微创骨皮质切开术与经典改良骨皮质切开术对成人正畸牙移动的临床效果对比

Comparative of the Clinical Effect of Minimally Invasive Corticotomy and Classical Modified Corticotomy on Tooth Movement in Adult Orthodontics

目的比较微创骨皮质切开术与经典改良骨皮质切开术对成人正畸牙移动的临床效果。方法选取2020年1月至2022年12月在郑州大学第一附属医院就诊的120例错颌畸形成人患者,依据手术方式进行分组,即接受经典改良骨皮质切开术治疗的患者60例纳入改良组,接受微创骨皮质切开术治疗的患者60例纳入微创组。统计两组牙排齐时间、间隙关闭时间、牙齿位置移动变化量、软组织变化量、硬组织变化量。结果微创组牙排齐时间、间隙关闭时间短于改良组(P<0.05);术后1、2、3个月微创组牙位置变化量均大于改良组(P<0.05);两组软组织变化量差异无统计学意义(P>0.05);改良组硬组织上颌骨前后突距离、上颌骨鼻距离、A点至颧弓的垂直距离、上颌骨硬组织高度变化量均大于微创组(P<0.05),两组硬组织A点至第二上臼齿的垂直距离、上颌骨第二上臼齿的硬组织高度变化量差异均无统计学意义(P>0.05)。结论微创骨皮质切开术与经典改良骨皮质切开术加速成人正畸牙移动效果相仿,牙排齐时间、间隙关闭时间方面微创骨皮质切开术更具优势,但经典改良骨皮质切开术在上颌骨和下颌骨调整方面更具优势。

Objective To compare the clinical effects of minimally invasive corticotomy and classical modified corticotomy on tooth movement in adult orthodontics.Methods A total of 120 adult patients with malocclusion treated in the First Affiliated Hospital of Zhengzhou University from January 2020 to December 2022 were selected and divided into groups according to surgical methods.Sixty patients treated with classical improved corticotomy were included in the improved group,and 60 patients treated with minimally invasive corticotomy were included in the minimally invasive group.Tooth alignment time,gap closing time,tooth position change,soft tissue change and hard tissue change were counted.Results The dental alignment time and gap closing time in minimally invasive group were shorter than those in improved group(P<0.05).The changes of tooth position in minimally invasive group were greater than those in improved group at 1,2 and 3 months after surgery(P<0.05).There was no statistical difference in soft tissue changes between the two groups(P>0.05).The changes of anterior and posterior process distance,maxillary nasal distance,vertical distance from point A to zygomatic arch and maxillary hard tissue height in improved group were greater than those in minimally invasive group(P<0.05).There were no statistical differences in the vertical distance and the hard tissue height of the second upper molar between the two groups(P>0.05).Conclusion The effect of minimally invasive corticotomy is similar to that of classical modified corticotomy in accelerating the movement of adult orthodontic teeth.In terms of tooth alignment time and gap closing time,minimally invasive corticotomy has more advantages,but classical modified corticotomy has more advantages in maxillary and mandibular adjustment.