三种支抗形式矫治上颌前突的临床研究

Clinical study of three kinds of anchorage in the treatment of maxillary protrusion patients

目的:比较Nance弓与横腭杆、滑动杆与横腭杆,联合直丝弓矫治技术(Mclaughlin Bennett Trevisi,MBT)直丝弓技术,Tip-Edge Plus差动直丝弓技术治疗上颌前突、支抗磨牙与上颌切牙的位置变化,评价三种支抗的相关疗效。方法:选取11～17岁上颌前突病例36例,均拔除4颗前磨牙。Nance弓与横腭杆联合MBT直丝弓组12例(N+T组),使用直丝弓技术,应用强支抗进行矫治,一步滑动法;滑动杆与横腭杆联合MBT直丝弓组12例(S+T组),应用直丝弓技术,结合中支抗进行矫治,两步滑动法; Tip-Edge Plus组12例(TP组),使用Tip-Edge Plus差动直丝弓技术,应用弱支抗进行矫治。矫治前后进行X线头影测量分析。结果:N+T组上颌支抗磨牙前移量显著增加,与S+T组和TP组差异均有统计学意义。S+T组上颌切牙整体后移显著,与N+T组和TP组差异均有统计学意义。结论:三种直丝弓支抗形式均能取得预期效果,其中滑动杆与横腭杆联合MBT直丝弓技术在上颌前牙整体向后移动方面优于其他两组,Tip-Edge Plus差动直丝弓技术在磨牙支抗控制方面优于其他两组。

Objective:To compare the effect of transpalate-Nance arch and transpalate-sliding arch anchorage with MBT appliance and anchorage with Tip-Edge plus appliance by the position change of the anti-molar and maxillary incisor in the treatment of maxillary protrusion.Methods:A total of 36 patients with maxillary protrusion,aged 11~17 years old,were selected and divided into transpalate-Nance arch-MBT group,transpalate-sliding arch-MBT group and Tip-Edge plus group after extraction of four premolars.All the patients were treated by MBT technique and Tip-Edge plus technique and extraction space was closed by one-step method in transpalate-Nance arch-MBT group and Two-step method in transpalate-sliding archMBT group.Lateral cephalometric radiographs before and after treatment were taken and analyzed.Results:The average forward movement of first upper molar increased in transpalate-Nance arch-MBT group.The average backward movement of incisive crown and root increased.Conclusion:Maxillary protrusion patients could be treated successfully with straight wire and Tip-Edge plus technique.Transpalate-sliding arch anchorage system was effective in the backward movement of maxillary incisive crown and root than transpalate-Nance arch anchorage system and Tip-Edge plus technique.Maxillary anchorage molar controlled effectively in the Tip-Edge plus group than other groups.