上颌前牵引矫治早期骨性Ⅲ类错的面部软组织改变

Facial soft tissue changes after maxillary protraction treatment in Class III malocclusion

目的:评价上颌前牵引早期矫正上颌发育不足产生的骨性Ⅲ类错(牙合)后的侧貌美学改变。方法:选取19例骨性Ⅲ类前牙反(牙合)的生长发育期患者,男9例,女10例,年龄8-13岁,平均10.5岁,所有病例均处于生长发育高峰期或高峰前期,口内戴用上颌全基托式活动矫治器,口外采用面具式牵引架进行上颌前牵引矫治,矫正前牙反(牙合),至前牙反(牙合)解除,建立正常覆(牙合)覆盖矫治完成。测量比较矫治前后软组织美学指标的改变。结果:前牵引矫治后,软组织面角减小2.4°,H角变小3.65°,上唇沟点前移3.45mm,上唇缘点前移2.85mm,Pgs-VL距离显著减小1.70mm,下面高增加2.95mm,矫治后上唇前移,额部后下移。下唇位置改变不大。结论:上颌前牵引可使Ⅲ类凹面型得到明显改善,后缩的上唇治疗后均显著前移,颏部后下移动,使侧貌更协调美观。

Objective To study facial soft tissue changes after maxillary protraction treatment in Class III malocclusion with maxillary deficiencies. Methods The data of 19 successfully treated Class III patients were collected and studied. There are 10 girls, 9 boys in the patients, their average age is 10.5 years. All the patients were treated with Face Mask orthopedic maxillary protraction therapy with removable appliance on the maxillary arch. Cephalometric measurements about soft tissue changes were analyzed. Results After Face Mask therapy, the soft tissue facial angle decreased 2.4 degree, H angle decreased 3.65 degree, Ss-VL increased 3.45mm, Ls-VL increased 2.85mm. Pgs-VL significantly decreased 1.70mm, soft anterior lower face height increased 2.95mm. Upper lip moved forward, soft chin area rotated backed and downward after the treatment. Conclusion Cephalometric measurements analysis reflected that maxillary protraction treatment caused the Class III concave profile more balanced with the upper lip area becoming more marked and chin area moving backward and downward.