种植支抗对骨性Ⅱ类高角患者垂直向控制作用的回顾分析

Retrospective analysis of the vertical control effect of mini-implant anchorage on patients with skeletal ClassⅡhigh angle

目的探讨联合使用上前牙区及上磨牙区微种植体支抗对骨性Ⅱ类高角拔牙病例的垂直向控制中的作用。方法通过回顾性研究,采用自身对照的方法,选取10例联合使用了上前牙区和上磨牙区微种植体支抗的骨性Ⅱ类高角拔牙矫正的患者,对其治疗前后的头颅侧位片进行头影测量和比较分析。结果患者平均疗程31.6个月,矫治后下颌平面角SN-MP减小1.62°±0.79°(P<0.001),FMA减小2.25°±0.99°(P<0.001),后/前下面高比增加0.54%±1.18%(P<0.001),Y轴角减小1.55°±1.77°(P<0.001),ANB角减小0.78°±0.84°(P=0.017);面角增大2.52°±1.60°(P=0.001),Z角增大8.15°±3.33°(P<0.001);上颌第一磨牙到腭平面的距离减少(0.39±0.28)mm(P=0.002);上切牙到腭平面的距离减小(2.46±0.41)mm(P<0.001);平面与眶耳平面的夹角减小1.16°±1.46°(P=0.033),差异均具有统计学意义。结果显示矫正后上前牙压低、上磨牙压低,而下颌平面和咬合平面均发生了一定的逆时针旋转,从而在一定程度上改善了软组织侧貌。结论在上颌前牙及上磨牙区联合使用微种植体支抗,进行垂直向控制,可以产生一定量的下颌平面逆时针旋转,较好地改善了骨性Ⅱ类高角患者的侧貌。

Objective To investigate the efficacy of vertical control in Angle classⅡhigh-angle patients treated with premolar extractions using mini-implant anchorage in maxillary anterior and posterior buccal areas.Methods The average treatment duration was 31.6 months.Cephalometric radiographs of 10 patients before and after orthodontics treatment were compared.The patients were skeletal Angle classⅡextraction patients with high angle treated by fixed appliance,employing one mini-implant in the anterior and two mini-implants in the posterior buccal area of maxilla.Results Cephalometric analysis revealed highly statistically significant differences(P<0.05)in the following measurements:SN-MP decreased by 1.62°±0.79°(P<0.001),FMA decreased by(2.25±0.99)°(P<0.001),PFH/AFH increased by 0.54%±1.18%(P<0.001),Y-axis angle decreased by 1.55°±1.77°(P<0.001),ANB decreased by(0.78±0.84)°(P=0.017),face angle increased by 2.52°±1.60°(P=0.001),Z angle increased by 8.15°±3.33°(P<0.001),U6-PP decreased by(0.39±0.28)mm(P=0.002),U1-PP decreased by(2.46±0.41)mm(P<0.001),OP-FH decreased by 1.16°±1.46°(P=0.033).The good vertical control resulted in improved profiles for the patients.Conclusions The technique of using three micro-implants in maxillary anterior and posterior buccal areas provides effective vertical control.It induces a certain amount of counterclockwise rotation of the mandible,thereby improving the profiles of Angle ClassⅡhigh-angle patients.