组经治疗后软硬组织侧貌有明显变化,其硬组织SNA、ANB、NP-FH、NA-PA较之对照组水平增高,SNB、OP-FH水平则低于对照组,软组织H角、UL-Snpg、LL-Snpg水平增高,Z角、NLA、UL-Eline与LL-Eline水平降低,组间差异有统计学意义(P<0.05)。实验组第一磨牙、侧切牙、中切牙牙根体积相比对照组更高,其吸收率更低,实验组患者在治疗1、3个月后经检测发现,其咬合力与咀嚼效率均更高于对照组,且治疗后不良反应总发生率较对照组明显降低,差异有统计学意义(P<0.05)。结论:针对Ⅲ类错[牙合]畸形患者在治疗中应用微型种植钉支抗技术,对改善患者牙齿畸形与软硬组织侧貌有显著作用,且能降低牙根吸收率,减少不良反应发生率,值得在临床推广应用。

Objective To observe and analyze the changes of hard tissue and soft tissue profile in patients with ClassⅢmalocclusion treated with micro(mini)-implant nail anchorage.Methods 60 patients with ClassⅢmalocclusion admitted to our hospital(Dongguan Jianli Stomatological Hospital)from May 2016 to May 2017 were selected as the research objects.The selected cases were divided into control group and experience group according to the principle of digital randomization,30 cases in each group.The control group was treated with Multiloop edgewise archwire(MEAW)technique,while the experience group was treated with micro-implant nail anchorage.The clinical effects and the changes of hard tissue and soft tissue profile after different orthodontic interventions were compared between the two groups.Results According to the data of the two groups,there were significant changes in the profile of soft and hard tissues in the experimental group after treatment.The levels of SNA,ANB,NP-FH and NA-PA in the hard tissues were higher than those in the control group,while the levels of SNB and OP-FH were lower than those in the control group.The levels of H angle,UL-Snpg and LL-snpg in the soft tissues were higher,while the levels of Z angle,NLA,UL eline and ll eline were lower in the experimental group(P<0.05).The root volume of the first molar,lateral incisor and central incisor in the experimental group was higher than that in the control group,and its absorption rate was lower.After 1 or 3 months of treatment,the bite force and chewing efficiency of the experimental group were higher than those in the control group,and the total incidence of adverse reactions after treatment was significantly lower than that in the control group(P<0.05).Conclusion In the treatment of ClassⅢmalocclusion patients,the application of micro-implant anchorage technology has a significant effect on improving the dental deformity and soft and hard tissue profile of patients,and can reduce root resorption rate,reduce the incidence of adverse reactions.It is worth popularizing in clinical application.