Forsus矫治器治疗下颌后缩型安氏Ⅱ类患者对颞下颌关节影响的CBCT分析研究

CBCT Analysis of Temporomandibular Joint Effect of Forsus Appliance in Patients with Mandibular Retraction TypeⅡ

目的:探讨Forsus矫治器治疗下颌后缩型安氏Ⅱ类患者对颞下颌关节影响的CBCT分析研究。方法:选取2018年2月-2021年2月笔者医院收治的53例下颌后缩型安氏Ⅱ类患者为研究对象,采用随机数字表法分为观察组(n=25)和对照组(n=28),观察组采用Forsus功能矫治器进行矫治,对照组采用Twin-block功能矫治器进行矫治,两组均佩戴1年后,对比两组治疗效果,对比治疗前后上下齿槽角指标、骨性指标及上下颌中切牙指标。结果:观察组治疗总有效率为92.00%,对照组治疗总有效率为85.71%,两组比较差异无统计学意义(P>0.05)。两组治疗前后上齿槽座角(SNA)、下齿槽座角(SNB)指标组内比较差异均无统计学意义(P>0.05);治疗后,观察组上下齿槽座角(ANB)指标明显低于对照组(P<0.05);与同组治疗前比较,SNB升高,SNA、ANB降低,差异均有统计学意义(P<0.05)。两组治疗前后下颌升支高度(C0-C0)、下颌长度(C0-Cn)、下齿槽座角到FHp平面垂直距离(Pg-FHp)、颏前点至FHp平面垂直距离(B-FHp)指标相比,差异无统计学意义(P>0.05),与同组治疗前相比,治疗后C0-C0、C0-Cn、B-FHp、Pg-FHp均指标均明显升高(P<0.05)。治疗前及治疗后两组下中切牙角(L1-MPA)、上中切牙角(U1-PP)、上中切牙轴长与SN平面相交的下内角(U1-SN)指标相比,差异无统计学意义(P>0.05);与同组治疗前相比,治疗后L1-MPA、U1-PP、U1-SN指标均明显升高,差异均有统计学意义(P<0.05)。结论:Twin-block功能矫治器和Forsus功能矫治器对下颌后缩型安氏Ⅱ类均有明显的矫治效果,可促使患者骨性下颌及牙性改变,但Forsus功能矫治器更利于改善下颌关系。

Objective To investigate the eff ect of Forsus appliance on temporomandibular joint(TMJ)in patients with typeⅡmandibular retraction.Methods Fifty-three patients with mandibular retraction typeⅡin our hospital from February 2018 to February 2021 were selected as the research objects,and were divided into observation group(n=25)and control group(n=28)by random number table method.observation group was treated with Forsus functional appliance,and control group was treated with Twin-block functional appliance.After 1 year of wearing,the treatment eff ects of the two groups were compared,and the indexes of upper and lower alveolar Angle,bone indexes and upper and lower central incisors were compared before and after treatment.Results The total eff ective rate of treatment for the observation group was 92.00%and that for the control group was 85.71%,with no statistically signifi cant diff erence(P>0.05).There were no signifi cant diff erences in upper alveolar Angle(SNA)and lower alveolar Angle(SNB)between the two groups before and after treatment(P>0.05).ANB had no signifi cant diff erence before treatment(P>0.05).After treatment,the index of upper and lower alveolar seat Angle(ANB)in observation group was signifi cantly lower than that in control group(P<0.05).Compared with before treatment,SNB increased,SNA and ANB decreased(P<0.05).Before and after treatment,there were no signifi cant diff erences in the mandibular ramus height(C0-C0),mandibular length(C0-Cn),the vertical distance between lower alveolar Angle and FHp plane(PG-FHp),and the vertical distance between premental point and FHp plane(B-FHp)between the two groups(P>0.05).Compared with before treatment,C0-C0,C0-Cn,B-FHp and PG-FHp were signifi cantly increased after treatment(P<0.05).Before and after treatment,there were no signifi cant diff erences in the indexes of lower central incisor Angle(L1-MPA),upper central incisor Angle(U1-PP),and lower interior Angle(U1-Sn)of the intersection of upper central incisor axis length and SN plane between the two groups(P>0.05).Compared with before treatment,l1-mpa,U1-PP and U1-Sn indexes were signifi cantly increased after treatment(P<0.05).Conclusion The Twin-block appliance and Forsus appliance both have signifi cant eff ect on mandibular retraction typeⅡand can promote skeletal mandibular and dental changes,but Forsus appliance is more benefi cial to improve mandibular relationship.