口腔正畸MIA技术对安氏Ⅱ类错[牙合]青少年面部软组织侧貌的影响及相关因素分析

Influence of Orthodontic MIA Technique on Facial Soft Tissue Profile of Adolescents with ClassⅡMalocclusion and Analysis of Related Factors

目的:探讨口腔正畸微种植体支抗(Micro-implant anchorage,MIA)技术对安氏Ⅱ类错[牙合]青少年面部软组织侧貌的影响并分析其相关影响因素。方法:回顾性选取2018年7月-2020年7月笔者医院收治的100例安氏Ⅱ类错[牙合]畸形青少年患者资料,依据正畸治疗方案不同将其分为对照组(n=40)和研究组(n=60),比较两组治疗前后视觉模拟量表(Visual analogue scale,VAS)评分及临床疗效;根据安氏Ⅱ类错[牙合]青少年经口腔正畸MIA技术治疗后面部软组织侧貌改善程度将其分为高分组(VAS评分>60分)和低分组(VAS评分≤60分),单因素分析安氏Ⅱ类错[牙合]青少年面部软组织侧貌改善的相关影响因素,Logistic回归分析安氏Ⅱ类错[牙合]青少年面部软组织侧貌改善的独立影响因素。结果:治疗后,两组VAS评分均升高,研究组VAS评分高于对照组(P<0.05);研究组治疗总有效率高于对照组(P<0.05)。单因素分析显示,高分组和低分组上下唇突角、鼻唇角、下唇倾角、上唇倾角、Z角、上唇E线距(EP-UL)、上中切牙角上下牙槽座角(ANB)、上牙槽座角(SNA)比较差异均有统计学意义(P<0.05);Logistic回归分析显示,鼻唇角、下唇倾角是安氏Ⅱ类错[牙合]青少年经正畸MIA技术治疗后面部软组织侧貌改善的独立危险性因素,EP-UL是安氏Ⅱ类错[牙合]青少年经正畸MIA技术治疗后面部软组织侧貌改善的独立保护性因素(P<0.05)。结论:口腔正畸MIA技术能较好改善安氏Ⅱ类错[牙合]畸形青少年患者面部软组织侧貌,临床疗效较佳,且较大下唇倾角和鼻唇角、较小EP-UL的安氏Ⅱ类错[牙合]畸形青少年患者经口腔正畸MIA技术治疗后可能更易改善面部软组织侧貌。

Objective To investigate the influence of micro screw implant anchorage(MIA)technique in orthodontics on facial soft tissue profile of adolescents with ClassⅡmalocclusion and analyze the related influencing factors.Methods 100 young patients with ClassⅡmalocclusion admitted to the hospital from July 2018 to July 2020 were selected and divided into the control group(n=40)and the study group(n=60)according to different orthodontic treatment schemes.The visual analogue scale(VAS)scores and clinical efficacy were compared between the two groups before and after treatment.According to the improvement degree of the soft tissue profile after the treatment of ClassⅡmalocclusion adolescents with oral orthodontic MIA technology,they were divided into high group(VAS score>60 points)and low group(VAS score≤60 points).Univariate analysis was used to analyze the relevant influencing factors of facial soft tissue profile improvement in adolescents with ClassⅡmalocclusion.Logistic regression analysis was used to analyze the independent influencing factors on the improvement of facial soft tissue profile of adolescents with ClassⅡmalocclusion.Pearson analyzed the correlation between facial soft tissue profile and its influencing factors in adolescents with ClassⅡmalocclusion.Results After treatment,the VAS score of the study group was higher than that of the control group(P<0.05).The total effective rate of the study group was higher than that of the control group(P<0.05).Univariate analysis showed that there were significant differences between high and low groups in the angles of upper and lower lip protrusion,nasolabial angle,lower lip inclination,upper lip inclination,Z angle,upper lip E line distance(EP-UL),upper central incisor angle(U1-SN),upper and lower alveolar base angle(ANB)and upper alveolar base angle(SNA)(P<0.05).Logistic regression analysis showed that the nasolabial angle and the inclination of the lower lip were independent risk factors for the improvement of the soft tissue profile after the orthodontic MIA treatment of ClassⅡmalocclusion adolescents,and EP-ULwas an independent protective factor for the improvement of the soft tissue profile after the orthodontic MIA treatment of ClassⅡmalocclusion adolescents(P<0.05).Conclusion The orthodontic MIA technique can improve the facial soft tissue profile of young patients with ClassⅡmalocclusion,and the clinical effect is better.In addition,the facial soft tissue profile of young patients with ClassⅡmalocclusion with larger lower lip angle and nasolabial angle and smaller EP-UL may be easier to improve after MIA treatment.