倒置粘接下切牙托槽矫治骨性Ⅲ类错合畸形的临床研究

Clinical research of lower incisor brackets upsidedown in patients with skeletal ClassⅢmalocclusion

目的探讨倒置粘接下切牙自锁托槽掩饰性矫治骨性Ⅲ类错牙合的临床疗效。方法回顾性分析2018年1月至2023年1月来合肥市口腔医院正畸科就诊的32例骨性Ⅲ类错合畸形患者临床资料,根据粘接方式不同分为下切牙托槽倒置粘接组(观察组)和正常粘接组(对照组),每组16例。随访观察患者的矫正效果,比较两组患者矫治前后硬组织、软组织指标差异。结果观察组矫治前后SNB角(由蝶鞍中心-鼻根点-下齿槽座点所构成的角)的差值[1.00(-1.00,2.00)]小于对照组[1.50(1.00,2.50)],ANB角(由上齿槽座点-鼻根点-下齿槽座点所构成的角)的差值[2.50(1.00,3.00)]大于对照组[1.00(-1.00,2.0)],差异均有统计学意义(P<0.05)。观察组矫治前后L1-MP角(下中切牙长轴与下颌平面所成的交角)的差值[-1.50(-3.50,2.50)]、L1-NB角差值[-2.30(-3.60,2.00)]均小于对照组[-6.50(-8.60,-2.50)、-3.50(-5.50,-2.60)],差异均有统计学意义(P<0.05)。结论采用直丝弓自锁托槽矫治技术,倒置粘接下切牙托槽的方法矫治骨性Ⅲ类错合畸形,能够减小下前牙代偿性舌向倾斜,有效解除患者前牙反合,改善患者侧貌美观。

Objective To evaluate the effect of self-locking appliance placed upside-down at lower incisor brackets in skeletal classⅢmalocclusion cases.Methods The clinical data of 32 patients with skeletal ClassⅢmalocclusion who visited the Department of Orthodontics,Hefei Stomatology Hospital from January 2018 to January 2023 were retrospectively analyzed.According to the different bonding methods,the patients were divided into observation group with bonding bracket upside down and control group with common bonding bracket in the lower incisor,with 16 cases in each group.The correction effect of the patients was followed up,and the differences of hard tissue and soft tissue indexes between the two groups before and after correction were compared.Results The difference of SNB angle(the angle formed by sella-nasion-supramental)before and after treatment[1.00(-1.00,2.00)]was smaller in observation group than that in control group[1.50(1.00,2.50)],and the difference of ANB angle(the angle formed by subspinale-nasion-supramental)before and after treatment[2.50(1.00,3.00)]was greater in observation group than that in control group[1.00(-1.00,2.00)],with statistical significance(P<0.05).The difference of L1-MP angle(the intersection angle between the long axis of lower incisor and mandibular plane)and L1-NB angle before and after treatment[-1.50(-3.50,2.50)、-2.30(-3.60,2.00)]was smaller in observation group than that in control group[-6.50(-8.60,-2.50)、-3.50(-5.50,-2.60)],with statistical significance(P<0.05).Conclusions The technique of straight wire self-locking bracket with lower incisor bracket upside-down bonded could be effective to reduce the compensatory lingual inclination of the lower anterior teeth,relieve the anterior crossbite and improve appearance in the correction of skeletal ClassⅢmalocclusion.