两种上颌前牵方式分别联合快速扩弓疗效差异分析

Comparison of the effects of two kinds of maxillary protraction respectively combined with rapid maxillary expansion

目的:探讨传统上颌前牵与种植体支抗前牵分别联合快速扩弓对恒牙早期骨性Ⅲ类患者的疗效差异。方法:纳入11~13岁骨性Ⅲ类患者20人(男9例,女11例),随机分为传统组(A)和种植体组(B)(n=10),治疗前后分别拍摄侧位片和CBCT,用Winceph8.0和Invivo dental5.0测量,SPSS 24.0软件处理分析。结果:治疗后(1)A组SN-PP(°)减小(P<0.05),种植体组增大(P<0.05);(2)B组ANS-Ptm(mm)、A-Y(mm)、Overjet(mm)、Wits(mm)增量较A组更显著(P<0.05);(3)A组U1-SN(°)、U1-PP(°)、Y轴角、SN-MP(°)增量大于B组(P<0.05);(4)水平向U4cR-U4cL(mm)B组增量大于A组(P<0.05)。结论:快速扩弓联合种植体支抗前牵可以产生更明显的上颌前下方增量和较小的下颌顺时针旋转及垂直向、矢状向牙效应,水平向牙效应更明显。

Objective:To compare the effects of traditional maxillary protraction and implant anchorage respectively combined with rapid maxillary expansion in the treatment of skeletal ClassⅢmalocclusion.Methods:20 Patients(9 males and 11 females)aged 11-13 years old with skeletal Class III malocclusion were randomly divided into 2 groups(n=10)and treated by traditional protraction combined with rapid expansion(group A)and implant anchorage combined with rapid expansion(group B).Cephalometrics and CBCT images were taken before and after the treatment and analysed by Winceph8.0 and Invivo dental 5.0 software.The results were analyzed by SPSS24.0 statistical software.Results:(1)In group A,SN-PP(°)decreased(P<0.05),and in group B SN-PP(°)increased(P<0.05).(2)The increment of ANS-Ptm(mm),A-Y(mm),Overjet(mm)and Wits(mm)in the 2 groups were significant(P<0.05),and that of group B was more obvious(P<0.05).(3)The increment of U1-SN(°),U1-PP(°),Y Axis Angle and SN-MP(°)in group A was greater than that in group B.(4)The increment of U4cR-U4cL(mm)in group B was more than that in group B(P<0.05).Conclusion:Rapid expansion combined with implant-supported protraction can produce more significant maxillary anteroinferior movement and less mandibular clockwise rotation and vertical and sagitttal tooth effects,but more obvious horizontal tooth effects.