微种植体支抗结合直丝弓矫治器治疗安氏Ⅱ类1分类错[牙合]畸形的美学效果分析

Analysis of Cosmetic Effect of Micro-implant Anchorage Technique Combined with Straight Wire Arch Appliance in the Treatment of Angle ClassⅡDivision 1 Malocclusion

目的:探讨微种植体支抗(Mirco-implantanchorage,MIA)结合MBT直丝弓矫治器治疗安氏Ⅱ类1分类错[牙合]畸形的美学效果。方法:选取2019年7月-2021年4月笔者医院就诊的青少年安氏Ⅱ类1分类错[牙合]畸形患儿82例,随机分为观察组与对照组,每组41例,两组均给予MBT直丝弓矫治器矫治,在此基础上,观察组给予MIA作为支抗,对照组给予传统口外弓支抗,比较两组临床疗效等级、矫正周期、X线头影测量结果(硬组织、牙齿、软组织)、牙周微环境变化。结果:两组治疗后错[牙合]改善等级构成比比较差异无统计学意义(P>0.05);观察组平均矫治时间短于对照组(P<0.05);观察组治疗后X线头影测量硬组织指标下颌角颏顶点连线与SN平面夹角(GO-GN-SN)、[牙合]平面与SN平面夹角(OP-SN)水平低于对照组(P<0.05);观察组治疗后X线头影测量软组织指标鼻唇角,鼻小柱与上唇构成的夹角(NLA)大于对照组,下唇最凸点到E线的垂直距离(Eline-LL)小于对照组,治疗前后差值大于对照组(P<0.05);观察组治疗后X线头影测量牙齿相关指标U1-L1角度大于对照组,上中切牙长轴与SN平面夹角(U1-SN)以及上中切牙切缘至NA连线垂直距离(U1-NA)小于对照组,观察组治疗前后差值大于对照组,差异有统计学意义(P<0.05);观察组治疗后6个月牙周组织肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、基质金属蛋白酶-2/-9(MMP-2/-9)水平低于对照组,治疗前后差值小于对照组,差异有统计学意义(P<0.05)。结论:与传统口外弓支抗比较,MIA技术结合MBT直丝弓矫治器治疗安氏Ⅱ类1分类错[牙合]畸形可帮助患者建立良好的咬合关系和符合美学标准的颜面部外侧貌,对牙周环境造成的刺激较小,可有效缩短矫治时间。

Objective To explore the cosmetic efiect of miniature implant Anchorage technique(MIA)combined with MBT straight wire appliance in the treatment of Angle ClassⅡdivision 1 malocclusion.Methods A total of 82 adolescent patients with AngleⅡdivision 1 malocclusion in the author's hospital from July 2019 to April 2021 were randomly divided into observation group(n=41)and control group(n=41).Both groups were treated with MBT straight wire appliance.On this basis,the observation group was given MIA as Anchorage and the control group was given traditional extraoral arch Anchorage.The clinical curative effect grade,correction period,X-ray cephalometric results(hard tissue,teeth,soft tissue)and periodontal microenvironment changes were compared between the two groups.Results There was no statistically significant difierence between the two groups(P>0.05).The average treatment time of observation group was shorter than that of control group(P<0.05).After treatment,the hard tissue indexes measured by X-ray cephalography in the observation group were lower than those in the control group(P<0.05).After treatment,the nasolabial Angle of the observation group was measured by X-ray cephalography.The included Angle of the columella and upper lip(NLA)was larger than that of the control group,and the vertical distance from the most convex point of lower lip to line E(E line-LL)were smaller than that of the control group,and the difierence before and after treatment was larger than that of the control group(P<0.05).After treatment,the Angle of U1-L1 of tooth related indexes measured by X-ray cephalography in the observation group was larger than that in the control group,the Angle between the long axis of upper central incisor and SN plane(U1-SN),the vertical distance between the incisor edge of upper central incisor and NA(U1-NA),and the vertical distance between the incisor edge of upper central incisor were smaller than that in the control group.The difierence of observation group before and after treatment was greater than that of control group(P<0.05).The levels of TNF-α,IL-6 and MMP-2/-9 in the observation group were lower than those in the control group at 6 months after treatment,and the difierences before and after treatment were lower than those in the control group(P<0.05).Conclusion Compared with the traditional extraoral arch Anchorage,MIA technique combined with MBT straight wire appliance in the treatment of Angle ClassⅡdivision 1 malocclusion can help to establish a good occlusal relationship and facial profile in accordance with aesthetic standards,with less stimulation to the periodontal environment and can efiectively shorten the treatment time.