个性化咬合诱导矫治器在儿童安氏Ⅱ类1分类错合畸形患儿中的应用研究

Application of personalized eruption guidance appliance in the treatment of children with Class II division 1 malocclusion

目的探讨个性化咬合诱导矫治器治疗儿童安氏Ⅱ类1分类患儿的临床疗效。方法选取2020年6月至2022年5月于合肥市口腔医院就诊的儿童安氏Ⅱ类1分类患儿60例,按随机数字表法将治疗组分为个性化咬合诱导矫治器组(罗慕组)和传统功能矫正器组(TB组),每组各30例。收集同期30例安氏Ⅱ类1分类但未参与早期矫治的儿童为对照组,随访观察。应用逆向工程软件(Mimics Research 21.0)、Dolphin Imaging软件测量3组患者治疗(观察)前和治疗(观察)12个月后的下颌骨、上下牙弓及头颅侧位片中各项指标。结果罗慕组治疗12个月后较治疗前,下颌升支高度(Co-Go)、下颌基骨长度(Go-Po)、上牙弓宽度(UR6-UL6)、下牙弓宽度(LR6-LL6)、下齿槽座角(SNB)增加,上下齿槽座角(ANB)、上中切牙倾斜度(U1-NA)、覆合、覆盖减小,差异有统计学意义(P<0.05)。TB组治疗12个月后较治疗前,Co-Go、Go-Po、UR6-UL6、SNB、下颌平面角(FMA)、下颌角(Ar-Go-Me)、下颌中切牙倾斜度(L1-NB)增加,ANB、U1-NA、覆合、覆盖减小,差异有统计学意义(P<0.05)。3组患者治疗前后差值比较,LR6-LL6、FMA、L1-NB等差异有统计学意义(P<0.05)。治疗后,罗慕组主观性评分高于TB组(P<0.05)。结论个性化咬合诱导矫治器可以矫治儿童安氏Ⅱ类1分类错合畸形,同时有改善下牙弓宽度,控制下颌平面角和前牙唇倾的作用。

Objective To investigate the clinical effect of personalized eruption guidance appliance in the treatment of children with ClassⅡdivision 1 malocclusion.Methods Sixty patients with ClassⅡdivision 1 malocclusion treated in Hefei Stomatological Hospital from June 2020 to May 2022 were selected.The treatment groups were divided into personalized eruption guidance appliance(Luomu group)and traditional functional appliance group(TB group)according to random number table method,with 30 cases in each group.Meanwhile,con⁃sidering the influence of normal growth and development,30 patients who did not participate in early correction were recruited as the control group.Reverse engineering software(Mimics Research 21.0)and Dolphin Imaging software were used to measure mandible,upper and lower dental arch and cephalic lateral film of patients in three groups before treatment(observation)and 12 months after treatment(observation).Results After 12 months of treatment in Luomu group,mandibular height(Co-Go),mandibular length(Go-Po),upper dental arch width(UR6-UL6),lower dental arch width(LR6-LL6)and angle of lower alveolar socket(SNB)increased compared with those before treatment.The angle of upper and lower alveolar seat(ANB),inclination of upper and middle incisor(U1-NA),overbite and overjet decreased,and the differences were statistically significant(P<0.05).After 12 months of treatment in TB group,Co-Go,Go-Po,UR6-UL6,SNB,mandibular angle(Ar-Go�Me),mandibular plane angle(FMA),mandibular central incisor inclination(L1-NB)increased,while ANB,U1-NA,overbite and overjet de⁃creased.The difference was statistically significant(P<0.05).There were significant differences in LR6-LL6,FMA,L1-NB among the three groups before and after treatment(P<0.05).After treatment,the subjective score of Luomu group was higher than that of TB group(P<0.05).Conclusions Personalized eruption guidance appliance can treat ClassⅡdivision 1 malocclusion in children,improve the width of lower dental arch,control the mandibular plane angle and the inclination of lower anterior tooth as the same time.