微种植体支抗不同植入部位推上颌磨牙远移的稳定性及对软组织侧貌美学的影响

The Stability of Microimplant Anchorage with Different Implant-positions in Pushing Maxillary Molars Displacement and Its Effect on Soft Tissue Profile Aesthetics

目的:探讨微种植体支抗(Microimplant anchorage,MIA)不同植入部位推上颌磨牙远移的稳定性及对软组织侧貌美学的影响。方法:选择2018年1月-2020年12月笔者医院收治的90例非拔牙不完全Ⅱ类磨牙关系患者,按照随机数字表法分为腭侧组和颊侧组,每组45例。腭侧组患者于上颌双侧第一磨牙与第二前磨牙之间腭侧处各植入1枚微种植钉,颊侧组患者于上颌双侧第一、二磨牙之间颊侧处各植入1枚微种植钉。植入6个月后,比较两组第一磨牙远移距离、种植钉松动率及软组织侧貌美学参数(面型角、鼻唇角、上唇突度及下唇突度)。结果:腭侧组第一磨牙远移距离[(3.54±0.76)mmvs(2.60±0.61)mm]明显高于颊侧组,腭侧组的种植钉松动率(15.56%vs23.33%)明显低于颊侧组,差异均有统计学意义(P<0.05)。植入6个月后,两组下唇突度无明显变化(P>0.05);两组的面型角、上唇突度较植入前明显降低(P<0.05),两组比较差异无统计学意义(P>0.05);两组鼻唇角较植入前明显增高,腭侧组[(86.57±2.84)°vs(81.72±2.06)°]明显高于颊侧组,差异均有统计学意义(P<0.05)。结论:MIA腭侧植入推上颌磨牙远移的疗效明显,种植钉稳定性强,软组织侧貌美学效果好,优于颊侧植入。

Objective To discuss the stability of microimplant anchorage(MIA) with different implant-positions pushing maxillary molars displacement and its effect on soft tissue profile aesthetics. Methods A total of 90 non-extraction patients with incomplete Ⅱ Class molar relationship who were selected in our hospital from January 2018 to December 2020. The patients were divided into palatal side group and buccal side group according to random number table method, with 45 cases in each group. In the palatal side group, one microimplant screw was implanted in the palatal side between the first molars and the second premolars on bilateral maxillary. In the buccal side group, one microimplant screw was implanted in the buccal side between the first and second molars on bilateral maxillary. 6 months after implantation, the distance of the first molars, the loosening rate of implant screws and soft tissue profile aesthetic parameters(facial angle, nasolabial angle, upper lip protrudency and lower lip protrudency) were compared between two groups. Results The distance of the first molars[(3.54±0.76)mm vs(2.60±0.61)mm] in palatal side group was significantly higher than that in buccal side group(P<0.05). The loosening rate of implant screws(15.56% vs 23.33%) in palatal side group was significantly lower than that in buccal side group(P<0.05).6 months after implantation, there was no obvious change on lower lip protrusion in two groups(P>0.05). The facial angle and upper lip protrusion in two groups were significantly lower than those before implantation(P<0.05), and there was no significant difference between two groups(P>0.05). The nasolabial angle in two groups were significantly higer than that before implantation(P <0.05), the nasolabial angle[(86.57±2.84)°vs(81.72±2.06)°] in palatal side group was significantly higher than that in buccal side group(P<0.05). Conclusion MIA implantation in palatal side had obvious efficacy pushing maxillary molars displacement, with strong stability of implant screws and good aesthetic effect of soft tissue profile, which was superior to implantation in buccal side.