上颌螺旋扩弓器加前牵引器矫治上颌骨发育不足的美学效果观察

Cosmetic Effect of Screw Expansion Combined with Anterior Retractor in the Treatment of Maxillary Hypoplasia

目的:观察上颌螺旋扩弓器加前牵引器矫治上颌骨发育不足的美学效果。方法:回顾性选取2019年1月-2022年6月笔者医院收治的86例上颌骨发育不足所致骨性Ⅲ类错牙合畸形的青少年患者,根据其治疗方案不同分为观察组(42例)和对照组(44例),对照组采用单纯上颌前方牵引矫治,观察组在对照组的基础上加用螺旋扩弓器。对比两组患者临床疗效,收集患者治疗前后头颅侧位片,对比两组患者颌面及上气道结构变化;对比两组的治疗满意度。结果:观察组临床有效率为85.71%,高于对照组的59.09%(χ^(2)=7.570,P=0.006);两组患者治疗后的SNA、ANB、MP-SN角、NP-V、NP-A均较治疗前增大,PNS-R较治疗前增长,SNB、U1-SN、L1-MP角较治疗前减小,SPL较治疗前减短(P<0.05);两组患者治疗后SNA、SNB角和SPL比较差异无统计学意义(P>0.05);治疗后,观察组ANB、MP-SN角大于对照组,U1-SN、L1-MP角小于对照组(P<0.05);治疗后,观察组PNS-R较对照组长(P<0.05),观察组NP-V、NP-A大于对照组(P<0.05)。观察组整体美观度和牙齿功能性恢复满意度评分均高于对照组(P<0.05)。结论:上颌螺旋扩弓器加前牵引器正畸方案对上颌发育不足引起的骨性Ⅲ类错牙合治疗具有较好的临床疗效,可有效改善患者气道及颌面结构,改善患者面型,提高整体美观度,较单用上颌骨前牵引器受益更多。

Objective To observe the cosmetic effect of screw expansion combined with anterior retractor in the treatment of maxillary hypoplasia.Methods A total of 86 adolescent patients with skeletal ClassⅢmalocclusion induced by maxillary hypoplasia admitted to the author’s hospital were retrospectively enrolled between January 2019 and June 2022.According to different treatment methods,they were divided into observation group(42 cases)and control group(44 cases).The control group was treated with maxillary anterior retractor,while observation group was additionally treated with screw expansion.The clinical curative effect between the two groups was compared.The lateral cranial radiographs were collected before and after treatment.The changes of maxillofacial and upper airway structures,and satisfaction of family members between the two groups were compared.Results The clinical response rate of observation group was higher than that of control group(85.71%vs 59.09%)(χ^(2)=7.570,P=0.006).After treatment,SNA,ANB,MP-SN angle,NP-V and NP-A were increased,PNS-R was prolonged,SNB,U1-SN and L1-MP angles were decreased,and SPL was shortened in both groups(P<0.05).There was no significant difference in SNA,SNB angle or SPL between the two groups after treatment(P>0.05).After treatment,ANB and MP-SN angle in observation group were greater than those in control group,while U1-SN and L1-MP angles were smaller than those in control group(P<0.05).After treatment,PNS-R in observation group was longer than that in control group(P<0.05),NP-V and NP-A were greater than those in control group(P<0.05).The scores of overall aesthetics and satisfaction with dental functional recovery in observation group were higher than those in control group(P<0.05).Conclusion The clinical curative effect of orthodontics with screw expansion combined with anterior retractor is good on skeletal ClassⅢmalocclusion induced by maxillary hypoplasia,which can effectively improve airway and maxillofacial structures,improve facial contour and overall aesthetics of patients,with more significant effects compared with maxillary anterior retractor alone.