正畸-正颌联合治疗骨性Ⅲ类错[牙合]畸形长期稳定性的随访观察

Long-term stability of orthodontic-orthognathic treatment for skeletal classⅢmalocclusion

目的随访观察正畸-正颌联合治疗骨性Ⅲ类错[牙合]畸形患者的长期稳定性。方法回顾性分析2015年3月至2018年3月在许昌市第二人民医院进行正畸-正颌联合治疗的102例骨性Ⅲ类错[牙合]畸形患者的临床资料,治疗后对所有患者进行3年随访。收集正畸-正颌联合治疗结束时、结束后3年随访复诊时的头颅侧位片,测量并比较骨性硬组织、牙性硬组织以及软组织头影测量项目。结果正畸-正颌联合治疗结束后3年的骨性硬组织头影测量项目中N-Me距(全面高,指鼻根点与颏下点间的垂直距离)较治疗结束时明显减少(P<0.05),其余骨性硬组织头影测量项目比较差异未见统计学意义(P>0.05)。正畸-正颌联合治疗结束后3年的牙性硬组织头影测量项目中11-SN角(上中切牙-前颅底平面交角)、11-NA距(上中切牙-NA平面距离)均少于治疗结束时(P均<0.05),11-41角(上下切牙角)大于治疗结束时(P<0.05),其余牙性硬组织头影测量项目比较差异未见统计学意义(P>0.05)。正畸-正颌联合治疗结束后3年的软组织头影测量项目中UL-EP距(上唇凸点到E线的垂直距离)、H角(H线与NB延长线之上角)小于治疗结束时(P<0.05),其余软组织头影测量项目比较差异未见统计学意义(P>0.05)。结论应用正畸-正颌联合治疗有利于改善骨性Ⅲ类错[牙合]畸形患者的骨性硬组织、牙性硬组织以及软组织形态,并具有长期稳定性。

Objective To investigate the long-term stability of orthodontic-orthognathic treatment for skeletal classⅢmalocclusion.Methods The clinical data of 102 patients with skeletal classⅢmalocclusion treated by orthodontic-orthognathic treatment in Xuchang Second People’s Hospital from March 2015 to March 2018 were retrospectively analyzed.All patients were followed up for 3 years after treatment.The lateral cephalometric radiographs were collected and the cephalometric items of hard tissue,dental hard tissue and soft tissue were measured and compared at the end of the treatment,and during 3-year follow-up after treatment.Results Three years after the end of orthodontic orthognathic treatment,the N-Me distance(overall high,vertical distance between the point of the nose root and the point of the chin)in the cephalometric measurement of bone hard tissue was significantly reduced,compared with that at the end of treatment(P<0.05),and there was no significant difference in other hard tissue cephalometric items(P>0.05).Three years after the end of orthodontic orthognathic treatment,the 11-SN angle(upper central incisor anterior skull base plane intersection angle)and 11-NA distance(upper central incisor NA plane distance)of dental hard tissue cephalometric items were less than those at the end of treatment(P<0.05),11-41 angle(upper and lower incisor angle)was greater than that at the end of treatment(P<0.05),while there was no significant difference in other cephalometric items of dental hard tissue(P>0.05).Three years after the end of orthodontic-orthognathic treatment,the UL-EP distance(vertical distance from the upper lip projection to line E)and H angle(upper angle of line H and extension line NB)in the soft tissue cephalometric project were less than those at the end of treatment(P<0.05),and there was no significant difference in other soft tissue cephalometric items(P>0.05).Conclusions Orthodontic-orthognathic treatment can improve the morphology of bone hard tissue,dental hard tissue and soft tissue of patients with skeletal classⅢmalocclusion,and has long-term stability.