PAR指数联合头影测量在骨性Ⅲ类错[牙合]畸形疗效评价中的初步应用

Application of PAR index and cephalometrics for camouflage therapy and orthodontic-orthognathic surgery in adults with skeletal ClassⅢmalocclusion

目的:探讨PAR指数联合头影测量在成年轻中度骨性Ⅲ类错[牙合]畸形疗效评价中的价值。方法:选择65例成年轻中度骨性Ⅲ类错[牙合]者,依据治疗方法分为正畸掩饰性治疗组(C组)与正畸-正颌联合治疗组(S组),分别比较各组内治疗前后PAR指数及头影测量值差异,再比较2组间治疗前后PAR指数及头影测量差值差异,综合各项指标进行疗效评价。采用SPSS 25.0软件包对数据进行统计学分析。结果:PAR指数中,C组及S组治疗后牙排列、咬合、覆盖、覆[牙合]、中线、总分值及权重总分值均较治疗前显著减少(P<0.001),S组左右颊侧咬合及总后牙咬合治疗前后差值显著大于C组(P<0.001)。头影测量指标中,C组治疗前后SNA、NA-PA、L1-NB、U1-L1、U1-SN、L1-MP差异有统计学意义(P<0.05),S组治疗前后SNA、SNB、ANB、NP-FH、NA-PA、L1-NB、U1-L1、U1-SN、L1-MP差异有统计学意义(P<0.001)。S组SNB、ANB、NP-FH治疗前后差值显著大于C组(P<0.001)。结论:2种治疗方法对成年轻中度骨性Ⅲ类错[牙合]畸形均有疗效。在后牙咬合关系、下颌骨相对于颅部位置关系、上下颌骨对颅部的相互位置关系及下颌突缩程度方面,正畸-正颌联合治疗效果优于掩饰性治疗。PAR指数联合头影测量可以有效判断成年轻中度骨性Ⅲ类错[牙合]畸形疗效,是一种较好的评价方法。

PURPOSE:To investigate the value of PAR index combined with cephalometry in evaluating the efficacy of mild to moderate skeletal ClassⅢmalocclusion.METHODS:Sixty-five adult patients with skeletal ClassⅢmalocclusion were selected and divided into group C(camouflage therapy)and group S(orthodontic-orthognathic surgery)according to different treatment methods.PAR index and cephalometric values before and after treatment in each group were compared,and then the differences of PAR index and cephalometric values before and after treatment between the two groups were compared.The clinical effect was evaluated by these indexes.SPSS 25.0 software package was used for data analysis.RESULTS:In PAR index,the tooth alignment,occlusion,overjet,overbite,midline,total score and weighted total score after treatment of both groups were all significantly lower than those before treatment(P<0.001).The differences of left and right buccal bite and total posterior bite of group S before and after treatment was significantly larger than those of group C(P<0.001).In cephalometric measurement,the differences of SNA,NA-PA,L1-NB,U1-L1,U1-SN and L1-MP in group C before and after treatment were significantly different(P<0.05),while those in group S before and after treatment were SNA,SNB,ANB,NP-FH,NA-PA,L1-NB,U1-L1U1-SN and L1-MP(P<0.001).The differences of SNB,ANB and NP-FH before and after treatment in group S were significantly greater than those in group C(P<0.001).CONCLUSIONS:Both treatments are effective for adult patients with mild to moderate skeletal ClassⅢmalocclusion.The effect of orthodontic-orthognathic treatment is better than camouflage therapy in occlusal relationship of posterior teeth,the position of mandible relative to cranium,the mutual position of upper jaw and lower jaw relative to cranium,and the degree of mandibular convexity.PAR index combined with cephalometric measurement can effectively judge the clinical effect of adult patients with mild to moderate skeletal ClassⅢmalocclusion,which is a good evaluation method.