安氏Ⅱ^(1)患者矫治前后软硬组织变化及相关性分析

Changes and correlations of soft and hard tissue before and after orthodontic treatment of Angel Ⅱ^(1) malocclusion

目的研究不同垂直骨面型青少年安氏Ⅱ^(1)患者拔牙与非拔牙矫治前后颅面部软、硬组织在头影测量上的变化及其相关性,以期为矫治设计和预后评估提供参考。方法回顾性研究2018年7月~2019年6月于徐州市中心医院口腔科正畸治疗后的72例青少年安氏Ⅱ^(1)错合畸形患者的临床资料,其中高角型患者32例,均角型患者40例,根据矫治方法不同将其分为拔牙矫治和非拔牙矫治。将患者的头颅侧位片导入Uceph软件进行软硬组织标记、测量,对比治疗前后变化的差异性和相关性。结果高、均角型患者拔牙矫治前后,除SNB外其余软硬组织指标变化均具有统计学意义(P<0.05)。高角型与均角型两组组间差异无统计学意义。拔牙患者矫治前后软硬组织变化具有相关性(P<0.05)。高角型患者非拔牙矫治后U1-SN、U1-L1角、覆盖及颏唇沟角减小,L1-MP和鼻唇角增大。均角型患者非拔牙矫治后U1-SN、U1-L1角、H角、颏唇沟角及覆盖减小;L1-MP和L1-APo增大。以上差异均具有统计学意义(P<0.05)。结论对于青少年安氏Ⅱ^(1)高角型错牙合畸形患者倾向于采用拔牙矫治,矫治过程中加强垂直向控制;均角型患者矫治后软硬组织预后较佳;拔牙矫治前后唇突度、鼻唇角及颏唇沟角变化与切牙内收具有明显相关性。

Objective To study the cephalometric changes of soft and hard tissues of the craniofacial region and their correlation before and after tooth extraction and non-extraction treatment in adolescents with various vertical growth patterns of AngelⅡ^(1) malocclusion,in order to provide reference for treatment design and prognosis evaluation.Methods The clinical data of 72 adolescent patients with AngelⅡ^(1) malocclusion after orthodontic treatment in Xuzhou Central Hospital from July 2018 to June 2019 were retrospectively studied,including 32 patients with high-angle type and 40 patients with equal-angle type.According to different orthodontic methods,it is divided into extraction orthodontics and non-extraction orthodontics.The patient's lateral cephalogram was imported into Uceph software for soft and hard tissue labeling and measurement,and compare the differences and correlations before and after treatment.Results Before and after tooth extraction and orthodontic treatment in patients with high and equal angle,the changes of other soft and hard tissue indexes except SNB were statistically significant(P<0.05).There was no significant difference between the high-angle type and the average-angle type between the two groups.The changes of soft and hard tissue before and after orthodontic treatment in all extraction patients were correlated(P<0.05).The U1-SN,U1-L1 angles,overjet and LL’-B’-Pos angle are decreased,while the L1-MP and nasolabial angles are increased in high-angle patients after non-extraction orthodontic treatment.U1-SN,U1-L1 angle,H angle,LL’-B’-Pos angle and overjet are decreased after non-extraction orthodontic treatment in patients with equal-angle type;L1-MP and L1-APo are increased.The above differences were all statistically significant(P<0.05).Conclusion For juvenile AngelⅡ^(1) high-angle malocclusion patients tend to use tooth extraction for orthodontic treatment,and strengthen vertical control in the process of orthodontic treatment;Patients with equal-angle type have better prognosis of soft and hard tissues after correction;The changes of lip protrusion,nasolabia angle and chin-labial angle before and after tooth extraction were significantly correlated with incisor retraction.