隐形矫治器治疗青少年骨性Ⅱ类错[牙合]畸形患者的临床效果

Clinical effect of invisible appliance for the treatment of adolescents with skeletal class Ⅱ malocclusion

目的探讨隐形矫治器治疗青少年骨性Ⅱ类错[牙合]畸形患者的临床效果。方法选取70例骨性Ⅱ类错[牙合]畸形青少年患者作为研究对象,将其随机分为常规组和隐形组,各35例。常规组给予传统固定矫治器治疗,隐形组给予无托槽隐形矫治器治疗。测量两组患者治疗前后颞下颌关节相关指标(关节结节倾斜角、关节窝深度、髁突短轴长度、髁突长轴长度、髁突-正中面距、髁突上部高度、下颌骨升支高度、下颌骨长度、下颌骨升支高度与下颌骨长度比值),以及颞下颌关节间隙(颞下颌关节前间隙、颞下颌关节后间隙、颞下颌关节上间隙),并计算关节间隙指数(R值)。结果(1)两组内治疗前后的关节结节倾斜角、髁突长轴长度、髁突-正中面距、下颌骨升支高度、下颌骨长度、下颌骨升支高度与下颌骨长度比值及常规组治疗前后的关节窝深度比较,差异均无统计学意义(均P>0.05),而隐形组治疗后的关节窝深度较治疗前变小,两组治疗后的髁突短轴长度、髁突上部高度均较治疗前增加,且隐形组的髁突短轴长度、髁突上部高度均较常规组增加(均P<0.05)。(2)常规组治疗前后的颞下颌关节前间隙及关节后间隙,以及两组内治疗前后的颞下颌关节上间隙比较,差异均无统计学意义(均P>0.05),而治疗后两组的R值,以及隐形组的颞下颌关节前间隙及关节后间隙均较治疗前降低(均P<0.05),但隐形组的R值、颞下颌关节前间隙、颞下颌关节后间隙及颞下颌关节上间隙与常规组比较,差异均无统计学意义(均P>0.05)。结论采用隐形矫治器治疗青少年骨性Ⅱ类错[牙合]畸形患者可有效增加髁突短轴长度及髁突上部高度,有助于促进颌骨的正常发育及咬合能力的恢复。

Objective To investigate the clinical effect of invisible appliance for the treatment of adolescents with skeletal classⅡmalocclusion.Methods Seventy adolescents with skeletal classⅡmalocclusion were selected as the research subjects,and they were randomly assigned to routine group or invisible group,with 35 cases in each group.The routine group was treated with traditional fixed appliance,while the invisible group was treated with bracketless invisible appliance.The pre-and post-treatment indices related to temporal-mandibular joint with respect to angle of inclination of articular tubercle,depth of articular fossa,short-axis length of condyle process,long-axis length of condyle process,condyle process-median plane distance,height of upper condyle process,mandibular ramus height,mandibular length,and ratio of mandibular ramus height to mandibular length,as well as temporal-mandibular joint space in terms of anterior,posterior,and upper spaces of temporal-mandibular joints of patients in both groups were measured,and the joint space index(Rvalue)was calculated.Results(1)As compared with before treatment,no statistically significant difference in the angle of inclination of articular tubercle,long-axis length of condyle process,condyle process-median plane distance,mandibular ramus height,mandibular length,and ratio of mandibular ramus height to mandibular length of various groups after treatment,as well as depth of articular fossa of the routine group after treatment was found(all P>0.05),whereas after treatment,the depth of articular fossa of the invisible group was diminished as compared with before treatment,the short-axis length of condyle process,height of upper condyle process were increased as compared with before treatment,and the invisible group yielded increased short-axis length of condyle process,and height of upper condyle process as compared with the routine group(all P<0.05).(2)After treatment,there was no statistically significant difference in anterior and posterioRspaces of temporal-mandibulaRjoints of the routine group,and uppeRspace of temporal-mandibular joint of various groups as compared with before treatment(all P>0.05),while after treatment,both groups exhibited a decreased Rvalue,and the invisible group interpreted decreased anterior and posterior spaces of temporal-mandibular joints as compared with before treatment(all P<0.05);nevertheless,no statistically significant difference in Rvalue,and anterior,posterior,and upper spaces of temporal-mandibular joints of the invisible group was found as compared with the routine group(all P>0.05).Conclusion Employing invisible appliance for the treatment of adolescents with skeletal classⅡmalocclusion can effectively increase the short-axis length of condyle process and height of upper condyle process,and it is beneficial to promote normal development of jaw and recovery of occlusal ability.