安氏Ⅱ^(1)不同拔牙模式矫治前后牙弓与上气道形态及软组织侧貌变化临床观察

Clinical Observation on Changes of Dental Arch,Upper Airway Morphology and Soft Tissue Profile Before and After AngleⅡ^(1) Correction with Different Extraction Modes

目的:探究安氏Ⅱ^(1)不同拔牙模式矫治前后牙弓、上气道形态及软组织侧貌变化的临床疗效。方法:选择2016年6月-2020年6月来笔者医院就诊的98例安氏Ⅱ^(1)错[牙合]畸形需拔牙矫治的患者,按照随机数表法分成观察组和对照组,每组49例。观察组拔除上颌2颗第一前磨牙和下颌2颗第二前磨牙,对照组拔除上颌2颗第一前磨牙,之后采用矫正器进行矫正。比较治疗前后两组患者牙弓、上气道形态及软组织侧貌变化。结果:治疗后,两组上、下颌尖牙间宽度及上、下颌第一磨牙间宽度均减小,但观察组均小于对照组(P<0.05);治疗后,两组SPP-SPPW、U-MPW、P-T、V-LPW均高于治疗前,且观察组均高于对照组(P<0.05);治疗后,两组SPP-SPPW、U-MPW、P-T、V-LPW的横径较治疗前升高(P<0.05),但两组比较无显著性差异(P>0.05);治疗后,两组鼻唇角增大,颏唇角增大,上下唇突度减小,但两组间无明显差异(P>0.05)。结论:拔除上颌2颗第一前磨牙和下颌2颗第二前磨牙对安氏Ⅱ^(1)错[牙合]患者牙弓及上气道形态影响大于拔除上颌2颗第一前磨牙,两种拔牙方式均能改善面部软组组侧貌,但差异无明显区别。

Objective To explore the changes of dental arch,upper airway morphology and soft tissue profile before and after AngleⅡ^(1) correction with different extraction modes.Methods A total of 98 patients with AngleⅡ^(1) malocclusion who were treated for extraction and correction in the hospital from June 2016 to June 2020 were enrolled.They were divided into observation group and control group by random number table method,49 cases in each group.In the observation group,2 first premolars in the upper jaw and 2 second premolars in the lower jaw were extracted.In control group,2 first premolars in the upper jaw were extracted,and then they were corrected with appliances.The changes of dental arch,upper airway morphology and soft tissue profile before and after treatment were compared between the two groups.Results After treatment,the width of adjacent canine teeth at upper and lower jaws and the width of adjacent first molars at upper and lower jaws were decreased in both groups,which were narrower in observation group than control group(P<0.05).After treatment,SPP-SPPW,U-MPW,P-T and V-LPW were increased in both groups,which were higher in observation group than control group(P<0.05).After treatment,transverse diameters of SPP-SPPW,U-MPW,P-T and V-LPW were increased in both groups(P<0.05),without significant differences between the two groups(P>0.05).After treatment,nasolabial angle was increased,mentolabial angle was increased and the protrusion of the upper and lower lips was decreased in both groups,there was no significant difference between the two groups(P>0.05).Conclusion The effects of extracting 2 first premolars of the upper jaw and 2 second premolars of lower jaw are greater than those of extracting 2 first premolars of the upper jaw on dental arch and upper airway morphology in patients with AngleⅡ^(1) malocclusion.Both methods can improve facial soft group profile.However,the differences are not significant.