Twin Block矫治器治疗生长发育期骨性Ⅱ类错[牙合]畸形的效果

Effect of Twin Block appliance on skeletal class Ⅱ malocclusion during growth and development period

目的 观察Twin Block矫治器治疗生长发育期骨性Ⅱ类错[牙合]畸形的效果。方法 选取2019年12月至2022年6月在郑州市第七人民医院诊治的78例生长发育期骨性Ⅱ类错[牙合]畸形患者为研究对象,采用随机数字表法分为对照组与观察组,每组39例。对照组采取直丝弓矫治器治疗,观察组采取Twin Block矫治器治疗。治疗6个月后,比较两组头影测量牙齿、硬组织[由蝶鞍点(S)、鼻根点(N)、上齿槽点(A)及下齿槽点(B)分别组成的SNA角、SNB角、ANB角,上中切牙长轴(UI)与下中切牙长轴(LI)交叉构成的UI-LI角]、软组织[鼻唇角(鼻下点与鼻小柱点连线和鼻下点与上唇突点连线的前交角)、颏沟倾角(下唇凹点与软组织颏前点连线与眼耳平面的交角)、LI相对下颌平面(MP)的倾斜度(LI-MP)、上唇突点(UL)至审美线(Eline)的垂直距离(UL-Eline)、下唇突点(LL)至Eline的垂直距离(LL-Eline)]及牙齿[UI相对前颅底平面(SN)的倾斜度(UI-SN)、UI至N与A连线的垂直距离(UI-NA)、LI点至N与B连线的垂直距离(LI-NB)]的相关指标变化以及口腔健康影响程度量表(OHIP-14)评分,记录治疗期间不良反应发生情况。结果 两组治疗前后SNA角、SNB角、ANB角比较,差异未见统计学意义(P>0.05);但治疗后两组UI-LI角、鼻唇角、颏沟倾角、UI-SN均明显增大,LI-MP均减小,UL-Eline、LL-Eline、UI-NA、LI-NB均缩短,且观察组改善效果更好,差异均有统计学意义(P<0.05)。治疗后,两组OHIP-14评分均明显降低,且观察组评分更低,差异均有统计学意义(P<0.05)。两组不良反应比较,差异未见统计学意义(P>0.05)。结论 Twin Block矫治器应用于生长发育期骨性Ⅱ类错[牙合]畸形的矫治,能够显著改善患者软硬组织侧貌和牙齿畸形,提高口腔健康及生活质量。

Objective To observe the curative effect of Twin Block appliance on skeletal class Ⅱ malocclusion during growth and development period.Methods A total of 78 patients with skeletal class Ⅱ malocclusion during growth and development period in the Seventh People's Hospital of Zhengzhou were selected as the research objects from December 2019 to June 2022.According to random number table method,they were divided into control group and observation group,with 39 cases in each group.The control group was treated with a straight wire appliance,while the observation group was treated with a Twin Block appliance.After 6 months of treatment,the two groups were compared in terms of cephalometric tooth and hard tissue [SNA angle,SNB angle and ANB angle composed of sellar point(S),nasal root point(N),upper alveolar point(A) and lower alveolar point(B),and UI-LI angle composed of the intersection of the long axis of the upper central incisor(UI) and the long axis of the lower central incisor(LI)],soft tissue [nasolabial angle(the anterior intersection of the line connecting the nasolabial point to the nasal columella point and the line connecting the nasolabial point to the upper lip protrusion point),chin groove inclination angle(the intersection of the line connecting the lower lip concave point to the soft tissue chin anterior point and the eye ear plane),inclination of LI relative to the mandibular plane(MP)(LI-MP),vertical distance from the upper lip protrusion point(UL) to the aesthetic line(Eline)(UL-Eline),vertical distance from the lower lip protrusion point(LL) to Eline(LL-Eline)],and teeth [the changes in relevant indicators such as the inclination of the UI relative to the anterior skull base plane(SN)(UI SN),the vertical distance from the UI to the N and A lines(UI NA),and the vertical distance from the LI point to the N and B lines(LI NB)],as well as the score of the Oral Health Impact Scale(OHIP-14) were compared,and the incidence of adverse reactions during treatment was recored.Results There was no significant difference in SNA,SNB or ANB angles between the two groups before and after treatment(P>0.05).After treatment,the UI-LI angle,nasolabial angle,dip angle of mentum sulci and UI-SN angle were significantly increased,LI-MP angle was decreased,and UL-Eline,LL-Eline,UI-NA and LI-NB distance were shortened in both groups,and the improvement effects were better in observation group(P<0.05).After treatment,OHIP-14 scores in both groups were significantly decreased,which were lower in observation group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusions Twin Block appliance can significantly improve profiles of soft and hard tissues,dental deformity and improve quality of life in patients with skeletal class Ⅱ malocclusion during growth and development period.